The Swedish eHealth Agency has finalised its feasibility study on digital national infrastructure for national quality registers. The final report contains several proposals that are expected to contribute to a more coherent digital infrastructure for quality registers. These proposals also have the potential to be utilised more widely in health, medical care and social care.
Systematic improvement activities within healthcare and scientific research require access to accurate and up-to-date information about, for example, treatments, diagnoses and outcomes for a large number of patients. A significant part of this information is brought together in Sweden’s approximately one hundred national quality registers. These have been developed over a long period of time and have put Swedish health care and research in a strong position.
In order to operate quality registers in a secure and efficient manner, a well-functioning digital infrastructure must be available. The current infrastructure consists of many, often fragmented, parts. This situation is a contributing factor to the three proposals that the Swedish eHealth Agency has presented in its feasibility study.
Many actors involved in the study
In September 2021, the Swedish eHealth Agency was commissioned by the Government to carry out a feasibility study on how the Agency could provide a national digital infrastructure for the regions and municipalities that operate national quality registers. To respond to the instruction, the Agency carried out problem and needs analyses in dialogue with a large number of actors. The commission was partially reported on 1 June 2022 and finally reported on 1 February 2023.
The aim of the government commission was that the contents of the registers should be put to greater use, while reducing administration.
In its final report, the Swedish eHealth Agency proposes that the Agency, in cooperation with relevant actors, establishes and is responsible for a national body for interoperability in healthcare and health and social care. The intention is that this national body for interoperability will promote the development of common specifications together with the other actors involved. The increased use of common specifications is a prerequisite for the automatic transfer of information to the quality registers and for reducing manual administration. Research will also benefit as these specifications may contribute to increased interoperability and higher data quality.
Automated transmission requires secure communication
The Swedish eHealth Agency further proposes that a national interoperability solution be developed. This solution for interoperability should be based on common specifications and offer various technical services in healthcare and health and social care, including the secure and efficient communication required for the automated transfer of information from healthcare IT systems to the technical platforms of the quality registers. Ultimately, the eHealth Agency sees other needs that can also be supported, such as the interoperability solution could also be used to support the information provision requirements that arise from the European Health Data Space (EHDS) Proposal.
There are currently 17 different register platforms, which makes interconnection between different IT systems difficult. The eHealth Agency therefore proposes a state national register platform with associated operational support. This proposal is expected to increase the degree of standardisation, accelerate the consolidation of register platforms and reduce costs over time.
These proposals for a national state register platform and interoperability solution are comprehensive. This means that there are issues that could not be dealt with within the scope of this feasibility study. As a result, there are also proposals that the eHealth Agency be tasked with continuing to work with the relevant actors on these issues.
The Swedish eHealth Agency is a government agency that works to digitalise and improve the sharing of information between patients, the healthcare system and pharmacies in Sweden.
It offers a number of e-health services and digital solutions for individuals as well as staff working in healthcare and social services. The e-prescription service and the Covid certificates service are the most well-known.