Varuh ДЌlovekovih pravic

Problems with accessing doctors due to electronic appointments

The complainant wrote to the Ombudsman and complained that her mother aged 77 is unable to use the IRIS information system which is being introduced in the Ljubljana community health centre (ZD LJ). The complainant believed that it was unfair towards the elderly to reduce their access to the doctor in such a way. ZD LJ explained that IRIS is a healthcare computer system used by doctors and other healthcare professionals, which enables medical and administrative treatment of patients. The portal for patients represents a safer method of electronic communication, which only replaces current communication by e-mails. The reason for introducing the patient portal lies in the fact that the primary outpatient clinics of ZD LJ have been experiencing an exceptionally large increase in phone calls and e-mails in the last three years, resulting in additional burdening of healthcare staff, so that less time was available for personal treatment of patients. The Ombudsman found that the complainant’s information was not entirely accurate. A superficial assessment without detailed information can sometimes be incorrect and does not convey everything. It must be emphasised that the patient portal only supplements communication by e-mail, while all other communication channels between patients and the outpatient clinic (in person, by phone or by regular mail) remain unchanged.

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The Human Rights Ombudsman of the Republic of Slovenia (Ombudsman) received information from a complainant who made a complaint against the IRIS information system, which was being introduced by the Ljubljana community health centre (ZD LJ). The complainant explained that her mother aged 77 does not, or is not apt to, use an electronic appointment system for contacting her doctor. She does not know how to do this. The complainant believed that it was unfair towards the elderly to reduce their access to the doctor in such a way. She will take care of her mother herself, but believes that not all elderly people have the option to be assisted in doing so. The complainant is certain that the system is not functional for the elderly and gives them a sense of helplessness and does not support them in their efforts to function on their own in their environment.

The Ombudsman contacted ZD LJ to obtain information to clarify the issue.

ZD LJ explained that IRIS is a healthcare computer system used by doctors and other healthcare professionals, which enables medical and administrative treatment of patients. The portal for patients represents a safer method of electronic communication, which only replaces current communication by e-mails. The reason for introducing the patient portal lies in the fact that the primary outpatient clinics of ZD LJ have been experiencing an exceptionally large increase in phone calls and e-mails in the last three years, resulting in additional burdening of healthcare staff, so that less time was available for personal treatment of patients. With the introduction of the system, the healthcare staff was unburdened of administrative tasks. The patients gained the most from this, as the outpatient clinics have more time for personal visits and consultations by phone. Communication by e-mail was frequently non-transparent, unstructured and also unsuitable from the aspect of personal data protection. It also did not permit the exchange of health data if this was not coded accordingly, which caused more problems for patients.

The portal provides an overview of the list of prescribed medications and referrals, ordering of medications and referrals, insight into sick leave and the issue of sick leave certificates, making of appointments for examinations and collection of blood samples in the laboratory. Soon, an insight into medical devices and their ordering will be made possible. In the absence of the selected doctor, the message is automatically received by the substitute doctor. ZD LJ also explained that nothing changes for the patients who are incapable of online communication. Everyone who has not sent e-mails in the past will still be able to come to the outpatient clinic in person, call by phone or send regular mail. Persons who have used e-mails can authorise another person (relatives, carers or friends) to communicate with the outpatient clinic on their behalf, which has frequently been the case before with the use of e-mails. Persons who are not capable of online communication are offered support in person when visiting the outpatient clinic and by phone. Furthermore, the patient portal is also adapted for visually impaired persons.

The Ombudsman found that the complainant’s information was not entirely accurate. We also assume that it referred to the patient portal and not the IRIS system. We find it important to emphasise that a superficial assessment without detailed information can sometimes be incorrect and does not convey everything. From the letter of ZD LJ, the Ombudsman was able to ascertain that the institution is making an effort and helping users to access the portal independently. This particularly refers to those who are not skilled in communicating via e-mails. It must be emphasised that the patient portal only supplements communication by e-mail, while all other communication channels between patients and the outpatient clinic (in person, by phone or by regular mail) remain unchanged. 9.4-46/2022.

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