POLITICS & INSTITUTIONS - ECONOMY

Luxembourg adopts paperless medicine, but at what cost?



As Luxembourg’s online public health department eSanté launches a platform designed to better coordinate paperless medical records, so patient data accrues value. Shutterstock

As Luxembourg’s online public health department eSanté launches a platform designed to better coordinate paperless medical records, so patient data accrues value. Shutterstock

Already established as a financial centre and recently entering the space industry, Luxembourg is now forging ties with the rapidly expanding domain of medical data.

As Luxembourg’s online public health department eSanté launches a platform designed to better coordinate paperless medical records, so patient data accrues value. The shared medical electronic records or DSP (données de soins partagés) will improve the fluidity of the current specialist referral system and the coordination between medical centres while securely sharing patient information.

Designed to create a seamless process for patients, organising follow-ups will be easier, services will benefit from transparency of care, and communication between doctors will be faster. The added benefit of a system with such clarity is the reduction in poor drug prescribing. The patient role will also require adjustments, as emphasis is placed on understanding and directing one’s own care. 

A key point is that the referral system currently applies to patients with one of the 32 selected chronic diseases. Therefore, patients suffering with long-standing Parkinson’s, for example, will only be enrolled after consenting to share their data. The doctors enrolled will, in turn, have to agree to partake in the scheme. The specifics regarding which documents will be shared amongst various teams and which will be kept solely in the archives of individual doctors remain to be determined. 

Part of an ongoing diligent process, this initiative began in 2006 and has been in a pilot phase since 2015. It now comprises of 850,000 affiliates of the Caisse Nationale de Santé, four medical centres, including the CHL, and involves 237 healthcare professionals. To add to this structure, laboratories are also involved in trialling the exchange of 175,000 medical documents. So why is this a hot topic now?

By 2020, the DSP aims to be fully functioning, free for all, and secure. The key areas to tackle are patient identity verification, interoperability between various institutional systems and the legal framework.

It would appear that at present the legal aspect of the project is hindering it; however, the legal framework is what is imperative, as the risk of data security breach is inevitable. The takeaway for Luxembourg from other European healthcare institutions in the wake of paperless medical records is not to cut corners in this domain. From ransomware attacks in German hospitals to the WannaCry attack that cost the NHS millions in the UK, the main concern and focus for the launch of DSP is security.

With hacks on the rise, patient data has become invaluable. The latest Carbon Black report regarding medical data security highlights how this risk is very tangible. Medical data is inexpensively sold on the dark web. Hackers have the tools to shut down access to patient data or prevent medical institutions from accessing critical systems as evidenced by other nations.

While the digitisation of health records increases so does the power of a security threat. With 83% of healthcare physicians having experienced a cyberattack within their institutions, according to the 2019 Carbon Black report, threats are predicted to become more sophisticated. As almost half of these threats are in the form of data destruction and ransomware, Luxembourg must ensure it trains relevant staff adequately if it is to protect the launch of its DSP. 

Dr Lilani Abeywickrama is a Luxembourgish ophthalmologist currently based in London. Her main interest is advocating healthy living and precision technology within her specialty and is pursuing her interests in the field of healthcare management.