TELEHEALTH SUCCESS STORY 6:
The National Patient Summary in Sweden – the right information in the right place, at the right time and for the right users
The National Patient Summary service is a very important part of the work on implementing the Swedish national Strategy for eHealth through common eHealth solutions that improve patient safety, accessibility and quality of care.
The National Patient Summary is based on the need for an efficient tool that provides authorised health care and social services staff with access to critical patient information across organisational boundaries. The National
Patient Summary is the first of several such shared county council eHealth solutions and will help break ground for necessary security solutions and infrastructure.
Increased mobility, freer choice of care provider and greater specialisation in care mean that patients today often have contact with several different care providers (principals), each of which registers and stores its records locally. The National Patient Summary service now makes it possible for authorised health care and social services staff, with the consent of the patient, to access care information that has been registered with other county councils, municipalities or private care providers. More actors being able to access the same information creates more efficient and safer care.
What can be seen in the National patient Summary?
|Information type||Contains data on|
|Patient||Personal identification, next-of-kin, possible need of interpreting services, etc.|
|Attention and alert signals||Hypersensitivity to drugs, severe illness/on-going treatment, healthcare restrictions, infectious diseases, out-of-structure attention signal|
|Care services||Primary care, specialist care, home help, home care, disability services, special residential needs|
|Medication||Pharmaceuticals prescribed by the care provider,
dispensed at Swedish pharmacy
|Care contacts||Historical and future contacts (hospital, primary care unit or private)|
|Care documents||Final report, admittance report, daily report, primary care notes, primary care summary, specialist notes, other documents|
|Status||PADL, functional disabilities|
|Care plans||Varoius type of care plans for the patient|
|Examination results||Clinical chemistry, microbiology, ECG with sound and pictures over a link, image diagnostics with sound and pictures over a link, consultations|
Better quality of care
A comprehensive picture of the patient’s previous diagnoses, test results and medication makes it easier to establish the correct diagnosis and provide the proper treatment in time. It also facilitates working with preventive care and being able to jointly plan and coordinates care measures between county councils, municipalities and private care providers.
Better patient safety
The right decision-making data reduces the risk of incorrect treatment or incorrect medication. Being aware of matters such as hypersensitivity means that treatments involving risks and/or discomfort to the patient can be avoided. Evaluation and treatment are also easier in emergency situations when there is no time to wait for information from other care providers.
Shared information reduces costly duplication. For example, the same tests do not need to be run or examinations repeated. The patient does not have to retell his or her entire care history when meeting a new care provider, and records do not have to be sent by post.
The National Patient Summary shows whether the patient has consented to making information accessible. The patient can block information that he or she does not wish another care unit to see. In the long term, the National Patient
Summary will also make it easier for a patient to gain greater insight into, and influence over, his or her own care.
Content has been governed by the service
The National Patient Summary is accessed via a web interface and requires a login with strong authentication. Information displayed in the National Patient Summary has been defined by a large number of service representatives.
The first version includes information such as diagnoses, pharmaceuticals that are ordered, prescribed and dispensed, appointments attended and scheduled,
functional status, health care and welfare documents, and results of examinations such as clinical chemistry, microbiology, ECG and medical imaging. The functions and content of the National Patient Summary will be expanded over time to meet the needs of the service.
Logging, consent and blocking – the patient data
Act provides the framework for keeping coherent records Sweden’s new Patient Data Act, which entered into force on 1 July 2008, provides the legal framework for keeping coherent records and for a service such as the National Patient Summary. The Act is adapted to modern technology and is designed to facilitate the exchange of information between care providers, and between care providers
and patients, but always with the integrity of the patient in mind. For example, only staff with whom the patient has a current care relation, and to whom the patient gives his or her consent, are entitled to read the journal.
All health care and social services staff are bound by professional secrecy, and it will always be possible to see who has had access to the records. The patient has the right to access information that has been logged. Anyone who does not want his or her information to be available in one coherent journal that is kept between different care providers can request that it be blocked.
Authorisation is governed by an electronic id card, a catalogue service and security services
Implementing the National Patient Summary requires a high level of security, secrecy and traceability when information is shared between different organisations. This is why all health care and social services staff who have access to patient information must be listed in the national electronic catalogue service that is used to clarify who works for which are provider and what function each employee has. Care staff must also be able to identify themselves by means of a special electronic ID card. A national security infrastructure that uses a number of different services to help ensure patient integrity and manage access control, traceability and other security issues is also being implemented.
The national patient summary in operation
All 21 county councils and regions in Sweden support the launch and will subscribe to the service. Örebro county council and municipality were first to conduct a trial of the system in 2009 when the interface, technology and, above all, the benefits to their activities were tested and evaluated.
- The Count Council (hospitals and primary care centers) publish information from 5 systems
- Around 500 users in the municipality and 50 in the county council is trained to use National patient summary
(more users are going to educates in this year)
- Main use 07.00 – 16.30 with peaks in 10 – 11 and 14 – 15
- The web application is easy to understand and use
- Support issues mainly around log on procedure, the security solution and routines surrounding the use of the application
- National patient summary as a system has been stable and performed well
- Now the challenge is to abandon papers, faxes and old routines
Some Benefits experienced so far
Patient information is available at all times which has improved the patient safety
Patient information is available when new information is entered in the system – no waiting for paper copies in traditional mail
Less administration by referring to National patient summary as the source for information
Nationwide introduction in 2012
The goal of the joint action plan of the county councils and Regions is for the National Patient Summary to be introduced in all county councils by the end of 2012 and used to a significant degree for communication between county councils, municipalities and private care providers.
Support through the national programme and user groups
The national programme governs the roll-out plan of the National Patient Summary and also provides support and help while it is being introduced, including a standardised introduction process that includes tools such as workshops, check lists, demonstrations and training. The introduction process is continuously being developed together with care providers as they subscribe so as to benefit from each other’s experiences and make it easier and easier to deploy the National Patient Summary. Another important success factor is that all the major system suppliers work together with their user groups on how to link up their own care system to the National Patient Summary. Getting started with the technical preparations and finding common solutions are a very important part of ensuring that the introduction goes as quickly as is planned..