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The availability of electronic health data favors scientific advance through the creation of repositories for secondary use. Data anonymization is a mandatory step to comply with current legislation. A service for the pseudonymization of electronic healthcare record (EHR) extracts aimed at facilitating the exchange of clinical information for secondary use in compliance with legislation on data protection is presented. According to ISO/TS 25237, pseudonymization is a particular type of anonymization. This tool performs the anonymizations by maintaining three quasi-identifiers (gender, date of birth, and place of residence) with a degree of specification selected by the user. The developed system is based on the ISO/EN 13606 norm using its characteristics specifically favorable for anonymization. The service is made up of two independent modules: the demographic server and the pseudonymizing module. The demographic server supports the permanent storage of the demographic entities and the management of the identifiers. The pseudonymizing module anonymizes the ISO/EN 13606 extracts. The pseudonymizing process consists of four phases: the storage of the demographic information included in the extract, the substitution of the identifiers, the elimination of the demographic information of the extract, and the elimination of key data in free-text fields. The described pseudonymizing system was used in three telemedicine research projects with satisfactory results. A problem was detected with the type of data in a demographic data field and a proposal for modification was prepared for the group in charge of the drawing up and revision of the ISO/EN 13606 norm. [ABSTRACT FROM PUBLISHER]

A multicentre trial of a Web-based personal electronic health record (pEHR) service was conducted in three different European hospitals. A total of 150 patients and 22 health-care professionals were involved. The service was customised according to the needs of three groups of patients who had congenital heart disease, Parkinson's disease and type 2 diabetes. Two structured questionnaires, one for patients and one for health-care professionals, were used to collect their views on the pEHR service. The questions were about usability and user friendliness, safety and trustworthiness, reliability, functionality, satisfaction and the potential revenue model of the service in the case of future deployment. Patients perceived the service as very motivating and felt that it could help them in managing their clinical information. Health-care professionals showed a very positive attitude towards the use of the service and its potential for future large-scale deployment. They were also keen to recommend the service to their patients. Both study groups were unwilling to pay for the service and preferred it to be sponsored by a third party (e.g. the National Health Service). [ABSTRACT FROM AUTHOR]