Digital service provision has been the main way of reaching out to clients by the private sector for at least for 20 years, . Even longer in some sectors and some countries even longer. In Estonia, online banking was launched 30 years ago, in 1994. By the turn of the century, not visiting any offices to subscribe for offices was the exception, not the norm, when subscribing to telecommunication and other well standardized services was rather a norm than an exception. The standardised services. Estonia’s online tax board was launched in 1997, which means that virtually anyone under . Almost no one under the age of 50 has ever seen the a taxman in Estonia.
Of course, in most countries the digital services of the public service space sector had to compete initially with traditional, appointment-based service model. Partially this was because the digital services were not offered in a universal way; nor linked to a single government portal; and weren’t accessible with a universal digital ID. Instead, the variety of methods for access and client identify verification created confusion and held back digital service space delayed development.
Since then, Consolidation followed in most countries, consolidation has happened. As people mostly transact online in their everyday life, governments have had to follow the trend, so it has not been . So it was no longer possible to force physical appointment-based services anymore. While most governments still do not provide single access point universal service portals for all public service delivery, at least they have made sectoral advances have been made (i.e. . For example, a single digital space for business management, then social service provision, and finally, healthcare).
In digital healthcare it is very important that citizens maintain Citizens control over who , when and how can see they health informationinformation about their health is very important. It is less of a problem in Europe, where governments often take full responsibility for organizing organising healthcare. The cost of insurance therefore does not depend on health patterns of any individuals, instead they are it is based on solidarity. In systems where all or part of the insurance cost is carried by citizens directly, there is always the risk of health profile-based prices; or in the case of high-risk patients, a lack of providers willing to deliver the service. It is hard to regulate against these risks, even if most governments try to do so.
Nevertheless, even Even in solidarity-based health insurance models, people are normally worried about who can see the sensitive data.
On the other hand, people understand that centralized healthcare databased databases reduce the need for repetitive actions by different healthcare providers, saving . This saves time for them (citizens and money for government). Therefore, it is the job of a government to provide for necessary safety clauses for citizens, allowing them control over their personal health data.
For example, in Estonia where citizens Estonians can donate their DNA sample samples to the Estonian Genome Bank, in exchange of their genetic risk profile, people . People are free to choose whether or not they to share that data with their family practitioner. For the rest of health data, citizens can verify that only their relevant healthcare providers have accessed their medical data and no any other doctor, nurse or hospital has done so. In this way, while complete digital health records exist for every citizen exists, they know each knows that personal information does not belong belongs to them, neither to their doctor nor the government, but themselves. It
This has made it easier to accept consolidated healthcare records /and systems. After all, if your medical data is stored on paper files, you have far less of a control over who has read it than in case of a you do with digital records, where every reader leaves digital fingerprints. (if If the system is adequately built, of course.).
Finally, based Based on personal experience, I can testify that fully digital personal health records compared offer far superior patient experience to an alternative where each provider maintains closely guarded guards patient data (technically, . They say they do so for safety reasons, but in reality very often because of business interest in reality) offer far superior patient experience. The risks related to such integrated systems can be managed by adequate safeguarding and firewalling fire-walling methods. Since many paper-based systems have long used the data safety arguments in order not to transfer to digital ecosystems, considerable efforts may be needed to convince the patients that digital healthcare records allow, in fact, better data protection and superior level of personal control over sensitive health information.
Final A final warning – - fragmented digital health systems which do not allow patients to transfer all their medical information , - including pictures, analysis etc. to the practitioner of their choice , - will not deliver neither savings nor patient satisfaction to patients. Therefore, digital healthcare systems must be designed to overcome the fragmented nature of many healthcare provision models! Even if it is in the business interests of hospitals /and practitioners not to share the results of whatever tests they have ordered for their patients, the law must be clear that the these results of the analysis belong to the patient, not to the hospital and therefore . Therefore they must be fully accessible via digital data systems to other providers if the patient so wishes.
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