France Francis H Roger
Health Services Research, Unit of medical informatics, School of Public Health and St Luc Hospital, Université Catholique de Louvain, Cliniques Universitaires St Luc, 10/3718 Avenue Hippocrate, B-1200 Brussels, Belgium.
Int J Med Inform. 2004 Mar 31;73(3):235-8. doi: 10.1016/j.ijmedinf.2003.11.006.
Access rules to electronic patient records (EPR) have been issued by the Belgian Council of Physicians. Access to identifiable data of the EPR is restricted to anyone responsible for diagnosis, treatment and continuity of care of the patient. By delegation, associated personnel, like secretaries, can also be authorised to have access. A new perspective is given by the availability in 2003 of a national identification card allowing electronic signature of patients. It could not only authorise but also forbid some accesses. A law in 2002 gives right to patients to access to their own record. Health personnel can also be identified by cards but the system is not yet implemented. In the meantime, local measures have been made. We describe practical solutions that have been taken as priorities in a University Hospital. It was felt more important to allow access to lifesaving EPR data than to restrict its access by too strictly theoretical rules. A pilot study (S3 project) is also in progress for interinstitutional communication in Belgium, using the unique identification number of the patient and a "third server".
比利时医师协会已发布电子病历（EPR）的访问规则。只有负责患者诊断、治疗和持续护理的人员才能访问可识别的电子病历数据。经授权，相关人员，如秘书，也可被授权访问。2003年推出的国民身份证允许患者进行电子签名，这带来了新的视角。它不仅可以授权，还可以禁止某些访问。2002年的一项法律赋予患者访问自己病历的权利。卫生人员也可以通过卡片识别，但该系统尚未实施。与此同时，已采取了一些地方措施。我们描述了一所大学医院优先采取的实际解决方案。人们认为，允许访问救命的电子病历数据比通过过于严格的理论规则限制访问更为重要。比利时正在进行一项试点研究（S3项目），用于机构间通信，使用患者的唯一识别号码和“第三方服务器”。
