[Patient group-specific data sovereignty needs and acceptance of electronic health records]. / Patientengruppenspezifische Datenhoheitsbedürfnisse und Akzeptanz der elektronischen Patientenakte.

BACKGROUND AND AIM: People in Germany are very sensitive about their health data. The electronic health record (ePA) also raises questions about the patient's need for data sovereignty and acceptance. The possibility of selectively withholding data stored in the ePA from physicians who continue to treat the patient (opt-out) and the patient's prior knowledge of the ePA could influence the need for data sovereignty and acceptance of the ePA. The aim of this explorative study is to investigate these influences for three patient groups: "acute patients," "diabetes type 2 patients," and "palliative patients," as differences are expected between these groups. MATERIALS AND METHODS: From August to October 2019, a quantitative survey was conducted among 140 patients in the abovementioned groups. RESULTS: Of the respondents, 76.0% supported the selective opt-out option and stated that this would increase their willingness to participate in the ePA. Specifically, 81.1% of acute care patients, 80.6% of palliative care patients, and 65.6% of type 2 diabetes patients made this statement. Differences between groups were not significant. A general prior knowledge of the ePA was related to a higher need for data sovereignty - 43.2% of those who had never heard of the ePA rollout would occasionally hide their health data from other physicians, compared with 54.5% who knew of the rollout. DISCUSSION: Consideration of the data sovereignty needs of patients in the further establishment of the ePA is recommended. The selective opt-out option can contribute to acceptance. Knowledge of the ePA should be expanded, especially in the doctor-patient discussion, to enable an informed decision.

Potential Interactions of Medication Prescribed in Discharge Letters from a Clinic for Hematology and Oncology.

BACKGROUND: As there are few data worldwide concerning the frequency and relevance of interactions of prescribed drugs in hemato-oncology, we analyzed the medication prescribed to patients at a clinic within a comprehensive cancer center. METHODS: Details of the medication prescribed for all patients in 2011 were extracted from their discharge letters. All potential medication combinations were assess with respect to the risk of interaction using 3 specialized websites. RESULTS: The files of 202 patients receiving 275 drugs were extracted; 4,303 drug combinations were created. Overall, 88% of these combinations were found to be harmless with an interaction value (IV) of 1. However 10% showed potential risk of probable interaction (IV 2 + 3). 47% of the patients had at least 1 drug combination with a risk of interaction. A maximum of 29 drugs with 15 probable and possible interactions were found. CONCLUSION: Awareness for this topic should be raised in physicians and patients. An important step for avoiding risks of interactions is a systematic check of all drugs prescribed. There is urgent need for reliable data on clinically relevant interactions and for a better network in which physicians and pharmacists can exchange data about relevant interactions.