To Örebro University

Patients' online record access (ORA) enables patients to involve their informal caregivers in care management by sharing health information, either through proxy access functionality or informally. The European Health Data Space mandates that member countries should ensure that patients can assign a proxy to have online access to their health data. In this study, we aimed to explore the current state of proxy ORA in four countries with mature ORA implementations; Sweden, Norway, Finland, and Estonia. We identified three types of proxy ORA; full proxy ORA, no proxy ORA, and controlled proxy ORA. Further guidance on ethically sound and secure proxy ORA functionality that complies with national and EU regulations and policies is warranted to ensure equal rights for citizens across Europe.