Denmark Patient portal

Sundhed.dk: A National Healthcare Portal

Since year-end 2003, Denmark has had a healthcare portal, Sundhed.dk, which is funded by the same organizations as MedCom. The portal was developed by IBM Acure and runs on an IBM WebSphere portal server, WebSphere application server and DB2 database. The content is contributed by the stakeholders (principally the counties and local authorities).

As part of the Danish health care sector, sundhed.dk plays a crucial role in supporting transparency and patient empowerment and providing health professionals with the possibility to access patient health data residing outside of local systems and across sectors and boundaries. This contributes greatly to the delivery of more coherent and effective health care for Danish citizens.

The functionality of sundhed.dk has been regularly extended and improved with the inclusion of new services and information. As a result, there has been a clear and measurable increase in the use of sundhed.dk such that in the first quarter of 2019, there was an average of 3.9 million total visits per month (from citizens and health professionals combined). This represents a significant portion of Denmark’s population of 5.8 million people who are accessing the portal each month.

In terms of technical design, sundhed.dk is based on a federated IT-architecture that integrates with local systems. That is, sundhed.dk displays data from more than 120 different sources without storing or duplicating data. This ensures that timely, efficient and secure requests to display citizen health data are achieved as well as high accessibility to the portal across different end-user platforms (PC, tablet and mobile phone).

Clinicians can view the same information as patients. In addition, they can view clinical knowledge (the Cochrane Library), job listings, laboratory test results (a pilot project) and guidelines for referring patients to hospitals.

The portal uses a public-key infrastructure for security. Access by patients requires a digital signature; 650,000 have been issued to date. Patients store the digital signatures on their personal PCs and can also transfer them onto thumb drives if they wish to access the portal from another PC.

Access by clinicians or pharmacies requires special security certificates. Patients can view the name of the person viewing their data, the date and time of the access, and the action taken.

In theory, Danish patients have to give explicit consent each time data is shared, they are allowed to choose which clinicians can access their medical records, and they are allowed to restrict access to data on mental and sexual health. In reality, patients are encouraged not to exercise these powers. Consent to share data is requested only when the patient changes physicians or hospitals.

Feature of Sundhed.dk

• In a secure part of the website, the patient has access to personal health data on treatments and notes from hospital records, information about medicine and about visits to the GP etc.
• Access to various e-services including making appointments with GPs, prescription renewals and electronic communication with the GP.
• Access to information on waiting times at all public hospitals and ratings of hospitals in terms of patient-experienced quality and service.
• Patient networks give the patient the possibility to discuss their own disease, treatment etc. with other patients with a similar diagnosis, especially relevant for patients with a chronic disease.
• Access to sundhed.dk´s handbook for patients, which consists of 3.000 articles with information on diseases and treatment
• The main entry for access to existing patient data that is not already accessible in the health care professional’s own EHR system. This typically includes access to data in e-Journalen and the Shared Medication Record. Every access is logged with information on time of access and the name of the health care professional’s organisation.
• Access to the professional version of sundhed.dk´s handbook for physicians, covering a wide range of health care with articles, guidelines, educational programmes, tests, video animations etc.