Delayed health record: doctors in trouble, extension of Pss deadline for use in emergency rooms

It should contain the main health information of each patient and becomes crucial in emergencies such as the arrival of a sick person in an emergency room, because it can be consulted by doctors and facilities even in the absence of the explicit consent of the person concerned. It is the Synthetic Health Profile (PSS) or Patient Summary: the computer document contained within each electronic health record that, according to a decree issued by the Ministry of Health, was to be operational from 30 September. But the family doctors, who had the task of compiling and managing it, in the vast majority of cases have not done so - at the moment, according to the latest available data, only 5% of doctors have already compiled this document - and they denounce "enormous difficulties" starting with the outdated computer systems, in addition to the problems that arise in terms of privacy and data security. And so an extension is on the way that postpones the deadline for drawing it up to the end of December in a decree that will be examined by the next State-Regions Conference.

The summary health profile should, as mentioned, be drawn up and updated for each patient by the general practitioner or paediatrician: it is in fact a computer document that summarises a patient's essential clinical data such as chronic pathologies, allergies, ongoing therapies, malformations and disabilities, prostheses and family history. The aim is to allow immediate knowledge of the subject's clinical picture mainly in critical and emergency situations. Citizens can view it via their Electronic Health Record, and in an emergency the data can be consulted even without the patient's consent, again with the aim of ensuring timely intervention. Also because at the moment less than half of Italians have given consent to the use of the health record by healthcare professionals. The PSS is provided for in the 2023 decree on the Electronic Health Record 2.0. At the beginning of September, the Ministry of Health published the 27 June 2025 decree in the Official Gazette with the implementation guidelines for the definition of the information content of the PSS, and the deadline for its full implementation is 30 September.

The deadline of 30 September, however, doctors warn, is purely theoretical since there are various thorny issues to be resolved, starting with fragile computer networks, archives to be protected from possible violations, and bureaucratic burdens for doctors who are already overburdened. The President of the Order of Physicians of Milan, Roberto Carlo Rossi, is critical: 'The PSS will be able to bring improvements in the assistance of citizens, but it presents numerous and heavy criticalities connected with cyber-security, privacy, and ethical and medico-legal problems. It will be a tool to be approached with great caution by the colleagues who will be compiling it'. In addition, he says, 'with a computer system that is watery on all sides, the application of the new decree on Pss will be difficult if not impossible. But, evidently, in order to meet the deadlines of the NRP and aspire to receive the relevant funding, everyone has to pretend that by the end of September this system can reasonably be up and running. Everyone except those who have to work with this system and guarantee the health of citizens. We will make our voice heard'.

Alongside the knots of IT security and privacy, the Order of Milan also draws attention to another risk: the possibility of particularly sensitive data being misused, raising ethical dilemmas about the inclusion of sensitive data such as addictions or mental disorders. The PSS 'raises ethical questions,' underlines Rossi. 'Some data, such as those relating to mental health or addictions or certain diseases, could be considered too sensitive to be shared. There is a risk that the Pss could be used to discriminate against citizens, for example in employment or insurance'. The secretary of the Italian Federation of General Practitioners (Fimmg), Silvestro Scotti, also expresses perplexity: 'The software systems that family doctors' practices have in place need adaptations and updates aimed at the Pss, which have not been carried out. Therefore,' says Scotti, 'the deadline of 30 September is impracticable'. Lastly, the deputy secretary of the Fimmg Nicola Calabrese concludes, 'the lack of specific training for GPs with respect to this new procedure, which, in addition to increasing the burden on doctors, has a certain complexity'.