Health Psychologist and Senior Research Fellow, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand; i3, Waitematā District Health Board (DHB), Auckland, New Zealand.
Health Consumer. Waitematā DHB, Auckland, New Zealand.
N Z Med J. 2022 Jun 10;135(1556):114-123.
A patient and whānau centred healthcare system includes patients having easy access to their health records when and where they need it. Accessible digital solutions providing patients with access to their health information, including hospital-held healthcare records, will support patients and whānau to be active and informed participants in their health. A Northern Region proof-of-concept, providing patients with electronic access to their hospital-held health information, identified several challenges in the design of such "portals". The purpose of this paper is to present a discussion of these challenges, and to present a review of the literature on how other countries and health settings have managed them. The review has led to recommendations around how delegated access, auditing access, adding and correcting of information, the timing of test result availability, and retrospective records should be handled. However, more investigation is required into the challenges surrounding how various types of more sensitive information should be handled. There is still considerable work to be done on how to technically and operationally transform these "default design principles" into reality within the complexity of New Zealand hospitals' electronic health information systems.
以患者和家庭为中心的医疗体系包括患者在需要时和需要的地方能够轻松访问他们的健康记录。提供患者访问其健康信息（包括医院持有的医疗记录）的可访问数字解决方案，将支持患者和家庭积极参与他们的健康。北部地区的一个概念验证项目为患者提供了电子访问其医院持有的健康信息的权限，该项目在设计此类“门户”时发现了几个挑战。本文的目的是讨论这些挑战，并回顾文献中其他国家和卫生环境如何应对这些挑战。该审查提出了有关如何处理委托访问、审核访问、添加和更正信息、测试结果可用性的时间以及回顾性记录的建议。然而，还需要进一步调查如何处理各种类型的更敏感信息所带来的挑战。在新西兰医院的电子健康信息系统的复杂性中，如何将这些“默认设计原则”转化为现实，仍有大量工作要做。
