Creating online personal medical accounts: Recent experience in two developed countries
Journal
Health Policy and Technology
Journal Volume
8
Journal Issue
2
Pages
171-178
ISBN
2211-8837
Date Issued
2019
Author(s)
Saltman R.B.
Abstract
Background: Online personal medical accounts are increasingly viewed as a useful mechanism to both inform and educate patients and citizens about their individual health condition. A number of countries have announced major national projects to put this type of information system in place. Methods: This article adopts a comparative health systems approach to examine the experience of two smaller developed countries – Taiwan and Estonia – that now have universal national medical account systems in current service. The comparison focuses on the structural similarities and differences of both core characteristics of these two health systems and of their specific personal medical account arrangements. Results: While Taiwan has multiple separated systems with voluntary options for patients, Estonia has a single integrated one which is mandatory for all citizens. Further, the Estonian system is more advanced in providing the ability to book or cancel medical appointments. Both systems directly control patients for system management purposes, allow patients access to prior medical records, and reorient the focus of health management from curative toward preventive care. A centralized and technically competent government agency and the political willingness of citizens to grant information-gathering powers to it appear to be essential elements in the successful implementation of these systems. Concerns about individual privacy protection and citizens' ability to decide whether to participate are also discussed. Conclusion: A number of core issues regarding the technical introduction and political acceptability of personal medical accounts remain unresolved and will require considerable attention in the future.
SDGs
Publisher
Elsevier B.V.
Type
journal article