The future of the national virtual EPR in the Netherlands: Changes in approaching large-scale exchange of information in Dutch Healthcare

Abstract

This paper outlines, in brief, how a major project to establish a national virtual electronic patient record (EPR) in the Netherlands was cancelled by the Dutch senate, but could restart as a private initiative in an altered form and with a different intention. The infrastructure that was realized to support this virtual EPR - the Landelijk Schakelpunt (LSP, National Interaction Router) - as well as Aorta, the architecture of the information-exchange, could, fortunately, largely be reused. However alterations had to be made. How does this differ from the governmental EPR project and what are the similarities that could be maintained? In the Netherlands, chain-computerisation is a field of research developed by Professor Jan Grijpink at the University of Utrecht. In this paper, we wish to elaborate on a few of his central ideas, namely: that 'the dominant chain problem is the actual 'boss' in the chain' and that one has to 'keep the concept as lean as possible' in order to be successful. Once we adhere to these precepts, we see some major improvements: firstly in the way participants in the chain contribute to the shared goals and, secondly, in the way the infrastructure is set up as a multifunctional platform which can, therefore, more easily meet the practical demands of the participants.This paper is divided into two sections. The first section provides an overview of what preceded and briefly explains what the infrastructure is about. The second section sketches the change of strategic approach in relation to the two above-mentioned precepts in chain-computerisation.