Support Member States in the development of cross-border eHealth services

Potential of action

Digital Health technology is a critical component of the Digital Single Market. With the increased mobility of citizens across the European Union, national health policies and health systems need to exploit the full potential of digital technologies for health, including eHealth and telemedicine, to become more interconnected and support the continuity of care across borders. However, health data are far from being portable within and between Member States and many challenges – technical, semantic and legal – remain.

The Digital Single Market Strategy seeks, inter alia, to provide the necessary interoperability and standardisation tools to allow the cross-border movement of health data. This includes the establishing of an eHealth Digital Service Infrastructure. Services provided by the eHealth Digital Service Infrastructure are also significantly contributing to Pillars 1 and 2 of the Commission Communication on digital transformation in health and care[1], which focus on: (1) Citizens' secure access to their health data, also across borders; and (2) Personalised medicine through shared European data infrastructure.

Description of action

The objectives of the eHealth Digital Service Infrastructure are to enable:

• Cross-border exchange of patient data from e-prescriptions and patient summaries, by supporting Member States in setting up the National Contact Points for eHealth. This action will increase continuity of care, patient safety, patient access to highly specialised care and the sustainability of health systems. The ePrescription and eDispensation allow EU citizens to retrieve their medication in a pharmacy located in another EU Member State, thanks to the electronic transfer of their prescription from their country of residence to the country of travel. The Patient Summaries provide background information on important health-related aspects such as allergies, current medication, previous illness, surgeries, etc., making it digitally accessible in case of a medical (emergency) visit in another country. It is a summary of the complete patient's health data in electronic format (electronic health records). The Commission has recently adopted a Recommendation the European Electronic Health Record Exchange Format with the objective of setting common standards for the electronic exchange of multiple types of health data. Electronic patient records and electronic prescriptions should be available to patients and health professionals across the EU, wherever they are needed and by whoever needs them. 
• The exchange of health data, in particular ePrescriptions, has already started. Three Member States (Finland, Estonia, and Croatia) began to exchange ePrescriptions across borders. Since January 2019, more than 5500 ePrescriptions have been dispensed.

• Additionally, doctors in Luxembourg and Croatia are able to receive Patient Summaries of travellers coming from Czechia.

• Malta and Portugal are expected to join these exchanges in Q4 2019/Q1 2020. By 2022, these services should be progressively put in place by the 22 European countries taking part in the initiative [1].

• Cooperation within European Reference Networks (ERN)[2] which connect designated healthcare providers and centres of expertise in the Member States, in particular in the area of rare, low prevalence and complex diseases and conditions. This action will help to provide affordable, high-quality and cost-effective healthcare and to improve these patients' access to the best possible expertise and care available in the EU for their condition. Solid cross-border IT solutions were set up for the coordination of the Networks and for the cooperation on patients with clinical problems, by supporting the virtual collaboration of health professionals within the ERNs. The first ERNs were launched in March 2017, involving more than 900 highly-specialised healthcare units from over 300 hospitals in 26 EU countries. Today, 24 ERNs are working on a range of thematic issues including bone disorders, childhood cancer and immunodeficiency. ERNs will also serve as focal points for medical training and research, information dissemination and healthcare evaluation.

In the future, patient registries might be deployed.

Main responsible at the European Commission: DG SANTE

Target date: 2016-2021

Status: Completed

More info (website):https://ec.europa.eu/cefdigital/wiki/display/CEFDIGITAL/eHealth

[1] https://ec.europa.eu/health/ehealth/electronic_crossborder_healthservices_en

[2] https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM:2018:233:FIN