European Patient Smart Open Services (epSOS)

Patient Summaries and electronic prescriptions are two key services that support high quality healthcare. They provide healthcare professionals with basic information from the patient’s medical and medication history. In many cases, a timely access to such information can save a patient’s life (e.g. in case of a patient allergic to particular drugs; chronic diseases).

The international project epSOS was the first step towards the provision of important patient data for a physician in case of patients seeking unplanned medical treatment abroad.

The objectives of the epSOS project:

The aim of the project epSOS was to test a cross-border exchange of Patient Summaries and electronic prescriptions. During the pilot testing, the epSOS information infrastructure enabled the healthcare professionals an electronic access to patient data stored in the Patient Summary abroad and to foreign electronic prescriptions. The data were seen in the physician’s native language.

The epSOS project ended on June 30, 2014. Development and implementation activities in the project epSOS were attended by 23 States. Slovakia was represented in this project by the National Health Information Centre. One of the most important results of the pilot testing was the fact that Finnish citizens were able to pick up their medication in Swedish pharmacies while these electronic prescriptions were issued in Finland.

Great benefit of the project epSOS is an identification of the most serious problems that currently impede cross-border transfer of patient data in an electronic form. The most serious problems identified by the projects epSOS include differences in national laws and semantic interoperability.

The consolidation of epSOS results and their possible further use in building IT infrastructure enabling cross-border transmission of Patient Summaries and electronic prescriptions is currently processed by an international project Expand.

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.”

Within this context, two key cases for cross-border communication have been identified. They include patient summary and ePrescription.

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.

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.