The patient as a key agent for the exchange of health information in Europe

Tino Martí

Health care between the countries of the European Union is regulated by Directive 2011/24/EU of the European Parliament and the Council, on the application of the rights of patients in cross-border healthcare, published on March 9, 2011, One of the objectives of the directive is to regulate access to patient information. The exchange of health information is important to ensuring quality care and allowing continuity and coordination beyond the borders of the different health systems existing in Europe, whether at national or regional level. 

Until now, the approach to the exchange of health information has been carried out through the so-called National Contact Points for eHealth (NCPeH), in charge of guaranteeing the exchange of health information between countries. The NCPeH have, first of all, the challenge of integrating the patient information produced within each country. In Spain, for example, this work is entrusted to the Ministry of Health, Consumption and Social Welfare, which develops it through the project of the Digital Medical Record of the National Health System and which should act as a link for the exchange of information with other countries of the European Union. The same architecture must also allow the exchange of the patient summary and the electronic prescription between autonomous communities.

However, the interoperability strategy between the countries of the European Union based on NCPeH is progressing slowly. To date, only a few countries have managed to exchange information on a bilateral and unidirectional basis. Finland exchanges the electronic prescription with Estonia and the prescription and patient summary with Croatia and the Czech Republic exchanges the patient summary with Luxembourg. The expansion plans of these exchanges involve 22 member states with the capacity to transfer these clinical documents by 2022.

At the beginning of 2013, we published in Advances in Clinical Management a post about virtual clinical practice and we echoed the Blue Button project in the United States, a service offered to patients so that they can download their health data from their healthcare provider.

Following the philosophy of facilitating access to health information to the user himself, at the beginning of 2019, the InteropEHRate project was started, funded by the European Commission, whose objective is to generate the protocols for the exchange of health information so that the patient is the vehicle transport of the same and the nexus between health providers regardless of the country of origin and care.

InteropEHRate is testing the transfer of information between the healthcare provider's information system and a smart electronic health record resident in the patient's mobile phone that does not require internet access for the transfer of information (device-to-device exchange through Bluetooth). With this information in their hands, the patient can exchange it with the provider both in her country and abroad and, at the same time, donate her data for health research purposes.

The ecosystem created by InteropEHRate also includes the possibility of accessing patient data in an emergency and opens the door to endless possibilities to extend the value offered to the user through the integration of health and wellness applications.

Converting this type of service into a right for European citizens could be a complementary - and perhaps more pragmatic - alternative to interoperability between health systems in Europe. But, like almost everything, better test it first.