10.04.2023 Overzicht epSOS project

From strategies to services – eHealth as the enabler for

cross-border healthcare

Michiel SprengerSenior adviseur ICT en Innovatie

Nictiz

Closer Cooperation on healthcare in the EU

– from threat to possibility• Healthcare is a strict national prerogative• Previously only a limited co-operation on a general policy

level• Substantial variations between national healthcare

systems, but also similar challenges are faced and….• …substantial similarities in political ambitions to reform

healthcare as well as in the challenges to reach these goals

• The work started in 2003-2006 at the Ministerial Conferences

• In 2004 the eHealth Action Plan was adopted and the I2010 was created

• And in 2007 in Berlin the eHealth Initiative was created.…

epSOS – a highly political project

• Member State obligation to deliver the best possible medical treatment – at home or when travelling

• Introducing a new dimension in national healthcare systems

• Main political objectives:– support patient mobility nationally and in the EU– ensure that patient safety is guaranteed– increase efficiency and cost-effectiveness

in cross-border care

Waar gaat epSOS over ?• Pilotproject• “Cross-border interoperability”• Twee gebruikssituaties (use cases):

– Patiënt heeft in ander land zorg nodig (acuut of niet) en arts heeft daarvoorpatiëntsamenvatting nodig

– Patiënt heeft medicatie nodig in ander land:• Nieuw• Op recept “van thuis”

• Bouwen op het bestaande !!

Wie doen er mee ?

12 van de 27 lidstaten

The epSOS Project Team

• The Project Team consists of 27 beneficiaries from 12 member states: AT, CZ, DE, DK, EL, ES, FR, IT, NL, SK, SE and the UK :

• 9 National Ministries of Health,18 National/regional Competence Centers; ANDA, ATNA, CATA, CLM, DENA, DKNA, ELGA, EMPIRICA, FRNA, GEMATIK, GIPDMP, FRNA, IHE, IZIP, LOMBARDY, MEDCOM, NHIC, NHS, NICTIZ, NLNA, SALAR, SENA, THESS, CNRS, FRAUNHOFER, PHARMAXIS, ZI

• Competence Centers Including/working with local organizations with thousands of Contributors

• IHE-Europe representing ICT industry team (40+ members)

• Empirica responsible for administrative management

Goals & Challenges

• Goal for the epSOS eHealth Project:– “to develop a practical eHealth framework and ICT

infrastructure that will enable secure access to patient health information, particularly with respect to a basic patient summary and ePrescription, between European healthcare systems”

• Challenges to get there:– Legal Interoperability– Organisational Interoperability– Semantic Interoperability– Technical Interoperability

Regio-situatie

• In sommige landen zijn regio’s zeer zelfstandig• (gedeeltelijk) eigen wetgeving, minister van gezondheid, etc• In epSOS:

– Spanje: Spanje + Andalusië, Catalonië, Castilla-La Mancha– UK: Engeland, Schotland– Italië: Lombardije

• Kansen: landelijke convergentie-pogingen leerzaam voor EU !

Time schedule

Inbreng Nederland• Ministerie VWS (NLNA)• Nictiz

• Plaats in Project Steering Board (PSB, VWS)• Plaats in Project Executive Board (PEB, VWS, Nictiz)• Participatie diverse deelprojecten• Leiding van WP1.1: analysis

WP 1.1, analysis

• Analyseer use cases• Onderzoek in 12 landen en X regio’s het lokale

equivalent (dwz benodigde zorg buiten de normale “eigen” omgeving maar binnen het land / de regio)

• Leid daaruit af “opportunities and constraints” voor de epSOS oplossing

Use cases

• Mobiliteitsscenario’s– Incidenteel in ander land (vakantie, zakenreis)– Structureel in ander land:

• Regelmatig afwisselend (“grenswerkers”)• Langduriger (“overwinteraars”)

• Zorgvraag die samenvatting nodig heeft• Medicatie:

– Herverstrekking– Nieuw voorschrift en verstrekking

Enquete naar nationaal(regionaal) analogon

• 160 vragen• 16 landen / regio’s antwoord• Analyse afgerond

– Robert Breas, Michiel Sprenger, Albert-Jan Spruyt, Wouter Tesink– Industry team

• Rapport klaar – final approvement

In zes onderzoeksgebieden

1. Patiënt identificatie2. Patiënt consent3. HCP / HCP organisatie identificatie4. Transactie logging5. Patiënt samenvatting (proces en inhoud)6. Medicatie (proces en inhoud):

– Voorschrift– Verstrekking– Overzicht

epSOS scenarioCountry A (“home”) Country B (Patient + HCP)

Natio-nal con-tact

point

Natio-nal con-tact

point

National Infrastructure

GP

Phar-macy

National Infrastructure

2 13

Availability of patient summary 2008

Nationally available & operational

Regionally available

& operational

Not available / unknown

EU memberstate(not participating)

Non EU country

>25%

<25%

>25%

<25%

Availability of patient summary 2010

Nationally available & operational

Regionally available

& operational

Not available / unknown

EU memberstate(not participating)

Non EU country

>25%

<25%

>25%

<25%

Availability of ePrescription 2008

Nationally available & operational

Regionally available

& operational

Not available / unknown

EU memberstate(not participating)

Non EU country

>25%

<25%

>25%

<25%

Availability of ePrescription 2010

Nationally available & operational

Regionally available

& operational

Not available / unknown

EU memberstate(not participating)

Non EU country

>25%

<25%

>25%

<25%

Not available

EU memberstate(not participating)

Non EU country

Nationally available

Regionally available

Only in one region

Can an HCP retrieve medication prescriptions on demand (status in 2008)

Retrievability of ePrescription 2008

Not available

EU memberstate(not participating)

Non EU country

Nationally available

Regionally available

Partially undefined

Can an HCP retrieve medication prescriptions on demand (status in 2010)

Retrievability of ePrescription 2010

Conclusies onderzoek

• 2010 >> 2008 (???) – optimisme viert hoogtij• Ondersteunend (identity etc) redelijk

ontwikkeld• ePrescription en Summary erg weinig echt af• Retrieve mechanisme belangrijk• Content: veel vrije tekst in Summary• Noodzaak NCP’s• Houd pilots simpel !!

Uitkomsten voor Nederland

• Heel veel inzicht in andere oplossingsrichtingen• Veel contacten• Druk op standaardisatie• Druk op eenheid van taal – SNOMED CT• Schaalbare toekomst, alles is deel van iets groters !

– Point of care– Ziekenhuis– Regio– Land– Europa

www.epsos.eu

www.epsos.eu