Privacy row over putting Dutch medical charts on file (News Feature)

By Rachel Levy Nov 12, 2008, 14:12 GMT

Amsterdam - If Dutch health minister Ab Klink has his way, the medical charts of all Dutch nationals will be stored in a single national database as of January 1.

From that day onwards, the family doctor can read what the neurologist has written down about his patient, while the neurologist can study his patient's medical history as registered by his family doctor.

'We support the launch of the electronic patient database,' Fulco Seegers, spokesman for the national family doctor association LHV, tells Deutsche-Presse Agentur dpa.

According to LHV, the electronic patient database can prevent medical mistakes and improve treatment.

Today, doctors depend on a patient's memory for information about his medical history. This can complicate or slow down treatment, particularly in those cases a patient is brought in a hospital unconscious or incapable of communication.

If hospital doctors can check a patient's medical file instantly and see what has been prescribed to him before, what other problems he suffers from, or which drugs he is allergic to, such problems will not occur, proponents say.

'But,' says Seegers from the LHV, 'we think the health minister is running too fast. Previous pilot studies of electronic patient databases have proven that patient privacy remains a big issue.'

Seegers said too many questions remain unresolved.

'Doctors get access to the database using a card, a code, and a patient's social security number. What if someone loses his card and code? Can the system be hacked? How is it protected? What if the doctor leaves the room for five minutes - will the system remain switched on, for all eyes to see?

'Who will be held accountable if not only a patient's personal doctor, but also a third party - a nurse, another doctor, or a stranger - sees his medical chart?' he asked.

In early November, health minister Klink sent all Dutch nationals a letter about the electronic patient database, telling them that the medical charts of all Dutch nationals would automatically be merged into a single patient file accessible to all doctors.

Those who object could opt-out by filling out a special form.

Their personal data would still end up in the national electronic patient database. But, doctors would need prior patient permission in order to access it.

Within a week, 15,000 people formally protested against the full access of their patient database.

Mark de Graaf, 32, from Amsterdam, was one of them.

'In the Netherlands, you need a referral from your family doctor to get an appointment with a specialist,' he says Mark de Graaf.

'Family doctors are instructed by the health care insurers not to refer people to specialists too often. In practice, I always need to wage a diplomatic war with my family doctor to get a referral.

'He never takes me seriously. If my specialist would have access to my patient file, he would undoubtedly see that my family doctor plays down whatever I told him. He would subsequently not take me seriously either,' de Graaf added.

Meanwhile both Dutch legislators and representatives of medical professionals are worried about the way the patient file is being launched.

Klink sent his letter about the introduction of the new system early November - but legislation necessary to introduce the electronic patient file has not even been passed by parliament yet.

LHV spokesman Seegers says a 'strong debate' between parliament and the minister is necessary.

But a Health Ministry spokeswoman said that 'as far as we know, no debate is required at this moment.'

Asked if the minister would respond to the questions raised by several legislators about the protection of individual privacy, the spokeswoman said 'the minister would 'send a letter to the parliament later this week.'

If it's up to the health minister, the circle of medical professionals having free access to a person's electronic medical chart, will be broadened soon.

LHV's says that only makes the issue of patient privacy all the more accurate.