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Chapter 60
DOI: 10.4018/978-1-4666-8756-1.ch060
Political Attitudes on the Dutch
Electronic Patient Record
ABSTRACT
In the Netherlands, the introduction of a nationwide electronic patient record (EPR) infrastructure was
rejected in 2011 after a heated political debate. Such debate is infuenced by the political attitudes of
politicians and voters, such as their trust in governments. The objective is to explore the relation between
political attitudes of individuals and the priority they give to health privacy. The method is from a new
survey that was developed; the Health Privacy and Political Attitudes Survey. The survey is as compatible
as possible with a few well-known surveys. With 218 respondents enough data was collected for a frst
explorative study. Little correlations were found between political attitudes and the individual’s priori-
sation of health privacy or their trust in a nationwide EPR. In general, most respondents valued their
health privacy highly and trust in a nationwide EPR was low, irrespective of their political afliation or
their political attitudes. One exception were respondents with authoritarian attitudes. Such individuals
had, on average, more trust in (government regulated) electronic records. More trust in the law cor-
relates with less fear for problems with the EPR. Interestingly, higher educated and older respondents
have, on average, the same level of trust in the EPR as others but are more apt to act when they distrust
the system (opt-out). In general, political attitudes and one’s trust in electronic patient records (EPRs)
are not strongly related, but individuals who score high on authoritarian attitudes and trust in the law
are more likely to also trust EPRs. Still, nearly everybody places a high value on health privacy, so EPR
providers should be careful in this regard.
1. INTRODUCTION
In April 2011, the plan to introduce legislation
for a nationwide Electronic Patient Record (EPR)
communications system in the Netherlands failed.
It was a close call – the letters informing civilians
about the new EPR were already sent. The Lower
Chamber of Dutch Parliament had passed the
legislation. The Senate (Upper Chamber) usually
agrees with the Lower Chamber, although some-
times minor adjustments are required. But this
time, the minister of health, Schippers (VVD
1
, a
Evert Mouw
Independent Researcher, The Netherlands