Article Preview
TopIntroduction
Nowadays, Information Technology (I.T.) is involved in improving the quality of diagnostic and therapeutic health services (Clemensen, Larsen, Kyng, & Kirkevold, 2007). Important reforms in this area include the establishment of health information coding, recording, storage and management of health information systems such as e-prescription (Kierkegaard, 2012) and e-health records (Pagliari Detmer, & Singleton, 2007). However, in order to take advantage of the capabilities of these systems, we need to take into account their proper management, reducing distortions, and following a protocol of consensus guidelines.
An important element of disease surveillance, prevention and treatment is the interoperability of these information models, which aims to improve the collection, exchange, and processing of data, and to disseminate results in a single and effective way (Brailer, 2005).
The E-Health Card is one of the most innovative projects available in health information systems and contributes to the evolution of health care services (Blobel, Pharow, Spiegel, Engel, & Engelbrecht, 2001). This project serves storage of medical information easily and securely, supporting direct access to them, ensuring confidentiality and is compatible with all computer systems, networks, and applications. The shape of this smart card is in the form of a plastic card with an integrated circuit on its surface, necessary for storing and controlling information, and a microprocessor for processing computer tasks.
Focusing on health technology in Greece, we note that the Electronic Health Card model does not apply to the public. In order to apply this system in the country, it is necessary to investigate the state of the art of healthcare technology, based on the legislation in this area.
The first was the online prescription of medications and the referral of medical tests, which was introduced by the Greek Law 3892/2010 (Chouvarda & Maglaveras, 2015), and is an important reform with the aim of upgrading healthcare. However, the increased pharmaceutical costs and the lack of proper and coordinated health policy are factors of the ineffectiveness of the patient seeking services. The immediate next reform acting on these impacts is the implementation of the electronic health record, technology-based patient history, coordination of care and its effectiveness, as mentioned in article 5, paragraph 3e by the Greek Law 4238/2014 (Entzeridou & Mollaki, 2018). An additional reform was essential for the progress of health services performed in primary health care through the adoption of Law 4486/2017, which replaced the primary health care structures and integrated local health units (Platis & Kyritsi, 2019).
Following this progressive course of health information in Greece, it is clear that the implementation of the Electronic Health Card is an important innovative step in upgrading this technology in the country. The idea of this system may have been initiated by testing Diabcard (Engelbrecht & Hildebrand, 1997) at a single general hospital in a pilot form, but its evaluation at the time showed that there was a need for improvement and further testing in terms of speed and functionality.
The first study on this topic was published by Morgan Jones, and Owen (1993), who analyzed how psychiatric patients with a tendency to self-injury are affected, using the card for immediate access to therapists' history. Another study in the US focuses on people with chronic diseases using the model to obtain useful information (Schwartz, Peng, Lester, Daltroy, and Goldberger, 1998). There are also further studies carried out in the Asian continent, but also in more developed countries such as Germany, Australia, and Austria, showing the benefits for healthcare. A study by Protti, Johansen, and Perez-Torres (2009) explored the application of health cards in primary schools in countries such as Denmark, Canada, New Zealand, and presents it as a major reform of information technology supporting primary services.