E-health in the public administration: is it possible to use electronic physician-bot

  • I. V. Venediktova
Keywords: e-health; public administration; health information; healthcare providers; healthcare consumers.

Abstract

Over the past decades, the role and functions of e-Health has been rethought on the basis of accumulation knowledge and experience. International research shows that the expansion of the use of information and communication technologies (ICT), and in particular electronic health passports can help ensure better quality of medical care, reduce medical errors and improve the quality of health administration. At the same time, while implementing such state-owned projects, a number of complications that involve: the lack of legislation and regulatory framework, the lack of resources and capacity, the need to develop and implement common standards, poor data quality, the complexity of linking disparate data from different sources, etc.; can arise. It is critically important to acknowledge the fact that successful investment in e-Health projects requires far more than the development of technological tools. It is not enough to develop or purchase an information system, it requires a holistic view of the planned results and necessary changes in organizational processes, structures, functions, standards and legislation, as well as taking into account the specifics of personnel resources, training issues, reimbursement of expenses and cultural traditions of people who will use the technologies of electronic security health.

The existence of a national e-Health strategy, harmonized with the goals of global health system, is seen as a key factor contributing to strengthening human-oriented health systems and building public health. According to an assessment conducted in 2015, 30 Member States of the WHO European Region (70% of the total number of responding countries) have policies or strategies for e-health at the national level.

The purpose of this article is the identification of the peculiarities and prospects of using the electronic health system in different countries. This study is based on normative legal acts of various states and international organizations, reports of the WHO and legal doctrine in the field of medical law.

The legal basis of the electronic health system provides opportunities for its effective use and patient confidence. This foundation is a key factor in the successful implementation of the electronic health system tools. Patient safety mechanisms, data protection and ethical standards are related to the collection and use of patient information and are needed to establish legal clarity between healthcare providers and consumers.

These mechanisms also provide for the exchange of information between healthcare providers (e.g., data on patients, illnesses and research materials) with guarantees of the reliability of information and data protection. Legal mechanisms are also needed to build an atmosphere of trust among consumers. The availability of a fully-fledged legal framework for health services, whether they are provided directly or through ICTs, plays an important role in providing high-quality health care.

The implementation of the benefits of the electronic health system requires that all users receive common acceptance. Therefore, legislation should focus on issues such as confidentiality, protection and quality of data, supplier integrity, access to data, and data dissemination, so that patients are better informed about the use and appointment of their data in the process of providing assistance.

The development and adoption of standards for interoperability and functional characteristics also require legal regulation in order to optimally develop the services, tools and technologies of the electronic health system. However, these mechanisms need to be shaped in line with current needs so that they can work effectively and continue to evolve as progress in their use for the needs of technology and society.

Recent changes to the legislation of Ukraine are also aimed at introducing an electronic health system. The Law of Ukraine “On State Financial Guarantees of Health Care of the Population” (2017) and the Procedure for the Functioning of the Electronic Health Care System, approved by the Resolution of the Cabinet of Ministers of Ukraine (2018) are the main legal acts regulating state policy in this field. In accordance with the requirements of this Order, the task of the electronic health system is to ensure the possibility of using electronic services by patients for the exercise of their rights under the program of state guarantees of public health services, automation of accounting of medical services and management of medical information, introduction of electronic document circulation in the field of medical care of the population according to the program of medical guarantees.

The protection of personal data in this electronic system implies that the document circulation in the electronic healthcare system is carried out in accordance with the requirements of the legislation on electronic documents and electronic document circulation. All electronic documents submitted to the central database shall be supplemented by an electronic signature of the author or a signature, equivalent to the abovementioned, under the law. The information during processing and exchange in the electronic healthcare system shall preserve the integrity of the protection provided by protection against unauthorized actions which may lead to its accidental or deliberate modification or destruction, in particular by imposing an electronic signature of the author or signature equivalent to abovementioned under the law. For entering information and documents into the central database, state classifiers, nomenclatures and reference books are approved, in accordance with the procedure established by the legislation, in particular, special classifications and lists approved by the Ministry of Health. The administrator provides technical support for the use of such classifications, nomenclature, directories and lists.

The WHO recommends to the states some steps so that the latter can improve the effectiveness of the electronic health system:

- Member States are encouraged to adopt national legislation that protects the confidentiality of medical data contained in electronic formats, and ensures compliance with individual rights of patients in their interaction with e-health. In particular, due national legislation should at least regulate the issues of access and ownership of patient data stored in the e-health field; determine who has the right to access this data; allow patients to restrict access at their discretion, make changes and delete data; ensure the right of patients to be informed about the risks associated with the abovementioned actions;

- Member States are encouraged to develop and implement policies or legislation to control the quality of data and standards for their transmission in support of electronic health in addition to establishing medical jurisdiction, legal liability and the mechanism for reimbursement of costs for services in the field of electronic health care;

- Member States shall periodically review national legal instruments relating to the electronic health system in order to take account of technological changes, as well as changes in the information landscape of healthcare.

The introduction of ICT in the practice of medical care provides additional benefits for the services concerned and promotes the development of specialist skills for healthcare professionals. Despite significant advances in the implementation of human-oriented medical models, there remain critical gaps in the planning and provision of health services in the world.

That is why it is so important to involve all stakeholders in the national health reform processes and it is extremely important for countries to consider health information and access to it as key factors for the transformation and standardization of healthcare delivery systems.

To improve the provision of medical and social care, it is necessary to clearly identify all potential consumers and providers of medical information. It is crucial that effective national healthcare reforms take into account patient opinions in order to identify the best ways to use the tools and services of the electronic healthcare system in order to provide more comprehensive assistance and active involvement of the population in the care of their own health and well-being.

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Published
2019-03-20
How to Cite
Venediktova , I. V. (2019). E-health in the public administration: is it possible to use electronic physician-bot. Medicne Pravo, (1(23), 18-25. https://doi.org/10.25040/medicallaw2019.01.018
Section
Articles