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The system has fully embraced digitalisation. Each region is responsible for storing electronic health record (EHR) data in the region’s data repository. EHR coverage is comprehensive, with healthcare providers legally required to report to these regional repositories. The two EHR systems in use (EPIC and Systematic) operate independently without direct data exchange. The national E-Journal show shows healthcare professionals information from the EHRs of other regions (Fragidis & Chatzoglou, 2018; Jensen & Thorseng, 2017; Tikkanen et al., 2020).
Health insurance covered the entire population of Denmark: both members of health insurance schemes and those with free access to state-provided healthcare services (Our World in Data, 2011).
Public vs private
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The national PHR
History
Sundhed.dk is a public, internet-based portal where every citizen can log in to see their medical records, and healthcare professionals see their patients' records.
Sundhed.dk dates back to 2001, when a broad political governing body was formed to support the development of a national e-health portal. This body included the Association of County Councils, the Ministry of the Interior and Health, the Greater Capital’s Hospital Association, and the municipalities of Copenhagen and Frederiksberg.
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Given the scale and complexity of building the shared infrastructure, the board of directors chose to conduct the tender as a competition in 2002. The Maersk Data Consortium—comprising LEC, ACURE, PLS/Ramboll, and Bysted—won the competition. The central office of Sundhed.dk signed a contract with the consortium in early 2003.
Patients did not gain access to their data until 2009.
In April 2009, Sundhed.dk was relaunched on a new technical platform, and an internal development department took over most of the service development, while external consultants were brought in only for standalone services—reversing the previous approach. One of the first initiatives at that time was to make medical records from public hospitals accessible to patients, allowing them to view parts of their records, such as treatments, diagnoses, and notes made by healthcare personnel (Jensen and Thorseng, 2017; Sundhed.dk, 2023).
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Features
Sundhed.dk has a federated architecture. It draws from 120 local systems without storing or duplicating.
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Patients can log in after identity verification. Their medical records include data from general practitioners (GPs), hospital electronic health record (EHR) systems (Petersen, 2019), and certain private health professionals (Hartlev, 2014). Features include (Sundhed.dk, 2023):
Accessing their health journal, with medical records from healthcare providers. Records include imaging reports, test results, referrals, discharge letters, medications and vaccinations.
Seeing past appointments with GPs, specialists, and public hospitals.
Requesting repeat prescriptions
Registering or deregistering as an organ donor, creating a treatment will, checking the status of screening procedures, and granting relatives power of attorney to view their health data.
Marking certain information as private, to hide from healthcare professionals using Sundhed.dk. A hospital’s employees can still see the data in their hospital’s local EHR.
Healthcare professionals can access their patients' covers the entire population of ’s health data through Sundhed.dk. It also provides clinical information and guidelines that may not be available in their local EHR. For example, GPs can access hospital EHRs, waiting lists, and contact details for other healthcare professionals (Petersen, 2019).
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