EU EHEALTH INTEROPERABILITY, STANDARDIZATION AND DEPLOYMENT
STRATEGY
Benoit Abeloos, Standardization and Interoperability
DG CNECT, Health and Wellbeing Unit
COCIR Workshop on Importance of Interoperability: Challenge and Opportunities. Status today and future trends
7 May 2014
• Directive on the application of patients’ rights in cross-border healthcare
• EU Regulation on European Standardization
• Digital Agenda for Europe: • Action 75: Give Europeans secure online access to their medical
health data and achieve widespread telemedicine deployment
• Action 76: Propose a recommendation to define a minimum common set of patient data
• Action 77: Foster EU-wide standards, interoperability testing and certification of eHealth
• eHealth Action Plan • Achieving wider interoperability of eHealth Services
• Facilitating uptake and ensuring wider deployment of eHealth
• European Innovation Partnership in Active and Healthy Ageing
• Medical Devices Directive, being revised
Policy drivers
Towards a single digital market in 2020
Source: Digital Agenda for Europe (http://ec.europa.eu/information_society/digital-agenda/ )
eHealth Governance
• The eHealth Network:
• Article 14 of Directive on the application of patients’ rights in cross-border healthcare
• Voluntary network of national authorities in charge of eHealth to
• Cooperate on sustainable economic and social benefits of European eHealth systems (interoperability, trust and security, quality & continuity of care, patient safety)
• Draw up guidelines on Patient Summary (adopted Nov 2014) and ePrescription
• Develop eID and authentication measures
• eHealth Governance initiative
• Prepares the work for the eHealth Network
• Experts, multi stakeholders, focused on MS
• eHealth Stakeholders' Group
• SDOs, patients, health care providers, SMEs, industry,…
European Innovation Partnership on Active & Healthy Ageing
The first attempt to bring together interested parties from public and private sectors to deliver innovative solutions for an ageing society
What?
6
EIP-AHA: Public Consultation
Standards uptake is key...
Standardization regulation and MSP
• Establishes the ICT standards multi-stakeholders platform composed of
• Member States – ministries in charge of standards
• ESOs – CEN, CENELEC, ETSI
• International SDOs: ISO, IEC, ITU
• De facto SDOs: OASIS, IEEE, IETF, W3C, GS1, ECMA, OMG…
• Consortia: Digital Europe, OpenForumEurope,…
• Advises on identification of ICT technical specifications
• Based on criteria in annex II of the regulation:
• Openness, Transparency, Consensus
• Maintenance, availability, IPR, relevance, neutrality and stability, quality
8
Interoperability Levels
Pri
ncip
les
Inte
ropera
bilit
y A
gre
em
ents
Governance
Legal Interoperability
Organisational Interoperability
Semantic Interoperability
Technical Interoperability
Achieving wider interoperability of eHealth services
The eHealth Interoperability Framework was originally defined in a study (http://ec.europa.eu/digital-agenda/en/news/ehealth-interoperability-framework-study-0)
Instruments
• Standardization Mandates with EU SDOs
• H2020 Work Program–eHealth Interoperability-PHC34
• Clinical information modelling
• Towards a common EU standards based medicines terminology
• SNOMED CT – a potential core EU terminology?
• Business modelling eHealth interoperability
• Connecting Europe Facility
• Large scale deployment of interoperable cross border services
• eHealth in 2015
• Identification of technical specifications
• eHEIF study
• Submission of IHE specifications – ongoing
• Other specifications to follow
EU Cross-Border eHealth Interoperability Project
Profile 1
Profile 2
Profile 4
Vision of eHealth EIF
10
International base standards and profile development
Base Standard 1
Base Standard 2
Base Standard 3
Base Standard 4
Base Standard 5
Profile 1
Profile 2
Profile 4
Profile 3
eHealth European Interoperability Framework: EU Recognised profiles
B-Use Case
A
B-Use Case
B
Profile 1
Profile 2
Profile 4
Profile 1
Profile 3
Profile 4
Profile 1
Profile 2
Profile 4
B-Use Case A1
B-Use Case A1
Specific
Profile
(Extensions)
National/Regional eHealth Interoperability Project
Profile 1
Profile 2
Profile 4
Profile 1
Profile 2
Profile 4
B-Use Case A1
B-Use Case A2
Specific
Profile
(Extensions)
Local (e.g. Hospital) eHealth Interoperability Project
Profile 1
Profile 2
Profile 4
Profile 1
Profile 2
Profile 4
B-Use Case A1
B-Use Case B1
Specific
Profile
(Extensions)
(Note: B-Use Case = Business Use Case)
The 10 initial use cases
Citizens at home
& on the move
- PC-based
Care Mgt.
- Mobile-based
Care Mgt.
- Sensor-based
Care Mgt.
UC 8
UC 9
UC 10
- Hospital IIIa
- Hospital IIIb
RIS LIS
RIS LIS
(2 hospital locations affiliated to same
hospital mgt. organization)
UC 6 UC 7
UC 3 + UC 4
National / Regional Level
Cross-border Level
- Primary
care physician
- Hospital I
Medical care provision
- Pharmacy
- Medical Specialist
- Rehabilitation
UC 2a/ 2b
Inpatient medical
care provision
- Hospital II
- Medical Specialist
- Rehabilitation
UC 1
Medical care provision
- Pharmacy
UC 5b
UC 5a - Primary
care physician
The EIF is a process
12
Review by eHealth
Governance Initiative
Review &
decision by
eHealth Network
EC initiative
Acerta’s
Data
Governance
Framework
MSP identification of tec specs
Receiving feedback
Ongoing initiatives
• epSOS • Large scale pilot – 13 nations piloting
• Ends in June 2014
• Interoperability Framework based on international standards and IHE profiles
• Extensions for cross border exchange of health data (IHE)
• Published open source components
• EXPAND
• eHealth Governance Initiative
• eHealth Stakeholders' Group
• eHR4CR – IMI
• SemanticHealthNet – NoE
• Discussions with IHTSDO for the use of SNOMED
The Antilope project
• Refining the eHealth Interoperability Framework
• Further defining the high level use cases
• Adoption and take up of standards and profiles for eHealth Interoperability (DAE action 77)
• Main dissemination target: procurers and (consequently) vendors
• Defining a quality assurance model for interoperability testing
• Identifying and addressing gaps in testing tools
• Defining an IOp Label and certification process
• Validating scalability to EIP and adoption
• A MoU (signed in Dec 2010 by EC VP N. Kroes and US Secretary of Health K. Sebelius) aims to foster a mutual understanding of the common challenges
• The Trans-Atlantic Economic Council (TEC) of Nov. 2011 reinforced commitment to the MoU
• Two issues identified of having immediate importance: • Development of international interoperability standards and
specifications for eHR
• Strategies for development of skilled health IT workforces
• A commonly agreed roadmap was published on 20 June 2013 – it needs to be updated
• eHealth Forum 2014, Athens, May 12-14: EU-US workshop • Gap analysis and terminology mapping will be presented
• The Trillium Bridge (www.trilliumbridge.eu) project is supporting this effort
• End result could be a standardization project
The EU-US roadmap and the Trillium Bridge project
Thank you!
• ec.europa.eu/digital-agenda/ehealth
@EU_ehealth @EU_ehealthweek
EU.ehealth Ehealthweek.eu
• Benoit Abeloos: [email protected]