Il Electronic Health Record (FSE) is a tool based on a computerized system capable of collecting and managing the health information of each individual resident in Europe. It was created with the aim of improving the efficiency and quality of healthcare, allowing the rapid and secure sharing of data between operators and facilities.
The mechanism underlying the ESF is rooted in the need to modernize il healthcare sector, improve continuity of care and optimize the management of clinical information. The Electronic Health Record allows information such as medical history, test reports, therapies followed, allergies and other important data on the health of each individual citizen to be stored in a structured and accessible way.
What is the Electronic Health Record and when was it born
Thanks to its ESF staff, each citizen can monitor and consult the entire history of their “health life”, sharing it with healthcare professionals to guarantee a more effective and efficient service. L’idea of the File dates back, from a legislative point of view, to 2012 (article 12 of Legislative Decree 179/2012) and in Prime Ministerial Decree no. 178 of 25 September 2015 is part of a range of activities relating to the provision of health services: from prevention to verification of the quality of therapies.
The Electronic Health Record is embraced in all Europen regions (including autonomous provinces), although the methods of implementation and the services offered vary, in many cases, even significantly. References to the regional files are available on this page on the website set up by AgID (Agency for Digital Europe).
In the most updated versionthe ESF provided by the regional body contains the following:
- identification and administrative data of the patient (exemptions due to income and pathology, contacts, delegates)
- reports
- emergency room reports
- resignation letters
- summary health profile
- specialist and pharmaceutical prescriptions
- medical records
- supply of medicines paid for by the NHS and not by the NHS
- vaccinations
- provision of specialist assistance services
- personal notebook of the patient
- card data for implant recipients
- invitation letters for screening
Not all Dossiers, however, currently offer this level of detail which will be gradually activated in the months to come.
Patient summary and personal notebook
Furthermore, each personal ESF contains the so-called patient summary i.e. the synthetic health profile. This is a document drawn up and updated by the general practitioner or pediatrician which summarizes the patient’s clinical history and her situation. In this way, even when the citizen is far from his place of residence, any doctor or professional can consult his essential information and ensure continuity of care.
The picture of the functions integrated into the ESF is completed personal notebookan area not endorsed by any healthcare professional that the patient can use to integrate additional information on his health status and the path followed.
The Electronic Health Record 2.0
We have said that each Region has adopted and is continuing to implement its own version of the Electronic Health Record. In some cases, for receive electronic prescriptions via email or SMS (documents can still be downloaded after logging in to the ESF) an additional procedure is required. Usually it is enough to access your personal file and then confirm your subscription to the service.
According to the statistics published on the official website of the project, there are over 57 million ESFs activated in our country in total, a very high number which is almost equal to the total of resident population. The actual use by the patients, however, is really another thing. With a large part of the citizens still unaware of its existence.
With the Electronic Health Record 2.0 we want to take a further step forward. The main mission looks atinteroperability between the ESFs of the various Regions. In other words, we want to ensure that the information entered into the ESF can be managed from anywhere and not just in the region of residence of the patient.
Look at the most updated FSE technical specifications: as per regulatory indications, the platform is provided at a central level to activate “bridges” between the various regional FSEs and standardize data management methods.
Access to the ESF: how it happens and who can do it
The interested citizen obviously has the possibility to log into, using the most suitable method for your personal ESF. You can do this by performing aauthentication via SPID and CIE or with the TS-CNS or, again, using the credentials issued by the local health authority.
The simplest and fastest way to carry out authentication consists in using SPID and CIE: once one of the two tools has been obtained, entry into the ESF takes just a few moments. In the case of SPID simply make sure you understand how entering the confirmation code generated on your mobile device works (received via SMS or OTP code generated through a dedicated app). This code is used as “second factor” for authentication, after entering the correct username and password.
The other subjects who can access
In addition to the patient, with his explicit consent, the contents of the ESF can be viewed by others health professionals (public and private) that intervene in the treatment process. Using the ESF administration panel, however, the citizen can specify in a rather detailed manner which subjects can or cannot access his health data (and even delegate a third party, for example a family member; a very useful aspect for elderly or vulnerable).
The Regions and the Ministry of Health for government and research purposes can themselves access the contents of the Dossiers. In these cases, however, the direct identifiers of the patients are not detectable, in compliance with the principles of indispensability, necessity, relevance and non-excess.
The aspects related to privacy that intersect with the management of the ESF are clarified on the page set up by the Guarantor for the protection of personal data.
What is opposition to precedent
Until the June 30, 2024unless further extensions are made, citizens can make use of a new feature of the Electronic Health Record 2.0, namely the possibility of opposition to the past. That is, patients can express an opinion against the inclusion in the ESF of data concerning their health and which were collected before 19 May 2020 (services provided by the NHS on prior dates). The opposition can be expressed through the Health Card System (TS) website.