Use Case Repository
The Madeira use case will implement the xShare Yellow Button allowing portability of the EHR from SEIS-RAM for patients from the Regional Health System in Madeira, and for tourists to share EHR data with local health authorities. The patient summary data (patient ids, demographic, allergies and intolerances, immunizations, history of procedures, clinical reports, diagnostic results, discharge reports, appointments, and surgeries) is stored in the SEIS-RAM system. The SEIS-RAM system communicates with the digital solutions previously developed, i.e. the patient portal and the mobile app from SEIS-RAM allowing patients to access this data upon registration and authentication. Both the patient portal and the mobile app require a 2-point authentication according to data register upon the Regional Health System registration, thus GDPR compliant.
The xShare Yellow Button will be installed on the patient portal and the mobile app, allowing the EHR to be accessed, downloaded, and then shared.
Once the user presses the xShare Yellow Button, the EHR is download and the patient can share their health data in the different scenarios described.
The button should offer two options for downloading health data, in a format that is readable by the user (e.g. pdf) and in an EU standardised format that complies with standards i.e. with language and coding required by health institutions. By having access to their health data in a standardized format, the patient can then share it with a health institution or health professional of their choice and even across borders. Also, the readable format for the user is of most importance, to encourage and motivate the use of the button by the user, thus additionally increasing knowledge of their health and well-being.
The possibility of placing the button in the app allows patients to always have access to their health data and the ability to share it at anytime and anywhere.
The ability to share the EHR will enable better management of health resources, more personalised healthcare and better preparedness and resilience within health population.
With the Madeira Health Service own HIS, SEIS-RAM, each patient has a unique EHR, featuring all medical records and social clinical data within the public health sector. This system aggregates more than 500,000 EHR and ensures interoperability with several external services such as the National User Registry (RNU), the communication and image archiving system (PACS), the Modulab, the National Cancer Screening System and Madeira’s Medical Emergency Register (REM RAM). SEIS-RAM comprises a dashboard where doctors, nurses and health professionals can manage and monitor provided health care services throughout public health facilities, as this system establishes communication between hospitals and health centres in the Madeira Archipelago.
Following this system, a patient portal was set up in which patients from the Regional Health Service have access to their patient summary in SEIS-RAM, namely: ID and demographics; allergies and intolerances; immunizations; history of appointments; medical reports; diagnostic results; surgery reports and emergency discharges. Health data featured on this portal can be exported in PDF format thus allowing patients from the public sector to share their health data with external health care providers e.g. private health sector. Additionally, a mobile app was also developed allowing the same functionalities of the previously described patient portal.
Previously, by taking part in Smart4Health project, also some additional work aiming health data portability was done in SEIS-RAM. Data from EHRs in SEIS-RAM (demographics, allergies and intolerances, diagnoses, and clinical exam reports) was mapped and sent in HL7/FHIR standards to the Smart4Health platform upon user request. Further enabling health data portability while seeking private/public care and eHealth tourism.
Due to a cyber-attack occurred on the SEIS-RAM system in August 2023, both structures mentioned above (app and portal) are not currently active as since then their security was compromised.
All efforts have been made to resume its operation according to GDPR and it is expected to be soon reactivated for patients.
Local patient |
Can access and share EHR data via the xShare Yellow Button in different scenarios:
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Tourist |
Shares EHR data with health authorities in Madeira in different scenarios:
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Health professional (medical doctors and nurses) |
Receives EHR data via the xShare Yellow Button in different scenarios:
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IT professional |
Developer/tester- develops and tests the xShare Yellow Button within the SEIS-RAM app/ patient portal. |
Smart4Health platform |
Source of information and knowledge as a pre-existing health data sharing system for smart guidelines and medical tourism. |
SEIS-RAM system |
EHR data source. |
HIDs |
xShare Yellow Button basic functionality |
Maturity |
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Download |
One-time share |
Linked options |
Start TRL |
End TRL |
Patient summary |
X |
X |
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6 |
9 |
Electronic prescription |
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Electronic dispensation |
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Medical image |
X |
X |
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2 |
8 |
Image report |
X |
X |
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3 |
9 |
Laboratory results |
X |
X |
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4 |
8 |
Discharge report |
X |
X |
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5 |
9 |
Telemonitoring |
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Care plan |
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The xShare Yellow Button to be featured in MADEHRAS will allow people to exercise their data portability rights under GDPR in a regional network with emphasis in medical tourism and for the public/private sector continuity of care. This will empower individuals to control their health data and ensure interoperability and security within health care providers between public and private health sectors, fostering a single market for digital health services and products.
The xShare Yellow Button will be employed to facilitate continuity of care in Madeira within citizens and tourists.
Image: EHRs in the SEIS-RAM health information system from the Madeira Health Service is connected to the SEIS-RAM app and the SEIS-RAM patient portal enabling citizen’s access to their personalised health data. The xShare Yellow Button will be implemented in these pre-existing digital solutions to the extent that they can enable downloading information from the EHR once the patient has been registered in the Madeira Health Service. The existing portal/app from SEIS-RAM will enable the xShare Yellow Button to download EHRs in the EEHRxF according to standards and guidelines. The EHR exchange will foster a genuine single market for electronic health record systems providing a consistent and efficient system to increase health systems resource management and surmount health threats by increasing resilience and preparedness in healthcare.
Select only one digital solution to present the xShare Yellow Button, the mobile app or the patient portal.
Select specific and the most important health data from the patient summary (e.g. immunization, clinical reports, etc) to be download in HL7/FHIR format when using the xShare Yellow Button.
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