22.06.2022 Overzicht epSOS project
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