AS1_BUC1

Submitted by sfranconi on Tue, 08/06/2024 - 13:23

This is a patient mediated use case, initiated by the patient, following his identification via the national eGOV infrastructure. Patient will receive health data, in a structured coded format, that will be ready to be shared.

When patient view their health data in the EHR System or the MyHealth app, the xShare button will be available, for them to get their data. They will be prompted if they need to extract the data or to donate for research etc. In both cases they will also be asked in which sections of data are they interested.

An xShare service will be created, to give patient access, after identification, to EEHRxF enabled EHR data, in a structured format (CDA/FHIR). The service can be integrated in the MyHealth@EU services, to ensure MVC compliance for cross border use in the EU.

Document Version: 
V1.0
Responsible party: 
Greece - IDIKA (add contact email)
Source: 
xShare
As-Is Situation: 
  • Persons have access to their own health data through the EHR System and the MyHealth mobile app. They cannot share (in Greece or abroad) or “donate” their data. 
  • Doctors in Greece have access to patient data through the EHR System (web or via API). 
  • Health data are provided for research only in public sector, through Ministry of Health. 
Currently available products/services and its vendors: 
National EHR system
MyHealth app
Which health-related standard does your organisation uses and its alignment to the EEHRxF?: 
Application of the EEHRxF to the new National EHR System.
Actors/Users and their Roles: 

Patient  

Final user: get data in the EEHRxF 

Health Professional, treating the patient 

Use patient health data in EEHRxF 

Third Health Professional 

Give second opinion on patient health data in EEHRxF 

Pharmaceutical companies, Research & Innovation Organizations, etc 

Uses patient anonymised health data in EEHRxF 

EHR app 

Incorporate the xShare Yellow Button in web and API 

MyHealth mobile app 

Incorporate the xShare Yellow Button 

Third Party apps 

Consume patient data in the EEHRxF 
User Perspective: 
Patient will receive health data, in a structured coded format, that will be ready to be shared. Data will also be available in PDF, with QR code. This is a patient mediated use case, initiated by the patient, following his identification via the national eGOV infrastructure.
System Perspective: 
When patient view their health data in the EHR System or the MyHealth app, the xShare Yellow Button will be available, for them to get their data. They will be prompted if they need to extract the data or to donate for research etc. In both cases they will also be asked in which sections of data are they interested. An xShare service will be created, to give patient access, after identification, to EEHRxF enabled EHR data, in a structured format (CDA/FHIR). The service can be integrated in the MyHealth@EU services, to ensure MVC compliance for cross border use in the EU.
Health Information Domain(s) - HIDs: 
Patient summary
Electronic prescription
Electronic dispensiation
Medical image and image report
Laboratory Results
Discharge report
Scenarios for the xShare Yellow Button: 

HIDs 

xShare Yellow Button basic functionality 

Maturity 

Download 

One-time share 

Linked options 

Start TRL 

End TRL 

Patient summary 

X 

 

 

3 

6 

Electronic prescription 

X 

 

 

3 

6 

Electronic dispensation 

X 

 

 

3 

6 

Medical image  
and image report 

X 

 

 

1 

3 

Laboratory results 

X 

 

 

3 

6 

Discharge report 

X 

 

 

3 

6 

Telemonitoring 

 

 

 

 

 

Care plan 

 

 

 

 

 
National/regional strategy: 
The next two years a new National EHR System will be implemented, according to the EEHRxF.
There will be available both a web and a mobile application for patient access.
Strategy towards EHDS: 
The Hellenic Ministry of Health and IDIKA participate to the Actions for Primary and Secondary use of Health Data, as to be aware of the work progress in EHDS and prepare for taking actions to conform the National EHR System to the EHDS Regulation.
Business Goals/Benefits and KPIs: 

The primary business goal is to empower citizens, by providing them electronic copy of their health data, enabling them to benefit from services outside the national health systems (ePrescription System, EHR System). 

KPIs: 

  • Number of persons that have pressed the xShare Yellow Button and downloaded their data. 
  • Number of downloads per HID. 
  • Average downloads per person per year. 
Application: 
In the EHR System and the MyHealth mobile app
Data Preconditions: 
Coded data in all sections, formatted according to the EEHRxF
System Preconditions: 
• Security and Privacy Policies will be studied and applied.
• For third party patient apps an eGov patient auth service must be available (not yet).
User Preconditions: 
Patient:
• Create awareness of the xShare Yellow Button.
• Will patient have to consent for sharing data (despite the patient identification/authorization process)?
• Will patient choose where to anonymize data to donate them?
Trigger: 
Patients need to extract and share their information from a patient triggered event, such as traveling abroad, healthcare visit outside the NHS, participation in research, donation of data, use of health app etc.
Challenges/Limitations: 
• Following the EEHRxF to format the data (by all stakeholders).
• GDPR issues.
• Selection of the right interoperability architecture, such as EUDI Wallet, MyHealth@EU.
• Transcoding/translation issues, extensions of the MVC
Involved stakeholders in the BUC definition: 
Executives of IDIKA and experts were involved. Other stakeholders have not been yet involved, as this was an initial approach of the BUC
Application of pseudonymisation filters: 
Yes
Basic Workflow: 
  1. A patient logs in to the NEHR and is well authenticated.  
  2. He/she selects the xShare functionality and is redirected to the xShare service.  
  3. He/she selects which of his/her available data to extract, based on EEHRxF specifications.  
  4. If he/she needs to send his/her data abroad, via the MyHealth@EU service, documents can be translated (when possible) to the select possible language.  
  5. A transaction is logged in the NEHR infrastructure, and he/she can now download the data in structured format (CDA/FHIR, etc) and optionally in PDF. 
  6. On the web browser he/she may download to a preselected folder locally on his/her computer.  
  7. On a mobile app via the sharing mechanism files can be shared to any application that can process and read EEHRxF enabled document types and optionally in PDF. 
  8. The xShare service will have a data donation feature logging this action. Data may (or must) be anonymised on request by the xShare tools. 
Alternative Workflows: 

Same as above but the entry point is Portal B of the MyHealth@EU service. 

The PATHED architecture and the EUDI architecture will be evaluated as implementable interoperability architectures.