Health record now in full swing, but patients and doctors snub it: here's what to know

As of today, the electronic health record - the digital treasure chest containing our entire health history - goes live throughout Italy. As of 31 March, regions and healthcare facilities (public and private) must upload all the documents required by law: reports, emergency room reports, discharge letters, summary health profile, specialist and pharmaceutical prescriptions, medical records, drug dispensing, exemptions, screening invitation letters, etc. In particular, facilities and outpatient clinics are obliged to comply with stringent technological criteria (e.g. with regard to privacy protection), but also to update data promptly (within 5 days) after examinations or visits. The dossier, which is also financed with funds from the NRP, is, however, still snubbed by many Italians: less than one in two has given consent for their health data to be used.

Citizens can access it via their Spid or digital identity card, finding there all the health documents that from now on have to be uploaded by public and private facilities: these range from the latest tests carried out to radiological examinations, from the drugs one usually takes to emergency room reports, and even hospital admissions or the 'patient summary', a sort of brief identikit of the patient written by family doctors A breakthrough that many Italians still do not know about, however, given that according to the last official monitoring, which dates back to last September, practically only one in four (27%) had accessed their file at least once in the last 90 days. But above all, less than one in two (44%) have given their consent for their data to be consulted by healthcare professionals. This non-adherence represents much more than a simple bureaucratic fulfilment born out of respect for patients' right to privacy. Because without citizens' consent, the health record is practically unusable in hospitals, doctors' surgeries or offices, and even in emergency rooms, when having an extra piece of information at a moment's notice can be crucial in saving a life.

The citizens of the South are the ones who snub the health record the most - where in the future they will be able to book appointments or change their family doctor: while 64% of people from Emilia and 53% of Lombardy frequent it, in Apulia and Sicily only 3% do so, while on the consensus front it ranges from 92% yes of people from Emilia and 89% of people from Veneto to a meagre 2% of people from Calabria and 3% of people from Campania. It is on this last point, that of consent, that the short circuit is triggered, without which the file cannot be accessed by healthcare personnel: patients' failure to consent to consultation obviously does not block the services to which they are entitled, but the data and documents contained therein are visible only to the patient himself and to the doctor who produced them, and 'will not be accessed for the purposes of diagnosis, treatment and rehabilitation, international prophylaxis and prevention', warns a message written somewhat in bureaucratic jargon that appears when one opens one's electronic health file, where one can always 'flag' one's consent. On this sensitive point, the Ministry of Health has also organised an information and education campaign for citizens that started a few days ago and will continue throughout the spring.

Access to the patient's health data - according to the latest rules governing its operation (Ministerial Decree of 7 September 2023) - would theoretically be possible, albeit in a limited way, in cases of emergency such as arrival in an emergency room: in these cases doctors and nurses can in fact consult at least the so-called summary health profile (the 'patient summary') in which each family doctor should briefly describe the condition of his patient, such as the presence of a pathology and the therapies chosen to treat it. The problem is that despite the fact that the 31 March deadline also applies to family doctors who are obliged to write the patient summary of their patients, in reality very few have yet fulfilled this obligation, given that at the moment about 3.5 million out of a potential 58 million have completed it. Therefore, there is still much to be done and several family doctors do not hide their reluctance: The Patient Summary "as currently envisaged within the Electronic Health Record 2.0, is not sustainable for general practitioners. We cannot continue to add new tasks for family doctors without taking into account the already excessive workload - says Simona Autunnali, national treasurer of the Snami union -. The manual compilation of the Patient Summary is inefficient and unacceptable. The system must be automated, using the data already present in the SSN. It must be up to the doctor to carry out the final verification and validation, also in light of the relevant medico-legal implications'.