Standardized regional electronic archive system nationwide will improve quality of health care

"We've a good basis for combining our high level of service expertise in health care with our proficiency in information technology. Finland could be a model for the use of electronic data in the field of health care," says Välimäki.

The national electronic client data system is made up of patient data records, electronic prescriptions and the possibility offered to patients to see their own health data online. The system covers public primary health care and specialist medical treatment plus private medical treatment. The MSAH is supervising the transition to the e-data system.

One of the key aims of the ongoing reform of the Finnish health care system is to strengthen primary health care. The electronic patient record archive system and the various solutions linked to it will bring about important new methods in this area.

"Primary health care will be able to operate as the gatekeeper in the whole treatment process, as doctors will be able to use all the data there is that concerns their patients and will be in a position to discuss with specialists online."

Välimäki says that the new system will mean that treatment safety will improve, as doctors will have the latest information on the treatment of their patients at their disposal and will know what has been done previously. "When in addition you have the follow-up on treatment and consultations with clients, the possibilities for improving treatment improve."

In his view the electronic patient archive system will be able also to bolster health promotion, as people will have the opportunity to view their own data and so have more information on their state of health and be able to follow the progress of their own treatment. This should motivate people to follow healthier life styles by allowing them to keep track of their health care record.

Välimäki also points out that the new system will enable decision makers and researchers to gain new kinds of information from data records that will help with developing services and treatment.

Health care reform includes the aim of increasing the patient's opportunities to choose where they receive treatment. The electronic patient data archive will also help with this. When clients want to transfer to another place of treatment, staff there will be able to use the clients previous treatment records with their permission. It would be harder to ensure clients' freedom of choice without the electronic data system.

Välimäki believes that doubts over whether the new electronic archive system will endanger patient confidentiality are groundless. He says that paper records are far more vulnerable and their viewing leaves no visible trace, unlike with electronic records, which always record when and why records have been accessed. With paper records no one ever knows what information has been viewed or for what reason.

The MSAH is now working on an amendment to legislation on the use of electronic patient archives so that procedures for granting consent concerning their use will be more flexible.

It has taken nearly a decade to complete the electronic data system for Finnish health care. From time to time the Finnish press have questioned why it has taken so long. Välimäki says that the use of different, incompatible data systems for health care across the country has slowed things down. Much of the work for the new system has focused on the replacing old systems. The MSAH's own structural overhaul has also been a factor. "It's hard to construct a standardised data system when the administrative system is not stable."

Work on constructing the new electronic data system has also been done by the Finnish Social Insurance Institution (known as Kela) and the National Institute for Health and Welfare, which have clarified the frameworks for patient and client data systems. In addition, municipalities have had to ensure that the new data systems are fully compatible regionally and nationally.

Välimäki also points out that the system has been constructed at little cost compared to that of similar electronic data systems in other countries. "It's unlikely that we could get more funding in the present economic situation. In the UK, for instance, billions of pounds have been spent on an electronic patient records system, but there is still no fully operational system."

He points out that in the UK, as in Finland, it was realised that it would be impossible to construct a central system, but that instead interlinked regional systems work best.

Merja Moilanen