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From strategies to services
– eHealth as the enabler for cross-border
healthcare
Sustainable Healthcare: Sharing Information
and Knowledge for better health in practice
14.12.2010 Page 2
a new era in legal and policy framework for EU
Cooperation on eHealth
• Proposal for a European Directive on patients’ rights in cross-border healthcare
• Commission Recommendation on cross-border interoperability of electronic health record systems
• Communication on telemedicine for the benefit of patients, healthcare systems and society
• eHealth Standardisation Mandate 403
• 2009, the European eHealth Governance Initiative,
through a Joint Action Initiative was launched
• Council conclusion on safe and efficient healthcare
through eHealth – December 2009
14.12.2010 Page 3
Austria
Czech Republic
Denmark
France
Germany
Greece
Italy – Lombardy
The Netherlands
Slovakia
Spain
Spain – Andalusia
Spain – Castilla la Mancha
Spain – Catalonia
Sweden
United Kingdom – England
United Kingdom – Scotland
12 epSOS Countries14.12.2010 Page 4
From Strategies to Services
Provide concrete cross border services that ensure safe, secure and efficient medical treatment for citizens when travelling across Europe
• Focus on services close to the patient:
– Patient Summary for EU Citizens
• Occasional Visit
• Regular Visit
– ePrescribing for EU Citizens
• Medication ePrescription
• Medication eDispensation
• Build on existing National eHealth Projects and use experiences and knowledge from all Member States
1. Accenture
2. Engineering Ingegneria Informatica S.p.A
3. Oracle
4. Agfa Healthcare
5. ETIAM
6. Posam
7. Apollo
8. GE Healthcare
9. RISE
10. BT
11. Gemalto
12. Sineura S.p.A
13. Carecom
14. Gnomon
15. Steria Mummert Consulting AG
16. Cisco
17. ICW
18. Tiani-Spirit
19. CMP Medica
20. Indra
21. TrebleM
22. CompuGROUP
23. Mawell
24. Insiel
25. T-Systems
26. dbMotion
27. Intel Corporation S.A.
28. X-tention
29. Dedalus
30. Microsoft
31. 3M
32. Electronic Record Company
33. Netsmart
The epSOS Industry Team
Federating national HCOs
Federating countries
A country becomes a member of the epSOS trusted domain.....
If a health care provider organisation (HCPO) demonstrates conformance to
epSOS requirements then it may offer the epSOS services
The HCPO is accountable to the NCP
The NCP is accountable to the epSOS community
epSOS Trusted Domain14.12.2010 Page 7
• Three different blocks in each dataset
– Patient Identification
– HCP identification
– Medicine: prescription and dispensed medicine data
Prescription Item ID
Original or copy of the prescription in Country A
Country B Single concept
—Active ingredient (Country B)
—Strength of the medicinal product (Country B)
—Medicinal product package (in Country A)
—Pharmaceutical dose form (in Country B)
Brand name of the medicinal product prescribed in
Country A
Number of packages
Posology
Date of issue of the prescription
ePrescription Dataset14.12.2010 Page 9
Information/dataset Contains
Patient Identification Unique identification for the patient in that country.
Patient Personal information Full name.
Date of birth
Gender
Allergies Allergy description and agent
Medical Alerts Other alerts not included in allergies
List of current problems Problems/diagnosis that need treatment and/or follow up by a
HCP
Medication Summary Current medications
Date of creation of PS Data on which PS was generated
Date of last updated Data on which PS was updated
Author organization At least an author organization (HCPO) shall be listed. In case
there is not HCPO identified at least a HCP shall be listed.
Country Name of Country A
PS minimum Data set14.12.2010 Page 10
Translation & Transcoding work14.12.2010 Page 11
Code sys SNOMED-CT ICD-10 EDQM ATC LOINC HL7 IHE ISO ISCO UCUM
Valu
eset
Advers
eE
ventT
ype
ReactionA
llerg
y
Alle
rgenN
oD
rugs
Resolu
tionO
utc
om
e
Blo
odG
roup
Severity
CodeN
oM
edic
ation
Socia
lHis
tory
CodeP
rob
sta
tusC
ode
Medic
alD
evic
es
Unknow
nIn
form
ation
Pro
cedure
s
Vaccin
ations
Illn
essesandD
isord
ers
DoseF
orm
Route
sofA
dm
inis
tration
Package
ActiveIn
gre
die
nt
Blo
odP
ressure
Pre
gnancyIn
form
ation
Docum
entT
itle
Sections
ActC
ode
Pers
onalR
ela
tion.R
ole
Type
Confidentialit
y
Role
Cla
ss
Entity
Nam
eP
art
Qualif
ier
Tele
com
munic
.Addre
ssU
se
Adm
inis
trativeG
ender
Tim
ingE
vent
NullF
avor
UR
L S
chem
e
ActC
ode
Role
Code
Countr
y
Language
Healthcare
Pro
fessio
nalR
ole
Units
Term:
Status:
500 terms 1700 600 5600 20 130 10 20 10 40
General Flow of Information14.12.2010 Page 12
country-B NCP
NatConn/Interface
Pro
toco
l
Te
rmin
ato
r
audit mgr
config mgrTransformationMgr
TSAM
workflow
scheduler
security mgr
country-A NCP
Pro
toco
l
Te
rmin
ato
r
workflow
scheduler
security mgr
NatConn/Interface
audit mgr
config mgrTransformationMgr
TSAM
We
b P
ort
al
ConsentMgr
ConfigSyncApp
eCRTS
Country-ANational
Connector
Country-AInfrastructure
Country-BNational
Connector
Country-BInfrastructure
HCP
IHE Gazelle / Testing Tools
Specified and tested Components14.12.2010 Page 13
• Scenario 1: acting as Country B (receiver of patient information)
• Scenario 2: acting as Country A (sender of patient information)
epSOS Pilot Site Candidates14.12.2010 Page 14
INFRASTRUCTURES INVOLVED PS/eP
HCPO 3.445
Hospitals 183
Farmacies 2.149
PoC 1.113
HUMAN RESOURCES INVOLVED
HCP 30.157
Total numbers
epSOS Pilot Site Candidates14.12.2010 Page 15
Q.C.- Scenarios 1-6
Best score.-Large QC & Extended Maturity & All Territory
Many HCP & Territories type 1,2
Piloting both as Country A and B & in a Strategic Territory Spot
Quality of coverage of use case elements
Piloting as
Country A & B
and
With all
scenarios
Ammount of
professionals &
domestic population
covered with eP or
PS
Good QC & good territory
coverage
Is in proposal for
epSOS II (in bold) or
Observer Status
1. Belgium
2. Bulgaria
3. Croatia
4. Estonia
5. Finland
6. Hungary
7. Iceland
8. Lithuania
9. Luxembourg
10. Malta
11. Norway
12. Poland
13. Portugal
14. Slovenia
15. Serbia
16. Switzerland
17. Turkey
epSOS Extension14.12.2010 Page 17
base from Mikael Erlandsson
Dialog med kommunen/andra vård-grannarGemensam uppslutning kring mål
Oh so you are
also implementing
eHealth?
Cooperation is Key14.12.2010 Page 18
