Tuesday, July 20, 2010

A Sobering Tale of A Mess in E-Health in Holland.

The following appeared a while ago

Dutch EHR plans put on hold

09 Jul 2010

Holland may have flown high in the World Cup but plans for a national electronic health record system now look set to go into extra time, Ton Smit reports.

Plans for a national Electronic Health Record in the Netherlands have been put on hold after the Dutch Senate voted to make major changes to the national programme.

Until the EHR legislation is approved the Dutch EHR programme will no longer be mandatory. Care providers will now only be allowed to link to the national EHR on a strictly voluntary basis.

In addition, there will be no more financial incentives to encourage GPs, pharmacists and hospitals to link to the national EHR infrastructure.

In the proposed legislation individual providers who refuse to connect to the national infrastructure face potential €33,500 fines.

The proposed EHR legislation fell into disgrace, after too many amendments were introduced. Many Senators also felt that the wrong technological model had been adopted. The Dutch EHR system is based on a pull model that dynamically pulls together records from local source systems.

The Dutch EHR is based on an online medication list and a patient medical summary for GPs.

The rollout of these two core services will now continue on a strictly voluntary basis –without financial carrot/stick incentives from The Hague.

In addition the Department of Health (VWS) will not be allowed to add new functionality to the present EHR rollout.

Considerable delays are likely as the legislation will probably be returned to Parliament. This decision will be made in two months.

Indonesian born Dutch Labour MP, Ing Yoe Tan, who was a key mover in the legislative changes- expects a delay of at least one year.

Much more here:


Please read the whole article. This is a sobering tale that shows how badly these mega-projects can go if not managed to fully engage both the public and the providers.

A salutary lesson for both NEHTA and DoHA as they dream the their ‘greata bigga system’!

Much better to go ground up – or even ‘middle out’ – rather than top down, which seems to be the only way some of the bureaucrats are thinking.

Be afraid, very afraid is all I can say!

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