Research Article Open Access Quality in Primary Care (2017) 25 (5): 267-272 Research Aricle 2017 Insight Medical Publishing Group Satisfaction of Medical Doctors in Handling the Citizen’s Electronic Health Record Nando Campanella Telemedicine Unit of Amazonas State University, Manaus, Brazil Sandro Novelli NBS s.r.l, San Benedeto del Tronto, Ascoli Piceno, Italy Pierpaolo Morosini Department of Internal Medicine, NBS s.r.l, San Benedeto del Tronto, Ascoli Piceno, Italy Guido Sampaolo Marche Region Health District, Italy Harold Wright Internaional Department of the University of the state of Amazonas Objective: To estimate the extent that medical doctors and citizens make use of an application of electronic health record (EHR) over 2013-2015. Materials and methods: Since 2006, the citizens of the health district of Ascoli Piceno (Italy) have had their own EHR assembled by retrieving health data from databases from all the health facilities available. EHR data consulting occurs through account subscription and log-in. Permission is given according to the professional proile of each subscriber. Results: The Primary Health Care doctors normally remained logged in for 72-76 min per working day and the Emergency Department Doctors for 255-280. The Hospital Clinical Unit Doctors had been navigating through the EHR application for 5-5.5 % of their working time. 56% of the Outpatient Care Specialists logged in. Only 13% of the citizens subscribed to an account. Conclusion: Within the context of a uniied and universal health system, the medical doctors are increasingly using the EHR. Keywords: Electronic health record; Navigation time; Health system; Primary health care; Secondary health care; Referral; Transition care; Emergency department; Outpatient care specialist ABSTRACT Abbreviaions: HER: Electronic Health Record; HL7: Health Level Seven International Organization; IHE: Integrating the Healthcare Enterprise; LAB-Rep: Database of the Laboratory test reports; LDAP: Lightweight Directory Access Protocol; PHC: Primary health care; PIN: Personal Identiication Number; RAD-Rep: Database of the Radiology Test Reports; RFID: Radio Frequency Identiication; SAML: Security Assertion Markup Language; SD: Standard Deviation; SHC: Secondary Health Care; XDS.b: Cross-Enterprise Document Sharing IHE Integration Proile Background and Signiicance Electronic Health Record (EHR) is a term used to portray a “repository of information regarding the subject of care in machine-processable format” [1]. However, the meaning and representation of the EHR changes throughout the different reports in the literature [2,3]. This case study focuses on the concept of citizen’s EHR (National Patient Registry) [4], which is a repository of health data and information in electronic format, being referred to any user of a uniied and universal health system, or rather, for all the residents of a health district. Such health systems most commonly represented in Western European countries and in Brazil, are bound by law to provide all citizens with medical care under three referral levels, namely: Primary Health Care (PHC), Secondary Health Care (SHC), including hospital in-patient care and outpatient care and Tertiary Care (highly specialized care). Whenever the patient is referred or counter-referred from one level to another (transition care), the vulnerability to medical error increases, due to the loss of information on the past and present clinical situation [5]. The citizen’s (becoming the patient’s with illness) EHR is intended to be the source of updated health information of the highest degree of objective reliability and legal force, according to the national regulations [6]. Such a tool enables the acting health professional to become quickly aware altogether of the clinical history, of the clinical tests reports (laboratory, radiology, pathology, etc.) and of the previous therapeutic prescriptions with poor or no support from the patient’s often uncertain memory. Thus, the databases, feeding into the citizen’s EHR in real time, must be fully interoperable, cleaned, updated and legally cleared by authorized health system oficials [7]. Afterwards, the health professional can provide a diagnostic and therapeutic strategic approach, according to a holistic vision of the patient, minimize the probability of mistakes and maximize the continuity of care.