Bianca Rouwenhorst: 'Don't wait for nationwide network coverage'

The Ministry of Health, Welfare and Sport is working on standards and a national network for data exchange. But Bianca Rouwenhorst urges health care providers and suppliers not to wait. "Pick up the gauntlet and get started now," she says.

What is the Ministry of Health, Welfare and Sport's digital strategy for the coming years? A question that concerns a lot of people, given the great interest in the keynote by Bianca Rouwenhorst, director of information policy and CIO of VWS. All the chairs were taken, people were sitting on the floor at the sides and even outside the fences interested parties were lined up to listen.

Trust as the most important pillar

"For digital transformation, data sharing and data availability, trust is one of the most important pillars. If we do nothing about that trust, then we can all want to create a digital transformation, but then we are doing it for nothing." The concept of trust is therefore central to the National Vision of Data Availability: healthcare providers must be able to trust that data is current and good, citizens must be able to trust that their data is being handled properly and securely.

Reliable infrastructure

But getting there requires, first and foremost, a reliable infrastructure over which data can flow properly and safely. "You shouldn't want to build that nationwide 'road network' yourself as a sector. That should be a public function." That is why VWS is working with a national coalition on such a nationwide network.

Such a network must have at least some generic functions: identification & authentication, authorization, permission, localization, and addressing. "These five generic functions will be technically ready and implementable by 2025, this year," Rouwenhorst announced.

Opt-out system

About that permission to share data: with the advent of the EHDS, the Netherlands is opting for an opt-out system in (mandatory) imitation of European rules. "The consent function will become opt-out in a couple of years, we just wrote in a letter to the Lower House. So if you object, you have to start registering that."

Rules and agreements

In addition to the generic functions, rules of the game and agreements are needed for a properly functioning infrastructure, Rouwenhorst explains. "We have chosen to use one agreement system for that. That is Twiin." The first healthcare institutions are already joining that standard, according to Rouwenhorst.

But even with a national infrastructure and a Twiin standard, you're not there yet, continues Rouwenhorst. "Different systems speak in different languages. But for data to flow securely, you need unity of language and unity of technology."

Setting standard by law

SNOMED and LOINC are those kinds of standards. "I can tell you here that we are looking into the extent to which we need to make that a legal requirement. Then we are going to mandate the use of these standards in this way. But I urge you: don't wait until that legislation is done. See what you can already do with it now in your own information systems."

More direction

The purpose of a reliable and secure data sharing system is to give citizens more control over their own data, Rouwenhorst said. "Imagine how we can increase patient safety by also allowing citizens to participate in keeping the data up-to-date."

This, of course, must be done in a secure manner. The NEN7510 standard is mandatory, "but it is shocking how few healthcare institutions can actually meet that obligation."

PBMs from private market players

This will happen in several ways. Similar to the individual pension statement, there will be a "my health statement," where everyone can see their data. Free of charge, the same for everyone, as a public government function. Then there are the PBMs - the personal health environment - offered by private market players, free or paid, with the user choosing what suits him or her. "That's really up to the market to develop that."

'Get to work'

With a clear call to action to all those healthcare professionals, suppliers and companies that had flocked, Rouwenhorst concluded her keynote. "Don't wait until we have that nationwide network. You can do things yourself right now. Pick up that gauntlet: delve into the WEGIS and the EHDS. Get to work on unifying language and technology. Work on data quality. Get off that stand and get in the ring!"