Abstract

Abstract: In the Netherlands, a push for centralized healthcare record access has been ongoing for about 15 years. The Dutch National switching point is a system for pulling records from GP and pharmacist systems from anywhere, at any time, by health professionals that own a healthcare smartcard. A law mandating this system under an opt-out regime was rejected in 2011, but the same system is now pushed forward as the universal standard for healthcare exchange by health insurers, with pressure placed on physicians to get their patients to opt in. In this talk I will shed some light on the political context that drives these developments. I will also discuss a new proposal to counter the potential monopoly of the switching point, that I am developing with GPs in Amsterdam. In this system, decentralized control by GPs is possible through a system that GPs own, and have in their practice under their control. The system implements a distributed capability model that makes use of existing healthcare smartcards for authentication and to implement end-to-end security. This in contrast to the national switching point which not only controls access policy, but which also – by architecture – has the potential to intercept data and to retrieve data from GP systems should (future) policy allow.

Bio: Guido van ‘t Noordende is a Dutch medical privacy campaigner and computer scientist who currently works at the University of Amsterdam. He also heads a start-up that develops the distributed patient record system discussed in this talk. Van ‘t Noordende holds a PhD in computer science from Vrije Universiteit, where he worked with Frances Brazier and Andy Tanenbaum on a distributed mobile agent system.