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Continued extensive use of paper in the exchange of patient information

​The exchange of messages between health trusts, municipalities and medical offices continues to be characterised by the extensive use of paper. Electronic coordination has clearly advanced the most between health trusts and medical offices. - Significant efforts remain to achieve the Storting's goal that all players should have adopted messaging by the end of 2014, says Auditor General Per-Kristian Foss.

Published 3/25/2014 12:30 PM

Document 3:6 (2013–2014) The Office of the Auditor General's investigation of electronic messaging in the health and care sector was submitted to the Storting on 25 March 2014.

The exchange of messages between health trusts and between health trusts and municipal care services is largely characterised by the use of paper, including faxes. There is extensive use of electronic messages between health trusts and medical offices. Nevertheless, patient information is often simultaneously sent both electronically and on paper, which entails the use of double procedures and additional work for the players.

The use of paper and double routines means that the exchange of messages is not performed efficiently, and that the original national targets for the work have not been reached.

Not all required national standards for exchanging messages have been developed. Furthermore, technical solutions already developed have not been adopted by all of the players or are not used in accordance with the intentions. These are major reasons for the continued use of paper in the exchange of messages.

- Nor does the Address Register function satisfactorily. A well-functioning address register is important for ensuring that messages reach the correct recipient and that patient information can be exchanged securely, says Foss.

The Ministry of Health and Care Services' management and use of policy instruments have not been adequately adapted to the objectives, status and challenges in this area.

- To ensure standardised solutions, progress in the implementation of electronic messaging and to facilitate the discontinuation of paper procedures, technical shortcomings and weaknesses must now be addressed and remedied, says Foss.

The Minister agrees with the Office of the Auditor General (OAG) that the Directorate of Health should develop all necessary national messaging standards and will follow up Norsk Helsenett SF's development and improvement of the Address Register. The Minister will also follow up the regional health authorities to ensure that technical solutions are introduced and adopted. The Minister believes that the combined use of policy instruments has fostered positive growth in the use of electronic messaging and that there has been considerable activity among the players since 2012. The Minister announces a review of ICT organisation in the health and care sector.

While the OAG agrees that there has been an improvement since 2012, it considers that there is still a need for significant efforts to achieve the goal that all players must have established electronic messaging by the end of 2014. The Ministry of Health and Care Services should strengthen the overall policy instruments to ensure progress in the work of ensuring that health trusts, municipalities and medical offices establish efficient and secure electronic messaging.

You can download the document through the link to the right.

The deferral of public access to documents prepared by or for the Office of the Auditor General in connection with Document 3:6 (2013-2014), cf. the Act relating to the Office of the Auditor General section 18 second paragraph, is hereby set aside.

 Contact person

​Director General Therese Johnsen, tel +47 22 24 11 74/+ 47 911 52 826

Riksrevisjonen, Storgata 16, P.O. Box 8130 Dep, 0032 Oslo, Norway

Phone: +47 22 24 10 00

Org.nr: 974 760 843