HealthManagement, Volume 3 / Issue 5 / 2008
EpSOS (Smart Open Services for European Patients), previously known as S.O.S. – “Smart Open Services - open eHealth initiative for a European large scale pilot of patient summary and electronic prescription” - is a Europe-wide project organized by 27 beneficiaries from twelve EU-Member States that includes ministries of health, national competence centres and industry. The key goal of epSOS, developed under the Competitiveness and Innovation Framework Programme (see box on page 12) is to build a practical e-Health framework and ICT infrastructure that will permit secure access to patient health information, especially on a basic patient summary and ePrescription, between European healthcare systems. From this perspective, epSOS’s parallels the nationwide health information network (NHIN), that is already underway in the US.
As is well known to our readers, the EU Member States still have their own systems of storing healthcare information; yet these systems often cannot communicate or exchange information between each other. According to the epSOS team, this situation should come to an end. The project is set to run for three years and in the end, anyone who falls ill in one country should have access to his or her health information in other European countries.
In support of this idea, Fabio Colasanti, European Commission Director General in charge of Information Society and Media confirmed that the challenge of increasing mobility of European citizens in the context of healthcare has already been addressed by the European Commission. He states that “together with the launch of its proposal for a ‘directive on the application of patients’ rights in cross-border healthcare, the issue of its July recommendation on the cross-border interoperability of electronic health record systems and the start of the epSOS pilot, the European Commission is laying the groundwork for improved healthcare options for travelling EU citizens.”
Therefore, the key issue addressed by the epSOS project is that of interoperability. Seeing that some countries still struggle with interoperability within their own national boundaries, the large-scale pilot is trying to identify, and later to test “the relevant tools to make things happen.”
Use Cases
Within this context, two key cases for cross-border communication have been identified. They include patient summary and ePrescription.
Ó Patient Summary:
Analyzing two situations (on the one hand, the case
of an occasional visitor in a foreign EU country, and on the other, a regular
patient using medical services of a country other than that of his/her origin),
the benefits of epSOS can be easily identified. In the first case, the
occasional visitor is a person on holiday or attending a business meeting, for
example. The key characteristic is that this type of visit is irregular,
infrequent, and may not be repeated. Under the circumstances of an incidental
encounter with the healthcare professional, one of the major problems arising
is the lack of a previous medical record of the person seeking care. A routine
case, however, can be best exemplified by someone who lives in one country but
works in another.
The distinguishing characteristic is that this type of visit is regular, frequent, and the person seeking care may be accustomed to using services in the country where he/she works as a matter of personal convenience. This is a type of situation where the healthcare professional may have some information available from previous encounters. However, in both cases, epSOS aims to provide European citizens with the possibility to travel safely all around Europe and have optimum care in case of emergencies.
Ó EPrescription:
Within the cross-border prescription area there are
two basic use cases. The first one concerns patients who need medicine that are
already prescribed at home when they are abroad. In this case, the pharmacist
should be able to electronically access the prescription from the same e-Health interface used for prescriptions ordered in the local country. When medicine is provided to the patient, the system should notify the home country node of the foreign patient about the dispensed drugs. The second use case is aimed at the medical professional who decides to prescribe medicine to a visiting patient from another country. In order to help the medical professional make the best decision on the pharmaceutical strategy to be used, the patient’s medical and pharmaceutical history from his/her home country will be available through the patient summary. When the electronic prescription is finalised, a copy of the prescription should also be sent to the patient’s national node for inclusion in the national medication summary.
Based on these two key cases for cross-border communication, the methodology will strive to build a common architecture and core services for the identification of users and institutions, security and confidentiality aspects, and aim to enhance various semantic aspects of the systems. These technical activities will be prefaced by an in depth analysis of the need for the creation of an appropriate legal and regulatory framework to enable field-testing.
Conclusion
epSOS is the first European e-Health project clustering such a large number and variety of countries in practical cooperation. The countries involved in the epSOS project are Austria, the Czech Republic, Denmark, France, Germany, Greece, Italy, the Netherlands, Slovakia, Spain, Sweden and the UK. Connecting what already exists, this pilot project represents a great incentive for the Member States, as they have to turn their heads towards their electronic health records systems and see what can be shared. In addition, the Swedish health ministry has played a fundamental role in setting up the epSOS pilot. Its goal, according to Daniel Forslund, head of the section on e-Health in Sweden’s Ministry of Health and Social Affairs, is “to improve patient safety. Citizens should be able to trust any healthcare system in any country they visit or work in.”
For more information, please visit: www.epsos.eu
