Summary
Objective: Lack of access to updated drug information is a challenge for healthcare providers
in Norway. Drug charts are updated in separate EHR systems but exchange of drug information
between them is lacking. In order to provide ready access to updated medication information,
a project for consent-based access to a core EHR has been established.
Methods: End users have developed requirements for additions to the medication modules in
the EHR systems in cooperation with vendors, researchers and standardization workers.
The modules are then implemented by the vendors, tested in the usability lab, and
finally tested by the national testing and approval service before implementation.
An ethnographic study, with focus on future users and their interaction with other
actors regarding medicines and medication, has included semi-/unstructured interviews
with the involved organizational units.
Results: The core EHR uses the EHR kept by the patient’s regular GP as the main source of
information. A server-based solution has been chosen in order to keep the core EHR
accessible outside the GP’s regular work hours. The core EHR is being tested, and
the EHR-vendors are implementing additions to their systems in order to facilitate
communication with the core EHR. All major EHR-system vendors in Norway participate
in the project.
Conclusions: The core EHR provides a generic basis that may be used as a pilot for a national
patient summary. Examples of a wider use of the core EHR can be: shared individual
plans to support continuity of care, summary of the patient’s contacts with health
providers in different organizations, and core EHR information such as important diagnoses,
allergies and contact information. Extensive electronic cooperation and communication
requires that all partners adjust their documentation practices to fit with other
actors’ needs. The implementation effects on future work practices will be followed
by researchers.
Keywords
Consent - core EHR - EHR - patient summary - medication - information systems - socio-technical
approaches - information infrastructure
