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eHealth is deeply integrated into Sweden's healthcare sector, with annual investments of around $1.22 billion in healthcare IT across all regions. Electronic health record solutions are universally adopted, with 99 percent of prescriptions issued electronically. The COVID-19 pandemic further accelerated the growth of digital health services, with digital consultations doubling in 2020, representing 11 percent of total medical appointments .https://www.trade.gov/country-commercial-guides/sweden-ehealth(International Trade Administration, U.S. Department of Commerce, 2023).
Inera AB, a company owned by the Swedish regional governments, manages the national patient portal 1177.se, including the PAEHR Journalen (Cijvat et al. , Cornet and Hägglund, 2021).
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Features
Note from the author: the bibliography for this section is from 2018. We weren’t able to find more up-to-date information, but if you have access to them, please contact us.
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medical notes from the EHRs (from all health care professions and all connected health care providers who have agreed to give access, both public and private),
list of prescribed medications,
lab results,
warnings,
diagnosis,
maternity care records,
referrals,
vaccinations
In some of the regions, users have access to a log function, to see whoever has accessed their record.
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Challenges and areas for improvement
Data Fragmentation: despite the existence of the national 1177 patient portal in Sweden, the country employs various Electronic Health Record (EHR) systems. To address the challenge of consolidating EHR data for patients, Sweden has implemented a national Health Information Exchange (HIE) platform, however, challenges persist in achieving a comprehensive overview of health data. Variability in information accessibility among care providers, influenced by differing policies and regulations, contributes to a fragmented patient view based on the location, timing, and purpose of seeking treatment. This is closely related to the difficulty of agreeing on a national regulatory framework for patients’ direct access to their health information.(Article published Oct 30, 2017 Maria Hägglund) https://www.philips.com/a-w/about/news/archive/future-health-index/articles/20171030-access-electronic-health-records.html
Another challenge has been change resistance from healthcare professionals: healthcare professionals have expressed resistance to how introducing this system might change their work. Concerns include potential increases in workload, with fears that more time may be spent explaining EHR contents and addressing patient inquiries. Some professionals worry that EHRs could lead to conflicts, misunderstandings, and misinterpretations, causing unnecessary worry among patients. However, experience with e-services over time tends to alleviate these concerns, with healthcare professionals who actively use the system expressing fewer worries.
(Article published Oct 30Hägglund, 2017Maria Hägglund) https://www.philips.com/a-w/about/news/archive/future-health-index/articles/20171030-access-electronic-health-records.html
In a 2022 survey on the usability of the Swedish Personal Health Record, the primary concerns raised were:
Due to regional adaptations of the national regulatory framework for Patient Accessible Electronic Health Record (PAEHR), different regions offer distinct features and present varying health information to patients.
Several regions did not retroactively provide information; the records only included data from the date the region launched the portal.
Many regions imposed restrictions on patient data availability in specific clinical areas, such as mental health. Some respondents perceived discrimination due to the limited access to their mental health-related data.
When a child turns 13, parents automatically lose access to their record. However, the child cannot access their record until they turn 16, resulting in a three-year gap with no access to the record.
The platform lacks a messaging feature that could allow patients and professionals to communicate with each other remotely.
.(Hägglund , and Scandurra, 2022).
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Published outcomes - statistics
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Unfortunately, we couldn’t find any screenshots of the Swedish PHR. If you have access to this information or can put us in touch with someone who has, please contact us at book@patientsknowbest.com
Bibliography
Cijvat, C.D., Cornet, R. and Hägglund, M., 2021. Factors influencing development and implementation of patients' access to electronic health records—a comparative study of Sweden and the Netherlands. Frontiers in Public Health, 9, p.621210. (online) Available at: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.621210/full (Accessed 3 May 2023).
eHealth in Sweden, n.d. GNIUS. Edited by Délégation au numérique en santé (Ministerial delegation for Digital Health). Available at: https://gnius.esante.gouv.fr/en/international-digital-health-systems/ehealth-in-sweden (Accessed 3 May 2023).Welcome to the Swedish eHealth Agency, n.d. eHälsomyndigheten
Hägglund, M., 2017. Electronic health records in Sweden—how can we go from transparency to collaboration? Thebmjopinion. (online) 23 June. Available at: https://wwwblogs.ehalsomyndigheten.se/languages/english/welcome-to-the-swedish-ehealth-agency/ (Accessed 3 May 2023).
https://www.researchgate.net/publication/352215101_Factors_Influencing_Development_and_Implementation_of_Patients bmj.com/bmj/2017/06/23/maria-hagglund-electronic-health-records-in-sweden-how-can-we-go-transparency-to-collaboration/ (Accessed 2 August 2024).
Hägglund, M., Blease, C. and Scandurra, I., 2020. Mobile access and adoption of the Swedish National Patient Portal. In: A. Värri et al., eds. Integrated Citizen Centered Digital Health and Social Care. The European Federation for Medical Informatics (EFMI) and IOS Press. Available at: https://www.diva-portal.org/smash/get/diva2:1509909/FULLTEXT01.pdf (Accessed 3 May 2023). doi:10.3233/SHTI200699.
Hägglund, M. and Scandurra, I., 2022. Usability of the Swedish accessible electronic health record: qualitative survey study. JMIR Human Factors, 9(2), p.e37192. (online) Available at: https://humanfactors.jmir.org/2022/2/e37192 (Accessed 3 May 2023).
International Trade Administration, U.S. Department of Commerce, 2023. Sweden - Country Commercial Guide. (online) Available at: https://www.trade.gov/country-commercial-guides/sweden-ehealth (Accessed 3 May 2023).
Moll, J., Rexhepi, H., Cajander, Å., Grünloh, C., Huvila, I., Hägglund, M., Myreteg, G., Scandurra, I. and Åhlfeldt, R.M., 2018. Patients’ experiences of accessing their electronic health records: national patient survey in Sweden. Journal of Medical Internet Research, 20(11), p.e278. (online) Available at: https://www.jmir.org/2018/11/e278/ (Accessed 3 May 2023).
Welcome to the Swedish eHealth Agency, n.d. eHälsomyndigheten. Available at: https://www.ehalsomyndigheten.se/languages/english/welcome-to-the-swedish-ehealth-agency/ (Accessed 3 May 2023).