Patients' Online Access to Electronic Health Records: Current Status and Experiences from the Implementation in Sweden.

The number of eHealth services for patients is rapidly increasing worldwide. This paper describes the status of a very important eHealth service for patients in Sweden, the Patient Accessible Electronic Health Record (PAEHR). As many countries are facing an introduction of national eHealth services providing health information to the patients, lessons learned from Sweden may improve the deployment and use of PAEHRs and similar eHealth services. Challenges that remain in Sweden relate to local differences in the implementation that lead to fragmentation and unequal access to information. Initiatives have been taken to reconcile some of the problems, e.g. an updated national regulatory framework for PAEHR. To date, evaluations are often performed from a healthcare provider perspective, focusing on aspects that are considered important by healthcare professionals and decision makers. Based on experiences of this nation-wide implementation we argue for the need to also base evaluations of eHealth on the perspective of the patients.