Electronic Health Records In The Netherlands, Luctor Et Emergo: What Emerged After A Decade Of Struggle?

We present a ten-year-update of the EPR-orientation-model for success of Electronic Patient Records (EPR’s), based on our research. An EPR is seen as a way to make healthcare more efficient and effective. Many initiatives lead to the implementation of EPR’s, but also regional infrastructures for informationand network services are realized. The law to realize a national EPR is rejected by the Dutch Senate, however. The EPR-orientation-model characterizes EPR in three orientations: administration, medical technology and care process. The developments in the last decade in the Netherlands are described in relation to the orientations. This leads to the extension of the model with external relations and the enlargement of the intersection between the administration orientation and care process orientation. The four criteria for a successful EPR from the end-user viewpoint are updated to five criteria. In order to be successful an EPR must: 1. Be micro-relevant to the end-users; 2.Provide complete and integrated patient data; 3. Be available and accessible anywhere and anytime; 4. Contain active elements, like alerts, decision support and workflow management; 5. Register data necessary for quality and finance, without extra effort for the care providers.