The coordination of care across borders: Exchanging patient information across international, national and institutional boundaries

PhD defence by Patrick Kierkegaard, 24th October 2014, at 13.30 p.m.


Patrick Kierkegaard

Patrick Kierkegaard, PhD at DIKU

eHealth offers enormous benefits to revolutionise health services, deliver better public services and tackle social challenges. Using eHealth can lead to several benefits, notably, the improvement of the quality, access and efficacy of healthcare such as reductions in clinical errors, cost-savings, improved quality of care, avoidance of unnecessary tests, improved work efficiency, reduced waiting times and improvement in the overall efficiency of the healthcare system. Although benefits exists, healthcare organizations have experienced difficulties attaining them and overall adoption of eHealth remains slow. Some of the challenges that is slowing the widespread adoption of eHealth are the technologies unintended and adverse effects on health professionals workflow, legal barriers, fears of depersonalization of healthcare services, high financial costs and difficulties associated with implementing a new system, and uncertainty that the technology may actually reduce overall costs. The coordination of care across boundaries presents a plethora of issues that need to be tackled from a policy, legal, practical research perspective.

This thesis attempts to address pressing issues with a particular focus on the implications health information exchange for the purposes of coordinating care will have on both the patient and healthcare professionals on three levels: international, national and institutional level.

The findings of this thesis imply that in order for cross-border health information exchange to be successful, national level policies, legislations and directives need to be uniformly implemented, harmonized and enforced. This includes those related to patients’ rights, privacy, certification of patient record related software, public information, digital signatures and security requirements.

Based upon the findings of the studies conducted presented herein, the author emphasises that the coordination of care via electronic data exchange can be successful but that several challenges need to be addressed.

Assessment committee:

  • Professor Finn Kensing, Professor, Center for IT Innovation, University of Copenhagen, Denmark
  • Professor Gunnar Ellingsen, Professor, Department of Clinical Medicine, University of Tromsø, Norway
  • Professor Christian Nøhr, Department of Development and Planning, Aalborg University, Denmark

Academic Supervisor:

  • Professor Jørgen P. Bansler, Department of Computer Science, University of Copenhagen