In the Danish health care sector the general practitioner acts as “gatekeeper” – keeping 90 % out of hospitals. Other key factors are the free and equal access for everyone and its universal coverage. The healthcare portal sundhed.dk is part of the public health sector as the Danish national strategy from January 2018 declares it “as national entry point for access to personal health data from hospitals, general practitioners and municipalities,” said Morten Elbæk Petersen, Director of the Danish Health Portal at the “Emerging Technologies in Medicine” Conference (ETIM 2018) in February in Essen.
Patients are equal partners
For Petersen, digitizing healthcare is one way of securing patient ownership and making citizens equal partners in exchange with healthcare workers. After all, the idea behind the portal, which was initiated in 2001 and launched in 2003, was the networking of data for physicians, hospitals and nursing homes as well as the strengthening of patients. Currently, the portal links the files of about 2,800 practicing physicians and about 50 public hospitals and all pharmacies. And the portal is successful: “Since the introduction of the state-owned and financed sundhed.dk portal, death rates have fallen and the average length of stay in Danish hospitals has been reduced to around 3.4 days,” Petersen reported.
The basis for the success was the trust-based culture in Denmark and the trust in the open access to personal data. “It is important to highlight the benefits of digitized and available data for patients and healthcare professionals to improve portal adoption,” says Petersen. Acceptance among the population is correspondingly high: surveys have shown that 3.3 people know sundhed, 24 percent believe that treatment has improved as a result of using the e-health portal; 41 percent said they gained a better understanding of their disease by accessing the data. The numbers are also proof of success: according to Petersen, sundhed.dk has a steadily increasing number of users. In January 2018, about 1.8 million unique visitors per month used the portal, with 5.8 million inhabitants.
Doctors and patients access data
sundhed.dk is a central point of access for patients and doctors to look at medical data. Doctors can issue e-prescriptions, send medical reports via the system to colleaguesand to nurses; they allow access to imaging and laboratory data, findings from other specialists like psychologists and physiotherapists as well as reports from hospitals, nursing homes and outpatient nurses.
The effort to access the system is low for patients. “At birth, every Dane receive an identification number that they can use to log in to the portal around the clock – via their desktop PC, smartphone or tablet,” says Petersen. The data are not stored centrally in one place, but decentralized at 120 different locations and are accessible by linking. By logging in, users can access their own personal page, where they can take a look at their individual medical history, examination results and medications up to the year 1977.
sundhed.dk provides citizens with contact details of all physicians, information about the quality and prices of treatments, as well as medical prevention and basic knowledge. Furthermore, patients can check their bills, make appointments with the family doctor, feed in their own vital data, renew prescriptions for medications and record the power of attorney and living will. The portal also offers free Health programs for chronic disease management (diabetes, cancer, osteoporosis), smokecessation, weightloss, pregnancy and birth.
And what about data security? According to Petersen, users do not have to worry about protecting their own data. “Patients can see which healthcare workers have accessed their personal information,” Petersen said. In addition, there are only “three to five cases of abuse a year” with unauthorized access to patient records.
Report: Sascha Keutel