Electronisch Patiëntendossier

Today everyone in the Netherlands received a letter about the new national electronic health record (EPD) and the possibility to object against registration. EPD aims to provide access to one's patient data to every care provider through a central information broker. I have submitted the form to disallow my data to be accessed through this system.

First of all, there's no clear benefit for me, and I think that goes for the large majority of people. The possible situation where someone has a critical condition and isn't treated by his regular doctor and is unable to inform the stand-in of this and the stand-in has the time to delve through the entire EPD and actually finds and correctly interprets the necessary information seems extremely small for anyone, let alone the big majority that doesn't suffer such critical conditions in the first place. Hence, making it the default for everyone seems very inappropriate. See also this interesting article, written in Dutch by my uncle.

Interestingly the same minister was recently opposed to a default-allow for organ donorship, which may address a problem that is much more real.

The other concern is security. I am not worried by the technical security of the system, it seems to be of acceptable standard (see this report by my friend Niels). I am more concerned about access restrictions: these are implemented post hoc, that is, anyone can access my file and I can check who accessed my it and whether they had the right to. However, this procedure involves sending in paper forms which I think in practice will not bring about much review.

Combined this project reminds me of voting computers - introducing new concerns while solving no actual problems.