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Electronic health record

An electronic health record (EHR) is a longitudinal record of a patient’s health information that is completed following contact with healthcare actors. The record ideally includes data from all clinicians involved in a patient’s care.

For many years, the Belgian government has recognised the need for the widespread deployment of EHRs so that information can be easily shared between healthcare providers and organisations. A Belgian eHealth action plan was launched several years ago. One of the action items relates to the roll-out of EHRs in hospitals. 

To learn more about the eHealth Action Plan, visit: https://www.ehealth.fgov.be/fr/page/plan-d-action-esante-2022-2024

The goal is to achieve an integrated EHR in which:

  • messages are exchanged between systems;
  • different functions are implemented within one integrated system.

In any case, core functionalities should be integrated and data should be captured and managed according to the Original Source Principle. This means that the information is not duplicated and is retrieved from the original source.

The chart below shows an overview of the core functionalities of an electronic health record and the level of implementation by December 2022 in general hospitals.

 
Core functionality rollout in general hospitals (%)

Effective data exchange is necessary not only to promote quality of care but also to accelerate the digital transformation of healthcare. This is relevant in order to solve two key bottlenecks:

  • the large record-keeping burden of healthcare providers 
  • a lack of information that healthcare providers and patients now face.

Moreover, the transformation towards a more data-driven organisation is crucial when it comes to enabling innovative solutions based on clinical decision-making support, machine learning and artificial intelligence.

       

       

     

A programme of financial incentives was established to promote the roll-out of EHRs. To that end, a number of Belgian Meaningful Use Criteria were defined in consultation with hospitals. In July 2022, €57 million was distributed amongst the country’s general hospitals. The budget was distributed according to the level of use of the various functionalities in the EHR.

In most areas, retrieving, aggregating and converting information into valuable insights is still a lengthy and manual process. This is due to various obstacles related to data exchange between information systems of different providers. Interoperability is important, partly because, in practice, patients often consult multiple healthcare providers during a care pathway and because information exchange between healthcare providers is crucial for optimal treatment.

The chart below shows the share of software providers for EHR as a function of the size of the hospitals[1]. Zorgi and Nexuzhealth are currently the largest providers, providing software to two-thirds of the market.

Share of software providers for EHR retrieval as a function of hospital size

                                                                                                                                                                 

 

[1]The size of hospitals is determined by the number of accredited beds.