The Austrian Medical Association (Österreichische Ärztekammer - ÖÄK, in German) has sent a letter to the authorities to help with the resolution of outstanding issues surrounding the implementation of ELGA (Elektronische Gesundheitsakte), Austria's electronic health records project, it was announced on 1 February 2012. The letter was sent to federal and provincial politicians, opinion leaders and disseminators.
In the letter, ÖÄK President Walter Dorner reaffirms its agreement in principle with an electronic data exchange in the medical field, but stresses at the same time that the present draft of the law "needs a thorough revision, to which ÖÄK wants to contribute". ÖÄK believes that there are still many unresolved, technical, organisational, financial and legal issues. In addition, in its current form the ELGA project is deeply unpopular with the medical profession. Dr Dorner reports that a survey of Vienna doctors found that 95 % of respondents were opposed to the present draft of the law.
ÖÄK offers its expertise to resolve these issues, to achieve consensus and thus the acceptance of the medical profession.
In response to the criticism that "only sporadic talks" about technical issues had taken place, the Ministry of Health set up a joint working group that met recently in late November 2011. Regarding data protection, however, there has been no progress. ÖÄK proposes the employment of the GIN (GesundheitsInformationsNetz) health information network, which has been used without problem for the eCard (the Austrian eHealth insurance card). ÖÄK considers this an attractive possibility since GIN has proven to be safe and effective for ten years.
ÖÄK also has concerns about the cost of ELGA. Indeed, it does not see ELGA as an austerity programme, but "a significant cost burden". It doubts the cost-benefit calculations produced by the Ministry, and is also concerned that no business meetings have taken place on this issue. "Our calculations show no savings, but excessive cost burdens on the budgets of federal, state and social insurance," says Dr Dorner. ÖÄK believes that even the medical benefits have not yet been reliably substantiated.
Regarding the hospitals, ÖÄK sees particular problems arising from the 24-hour operation and ELGA availability - what ÖÄK want here is a legal guarantee. Also, the specific procedures at the hospital must be regulated more precisely; even so there is a fear that the use of ELGA in hospitals could lead to significant delays in treatment. The internal hospital IT systems are already reaching capacity, and will in future need to process external information. Without a large-scale upgrade of these systems, this does not seem achievable.
Finally, the letter raises a legal issue. It views the proposed form of participation - compulsory for doctors and the right of refusal for patients - as constitutionally hard to maintain. ÖÄK believes that both groups should be participating voluntarily.