Ruotsalainen Pekka, Iivari Anna-Kaisa, Doupi Persephone
National Research and Development Centre for Welfare and Health (STAKES), Unit for eHealth and eWelfare, Helsinki, Finland.
Stud Health Technol Inform. 2008;137:379-85.
The strategy for utilizing information technology in the field of social welfare and health care in Finland was published in 1996. It was redefined in the year 2006. This updated strategy defined basic principles how digitized EHRs should be stored, accessed, disclosed and archived. The strategy together with new legislation opened the right to patients and citizens to access their own EHRs, ePrescriptions and audit-logs via the Internet. A national WEB-service platform forms the base for both public and private eHealth applications. National identification and PKI-services cover health professionals, patients and entities. Citizen's consent management is provided at national level. The access to personal health information is managed using rules derived from legislation. The roll-out of the national health information infrastructure with citizen access to personal health information should by law be finalized before the end of 2011. The implementation of the NHII is demanding, but the real challenge is to clearly understand what the impacts of citizen access to personal health information are and to what direction this kind of services should be developed. At the present state, the Finnish EHR-archive contains only information created by a health professional. Citizens' eHealth services can not be limited to the use of regulated EHR data and ePrescriptions. For health promotion, proactive prevention and health prediction more comprehensive information is needed. Therefore the next step is to develop legislation and to build a trusted environment for the use and access of heterogeneous health and welfare information.
芬兰社会福利与医疗保健领域利用信息技术的战略于1996年发布，并于2006年重新定义。这一更新后的战略明确了数字化电子健康记录（EHR）应如何存储、访问、披露和存档的基本原则。该战略与新立法一道，赋予了患者和公民通过互联网访问其自身电子健康记录、电子处方和审计日志的权利。一个全国性的网络服务平台构成了公共和私人电子健康应用的基础。国家身份识别和公钥基础设施（PKI）服务覆盖医疗专业人员、患者和实体。公民同意管理在国家层面提供。对个人健康信息的访问依据源自立法的规则进行管理。依法，全国健康信息基础设施的推出以及公民对个人健康信息的访问应在2011年底前完成。全国健康信息基础设施（NHII）的实施要求很高，但真正的挑战在于清楚地了解公民访问个人健康信息会产生哪些影响以及这类服务应朝什么方向发展。在当前状态下，芬兰的电子健康记录存档仅包含医疗专业人员创建的信息。公民的电子健康服务不能局限于使用规范的电子健康记录数据和电子处方。为了促进健康、积极预防和健康预测，需要更全面的信息。因此，下一步是制定立法，并为使用和访问异构的健康与福利信息构建一个可信的环境。
