Update on eHealth developments in Europe

Abstract

The European Union (EU) has long aspired to support the freedom of movement of its citizens between member states by facilitating the transfer of their health records across borders. This is not as simple as might first seem, because few countries have a robust legal basis for such a transfer, records in different European countries are often in different languages, and the structure of health records varies greatly from country to country. At present most exchanges are informal and unstructured; hardly the best formula for safe and efficient healthcare. Cross-border exchange of personal health data was first piloted during the epSOS (European Patient – Smart Open Services) project. This was a large-scale pilot that ran from 2008 to 2014 and involved not only most EU countries but also Norway, Switzerland and Turkey. It focused on how to transfer patient summaries and ePrescriptions when citizens need unplanned health care while travelling outside their home country. Malta took part from 2011 onwards, and succeeded in exchanging patient summaries with various countries, including Italy, Portugal and Slovenia. The epSOS project drew up specifications for other use cases, such as transfer of a health care encounter report back to the patient’s home country, and direct patient access to the cross-border data. However, these use cases have not been widely tested yet. The European Commission is now encouraging countries to set up cross-border health data exchange as a routine service, and is supporting this by making funds available from its Connecting Europe Facility (CEF). A call for applications opened in November 2015, inviting proposals from EU member states interested in connecting to the EU’s new eHealth Digital Service Infrastructure (DSI). The call closed in March 2016 (CEF-TC-2015-2); twenty countries submitted a proposal, and it is expected that the eHealth DSI will go live in the first quarter of 2018. In parallel, the EU has been actively cooperating with the US in the specification and testing of an International Patient Summary standard that draws upon EU epSOS and the US Meaningful Use experience.