By Rocío Mellas
Interoperability, secure medical information and cross-border exchange of health information are all key to understanding the European health model, one of the most advanced in the world in terms of Health IT.
In this report, two initiatives demonstrate the benefits of working in a network and the coordination of healthcare services for the development of ever more efficient healthcare systems.
epSOS: European Patients Smart Open Services
One of the largest eHealth projects in Europe is currently epSOS (European Patients Smart Open Services). It has the economic support of the European Union, and its purpose is to connect all the European healthcare services, fomenting interoperability with a clear objective: to achieve the cross-border exchange of health data to improve healthcare for its citizens – even if they are outside their home country.
The technical and semantic challenges to interoperability are perhaps the biggest obstacles the initiative, which started in 2008, has to face every day. In fact, the different levels of ICT development in each of the 23 countries that have adopted the epSOS project are notable.
To better understand how epSOS works it is important to note that it has been developed over two phases. The first, which up to now has only been implemented in 11 countries, is made up of the Patient Summary – access to a summary of patients’ electronic health records – and ePrescription – cross-border electronic prescriptions. The second phase, which is still in the pilot stage, hopes to implement projects that facilitate interoperability (for example: patient access to their Health Record Summary and the integration of the 112 emergency services and European Health Card processes).
epSOS makes clear the need to standardize clinical terminology and data protection in order to have a better coordinated and safer healthcare network.
International Technical Standards
Instead of developing specific distinct standards, the epSOS project adopts international standards and uses WHO ICD10 and ATC, EDQM, SNOMED-CT, ISO, ISCO, HL7 and IHE terminology to articulate the data and concept sets. In addition, the exchange of information between the different countries involved is carried out through the adoption of profiles set by the organization IHE (Integrating the Healthcare Enterprise).
Which companies support the epSOS project?
A number of specialized companies in the eHealth area are contributing their knowledge and experience to support the construction of a European healthcare network. These include: 3M, Cisco, GE Healthcare, IBM, Indra, Microsoft and UBM Medica.
One of the most committed contributors to the ePrescription initiative is UBM Medica (Vademecum International), which participates in the project by sharing its expertise in the development and coding of structured pharmacological information in electronic format.
PSIP: Patient Safety through Intelligent Procedures in Medication
Through the implementation of computer applications, the PSIP (Patient Safety through Intelligent Procedures in Medication) project seeks to prevent problems linked to Adverse Reactions to Medications (ARM).
Focused on patient safety, this initiative seeks to build up knowledge about ARM. “The objective of the project is to develop innovative computer applications that can automatically detect situations of risk or that can provide relevant information to warn of Adverse Reactions to Medications,” said Jean François Forget, Director of Strategy and Development at Vidal Products (UBM Medica)
The PSIP has two challenges: to identify ARMs and to prevent their occurrence. Both of these tasks require very close attention: it is calculated that in Europe more people die because of Adverse Reactions to Medications than in traffic accidents.
How does it work?
The PSIP Project is working on the development of tools that can analyze databases and record the number of ARMs that occur in every country, hospital or medical unit taking part in the initiative. This allows the description and identification of the type, consequences and probable causes of the ARMs that have been detected.
So, what happens once the ARMs have been detected? In order to identify, classify and adapt treatments to avoid potential Adverse Reactions to Medications, the project provides information to healthcare professionals and patients. To do this, an electronic decision support system (CDS) has been designed that includes the rules for ARM detection. Furthermore, the system provides information about the interactions with other medications that have been recorded on the database or other complementary electronic platforms to facilitate the prevention of ARMs.
Towards a fully coordinated healthcare model
Although both projects are underway, there are still certain issues to be resolved. The standardization of clinical terminology and protection of information are probably two of the most urgent of these. The epSOS and PSIP projects provide added value and serve as a foothold for continuing the process of cross-border exchange of healthcare data. Interoperability means using ICTs to improve healthcare services to citizens. It also leads to the creation of fully coordinated and increasingly safe healthcare networks.
