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

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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: benoit.abeloos@ec.europa.eu