1. Background of the Institute

1.1 The ProRec initiative

The onset of the ProRec initiative followed the conclusions of the Concerted Action MEDIREC (1994-1995). These resulted in a set of statements regarding the reasons why Electronic Health Record systems were not used more widely in any of the European countries, as well as suggestions (summed up in the "Lisbon Declaration") for possible remedies. The ProRec initiative has been developing since 1996 with strong support from DG "Information Society" (initially DG XIII), more particularly through the ProRec Support Action (1996-1998), and the WIDENET Accompanying Measure (2000-2003).

1.2 The network of ProRec centres

The organic tools of this initiative have taken the form of a network of national non-profit organisations (the "ProRec centres") , sharing the same goals and relying on the same fundamental principles.

In general terms, the common goals of the ProRec centres are:

• Building awareness of the limitations, shortcomings and obstacles on the way towards widespread development, implementation and use of quality Electronic Health Records (EHRs) and pointing them out. Among the range of criteria defining quality in the domain of EHRs, the ability to communicate and interoperate, is especially significant.
• Proactively helping to find and set up locally relevant initiatives to remove those limitations, shortcomings and obstacles.

It has been established that, in order to reach the above goals, and as a matter of basic principle, the ProRec national centres need to gather representatives as well as opinion leaders in a balanced way from both the users' and the solution providers' categories, while fostering strong relationships with public authorities and decision makers.

The means they put into action depend on an up-to-date analysis of the local peculiarities of the customers' or health care providers' needs and of the state of the market. These means may take various forms, such as:

• thematic working groups
• sectional fora
• thematic seminars
• a living web site
• publications either in paper or electronic format
• contributions of any kind
• lobbying

The scope of the ProRec centres may, for instance, include:

• analyses of the field situation regarding EHRs from different perspectives
• conceptual work to inspire proposals of a political nature, and possibly make suggestions to public authorities
• technical work to study generic specifications (e.g. European or international standards) possibly needing to be specifically adapted and thus making suggestions to standards development organisations and authorities.