Patient summary sharing on a cross-border and international scale

Purpose: 

Sharing information about the medical background and history of a patient by a healthcare professional in another country 

Relevance: 

Many people request medical help when travelling, working or living abroad. Medical information from the country of origin should be available to all citizens in Europe (in their native language). The current solutions (if any) for getting medical information from another country are often cumbersome, unsafe, incomplete and nonstandard. The treatment of patients without proper medical background information is hazardous and should be avoided. Benefits can be gained from increased quality of care (e.g. patient safety) (both medical and economical) and from decrease in effort of gathering health information/exchanging health information. This Use Case proposes a way towards solving this problem. 

Domain: 
Patient Summary
Scale(s): 
Cross-border
International
Context: 

The definition of a patient summary was laid down by the epSOS project as a starting point for the development and pilot testing of a patient summary for citizens who are travelling abroad and need medical help (unplanned).

Challenges are related to the level of data required and the quality of information relevant to support patient treatment effectively across 36 different participating European countries. Different countries operate different health care systems. Each country follows its own respective national jurisdiction, supports a different culture for healthcare provision, and uses a different (or several different) language(s) (which may also involve different connotations of similar medical terminology in literal translation).

A patient summary provides background information on important aspects such as allergies, current medication, previous illnesses and surgeries, et cetera. These are necessary for the proper treatment of a patient abroad, especially when there is a language barrier between the HCP (healthcare provider) and the patient.

Actually two use cases are possible with regard to the Patient Summary (PS). The first is the one in which an occasional visitor needs his/her PS in country B. The second is the one in which the person is a regular visitor in country B (i.e. someone who lives in one country but works in another country). The distinguishing characteristic is that this type of occasional situation where the HCO may have some information available from previous encounters. Both a PS of country A as well as one from country B needs to be consulted. In this use case the use case of the occasional visitor is described. More extensive information about this use case and Patient Summary requirements can be found in epSOS Deliverable 3.2.2. Information about identification, authentication, authorisation, and consent sharing can be found in epSOS D3.6. 

Information: 
Patient Summary (in patient’s language and country B language)
Patient consent
Participants: 
Patient
HCP in country of origin
HCP in another country
Functional process flow: 

(With reservation that preconditions are met – can be found in D3.2.2.)

  1. The patient consults a health professional in country B (= not home country)
  2. The patient is identified (identity confirmed by country A)
  3. The patients gives consent; either before travelling to country B or at country B via information paper (except for emergency cases)(reference: epSOS Deliverable 3.6 Identity management) The patient gives consent to the health professional. The health professional will then register this confirmation to participate in the epSOS network
  4. The HCP is identified, authenticated, authorised.
  5. The patient confirms his/ her willingness to participate
  6. The health professional retrieves the patient summary and uses it for the consultation. The patient summary is electronically transferred from the patient's country of origin to the health professional in the country that s/he is visiting (the "visiting country") in a secure way.
  7. Patient Summary is received in both the language of the patient (PDF of original PS) and a translated version for the HCP. 
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