Piloting cross-border eHealth services and the challenge of patient identification abroad

1. Piloting cross-border eHealth services and the challenge of patient identification abroad Piloting cross-border eHealth services and the challenge of patient identification abroad Andreas Grode Head of Technology & Innovation gematik (epSOS Beneficiary) Germany Reaping the benefits of eID in different business sectors within the EU and beyond

2. Goals & Challenges Piloting cross-border eHealth services and the challenge of patient identification abroad 2 • Goal for the epSOS eHealth Project: • “to develop a practical eHealth framework and ICT infrastructure [based on existing national infrastructures] that will enable secure access to patient health information, particularly with respect to a basic patient summary and ePrescription, between European health care systems” • Challenges to get there • Legal Interoperability • Organisational Interoperability • Semantic Interoperability • Technical Interoperability

3. The epSOS participating nations Piloting cross-border eHealth services and the challenge of patient identification abroad 3 http://www.epsos.eu/participants.html epSOS participating nations Switzerland contributes as extraordinary member • 47 eHealth beneficiaries • Ministries of Health • Competence Centers (working with local organizations with thousands of contributors) • IHE-Europe representing ICT industry team • from 23 member states: • .at, .be, .ch, .cz, .de, .dk, .ee, .gr, .es, .fi, .fr, .hu, .it, .mt, .nl, .no, .pl, .pt, .se, .sk, .sl, .tr,.uk,

4. Patient Summary Piloting cross-border eHealth services and the challenge of patient identification abroad 4 • Providing the HCP of Country B with the health related essential information needed • mainly in case of unexpected or unscheduled care • Out of Scope • Transfer of clinical information from Country B to Country A. • Providing the HCP of Country B with all the health related information of that patient (e.g.: Complete electronic patient record). • To develop an unique European Patient Summary per citizen • Other potential uses of the PS information (e.g.: public health, epidemiology)

5. ePrescription Piloting cross-border eHealth services and the challenge of patient identification abroad 5 • Electronic Prescriptions • Medicinal products for human use • Community pharmacies • Substitution of commercial packaging • Dispensation of a medicinal in Country B upon a prescription from Country A. • Information on dispensation returned to Country A • Out of Scope • Galenics/Treatment/procedure/clinical test prescription out of the scope • No reimbursement management • Specific and complicated topics are out of scope like narcotics and sealed prescriptions

6. Architecture Piloting cross-border eHealth services and the challenge of patient identification abroad 6

7. Patient Identification Piloting cross-border eHealth services and the challenge of patient identification abroad 7 COUNTRY B COUNTRY A Local IT at a Hospital, Pharmacy, etc. Gateway B GatewayA National Health care Infrastructure HCP authentication Patient identification Consent & HCP authorization Service entry point discovery Policy enforcement Policy enforcement Medical data retrieval Policy enforcement Policy enforcement Medical data notification 7

8. EHIC Piloting cross-border eHealth services and the challenge of patient identification abroad 8 The European Health Insurance Card • replaced the paper forms E111, E110, E128 and partly E 119 since 2006 • is a eye-readable only plastic card • provides a unique insurantnumber • is in use: ~200 Mio cards active Limitations of (e)EHIC as patient identifier • Patient and Insurant may differ ! • EHIC is currently only used (eEHIC: planed) to support reimbursement between Member States • An (e)EHIC is currently no mean to access medical data • not always permitted (depending on national legislation) • eEHIC is not a “real” eID (some elements are missing) • eIdentification (of the patient) is only the first step... ?

9. Thank you for your attention! „epSOS pilots setting sail“ Open event 10th of November 2011 Athens look at http://www.epsos.eu Piloting cross-border eHealth services and the challenge of patient identification abroad