Christiansen Ellen K, Skipenes Eva, Hausken Marie F, Skeie Svein, Østbye Truls, Iversen Marjolein M
1 Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway (UNN), Tromsø, Norway.
2 Helse Nord IKT HF, Tromsø, Norway.
J Diabetes Sci Technol. 2017 Nov;11(6):1234-1239. doi: 10.1177/1932296817709797. Epub 2017 May 31.
Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.
使用共享电子健康记录为不同医疗机构的卫生人员之间开展灵活且富有成效的合作开辟了一系列新的可能性，这对患者有益。然而，仍存在未解决的法律和安全挑战。本文的总体目标是强调在使用共享电子合作平台和健康记录系统之前应考虑的法律和安全挑战，以避免实施后出现法律和安全“意外情况”。通过使用一个基于网络的溃疡记录系统所获得的实践经验教训（该系统涉及患者、社区护士、全科医生以及专科医疗保健中的医院护士和医生）来说明我们所面临的挑战。对可能的法律和安全挑战进行讨论对于成功实施共享电子协作系统至关重要。关键挑战包括：（1）责任分配；（2）文档记录程序；（3）集成或联合访问控制。我们讨论并提出如何应对法律和安全方面的挑战。这一讨论可能对当前和未来的用户以及政策制定者都有用。
