Bavaria launches patient-controlled health records

Tags: Community GP Information iS Network Prescribing

27 Oct 2005

The German Patient-Partner Association (PPV), a health provider network, and the German statutory health insurance organisation AOK Bavaria are to introduce electronic communications between GPs and patients.

The system will include a patient-controlled personal electronic health record, which enables patients to determine who can access their record, or nominate their doctor or carer to set access controls.

PPV, which has over 343 linked medical experts in a range of disciplines, will use an online health record LifeSensor, provided by German eHealth company InterComponentWare AG, to enable the new electronic links between GPs and their patients.

The Bavarian implementation of the LifeSensor personal health record follows a successful trial earlier this year. The record system is claimed as one of the most advanced in Germany, significantly ahead of the national health card project, which is beginning with electronic prescribing and then later introducing a personal health record.

The LifeSensor online health record will provide clinicians from the PPV health network with access to copies of their patient's health data, as recorded by other clinicians within the association.

Clinical data within the online personal health record will include medications, allergies, vaccinations and details of check-ups and lab results. The intention is to use the record to increase communication and collaboration between clinician and patients, and between different groups of clinicians caring for a patient.

Patients will own their online record and be able to decide which clinicians can access their data, change or delete it. If a patient does not want to assign these access rights themselves they can ask their GP, pharmacist or other representative to assign authorisations to access the record.

Dirk Schuhmann from InterComponentWare, told E-Health Insider that the personal health record had two main purposes. The first is: “To share data between physicians, so they can access data that other clinicians have entered.”

The second aim is to provide a personal health record “fully controlled by the patient, so they can choose what physicians have access, or they can nominate a clinician who will provide access to others,” said Schuman.

The record includes special protocols for care of geriatric patients and patients with chronic wounds, enabling easy electronic communications between clinicians and care givers.

Dr Elmar Schmid from PPV, said: "With the personal health record LifeSensor, the linked GPs and medical specialists can access extensive patient information for the first time in a joint online database. Pharmacists, physiotherapists and nursing staff can also access certain information in the record, which they are authorised to view."

The electronic links and information exchange will also be used to enable some GPs in the PPV organisation to concentrate on the treatment of rarer conditions, with other clinicians referring patients on to these specialists. The LifeSensor personal record is designed to ensure that a patient's GP is always informed about their latest treatment and therapy status.

PPV clinicians can compile an individual care team for patients requiring outpatient care, which may include a community nurse and a physiotherapist. The encounters with members of the care team are documented in a case protocol contained within the personal electronic health record.

The service is available to Bavarian patients insured by AOK, offering them integrated care and the advantages of a personally controlled electronic health record and electronic communications with participating doctors.

For patient travelling abroad the record will also be securely available online and in English if required.

Readers Comments

They can afford it

27 Oct 05 15:55

Given their considerably higher level of GDP spend on healthcare and that 4.5% of that is spent on IM&T, they can afford an opt in system - and so can we if we either spend more or cut down on other services/drugs etc.

In addition patients in germany are used to carrying out the 'gatekeeper' role that GPs in the UK undertake on patients behalf - so we are talking a different culture.

Who needs the record?

sayww@est.nhs.uk

28 Oct 05 09:18

If a clinician treats a patient, that clinician will need to keep a record. If not permitted access to the main repository of that patient's records, the clinician will end up craeating his/her own record. This will result in fragmentation and inacessibility, as no one will know where all the bits are.

Without a record of care, the clinician will be unable to mount a defence against claims of malpractice etc. It is a requirement to keep contemporaneous records of care given.

William

Sealed envelopes

28 Oct 05 10:15

CRS has the concept of 'sealed envelopes' for both clinicians and patients. Patients can seal off certain categories of information from clinicians and vice versa. A clinician could break the seal - for example in an emergency - but this action would be recorded. I don't think all of the rules have been codefied. For example, it's not yet clear whether patients would be able to break the seal.

Richard Granger responded to some questions about it at the Kings Fund seminar in Feb this year (see http://www.connectingforhealth.nhs.uk/news/140405).

In Germany, everybody needs the record

28 Oct 05 10:18

Re: William

As there is currently no "main repository" for patient records in the German health system, this web-based health record is badly needed. The treating clinician will always keep his/her own record of care. Only copies of this record will be sent to the electronic health record, thus providing quick and easy accessibility for other treating clinicians.