Europe 2014-2020: e-santé (projets et réalisations)
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Commission Européenne, présentations de la Délégation générale Société de l’Information à la délégation d’Aquitains conduite par AEC, 30 janvier 2012: e-santé, TIC et bien-être (exemples de projets et de réalisations)
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Europe 2014-2020: e-santé (projets et réalisations)
- 1. epSOS - Smart Open Services for European Patients Un projet européen de eSanté Le projet epSOS est un projet d’ intéropérabilité dans le domaine de la eSanté co-financé par l’Union Européenne qui a pour objectifs : - d’améliorer la qualité et la sécurité des soins des patients voyageant dans l’UE -réduire la fréquence d’erreurs médicales et la répétition (redondance) des diagnostiques. - fournir aux professionnels de santé un accès rapide au dossier personnel résumé du patient (« life saving data ») 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 1 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 2. Les services epSOS es Patients auront la chance d’utiliser des services e-santé transfrontaliers testés : n En 1ère phase: ésumé Patient rescriptions électroniques (ePrescription / En 2nde phase: systèmes „eMedication“) ntégration des services d‘urgence 112 ntégration de la Carte Européenne d‘Assurance de Santé (EHIC): Céline Deswarte 12 Conférence Annuelle « Cartes Santé 2012 » ème Présentation de 2 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 3. L’ ePrescription epSOS est un service qui est constitué des prescriptions électroniques et des « electronic dispensing » du patient. Prescription: Il s‘agit de la prescription électronique de médicaments par le biais d‘un software qui transmet directement la prescription à la pharmacie où elle sera retirée. *L’ePrescription est testé entre la Suède, la Finlande, le Danemark, la République Tchèque, l’Espagne, l’Italie et la Grèce. 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 3 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 4. Le résumé Patient epSOS est un ensemble de données standardisées, qui inclut les données cliniques les plus importantes, essentielles pour des soins de santé sûrs et sécurisés. e Résumé Patient epSOS contient les données suivantes: nformations générales à propos du patient n résumé médical ne liste des médicaments actuels 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 4 nformations à propos du Résumé Patient - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 5. Netc@rds - vers une eEHIC Netc@cards est un project européen qui vise à faciliter la dispense de soins pour les citoyens européens en déplacement dans un autre pays de l’UE (ex: pour les vacances, en voyage d’affaires etc.), et d’instaurer les bases d’une carte européenne d’assurance maladie électronique (e-EHIC) Mission: •Permettre aux professionnels de santé de vérifier que le patient étranger possède une assurance santé •Echanger en ligne des données administratives entre des assurances de santé nationales et faciliter le remboursement Acteurs: - Sécurité sociale et les mutuelles de santé -Instituts de recherche/technique (ex: de standardisation) - Hôpitaux et/ou des organisations de santé - L’autorité de santé régionale *Bénéficiaires 17 Etats de l’UE et de l’EEE: Autriche, Bulgarie, République Tchèque, Finlande, France, Allemagne, Grèce, Hongrie, Italie, Liechtenstein, Pays Bas, Norvège, Pologne, Romanie, Slovaquie, Slovènie, Suisse 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 5 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 6. Netc@rds – Comment cela marche? Les données du patient peuvent être accédées de façon sécurisée par: - reconnaissance optique ou “scanning” de la carte plastique EHIC information ; ou - lecture de la carte de santé électronique nationale/régionale et vérification en ligne des données Revue technique: - Fournir des solutions sûres et interopérables pour le passage à une e-EHIC; - Cela comprend un réseau sécurisé de portails et de bases de données nationaux (ex: portail de la mutuelle de santé); - Chaque portail peut être connecté à un ou plusieurs registres nationaux ou régionaux à la fois en vue de faire le checking administratif en ligne. 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 6 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 7. Netc@rds – Opportunités Données administratives eEHIC : potentiellement utilisable comme outil d’identification du patient et de retrait de données lors de l’ accès à des applications eSanté (ex epSOS LSP). Bénéfices pour chaque intervenant clé: Professionnels de la santé: Accès rapide à des données administratives clées, moins de bureaucratie Patient UE: User-friendly deployment of national/regional health insurance card, no other paper documents required before travelling/moving to another EU country Sécurité sociale/Mutuelles de santé: Quicker cost refunding, reduction of fraud, and streamlined interstate claims 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 7 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 8. STORK Secure Identity Across Borders Linked EU project on cross-border recognition of electronic identity (eID) (2008-2011) STORK aims to establish an EU-wide eID interoperability platform in eGovernment. Mission: To facilitate citizens and businesses in accessing public services (social insurance, taxation, student diploma, etc.) from abroadfrom any EU MS. How? - developing common rules and specifications; - testing some of the most useful services to EU citizens abroad; - interacting with other key EU initiatives (e.g. epSOS, Netc@rds). Funding: 20 millions under the EU ICT CIP 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 8 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 9. eID cross-border challenges All MS have their own eID infrastructures STORK key features: - Establishes a common legal, organisational and technical platform to recognise all existing eIDs No replacement of MS structures - Privacy guarantees: - User always controls data - Platform does not store data Electronic identification is key in eHealth as to ensure: -unambiguous identification of user (patient or HCP) and secure data protection/privacy -facilitate cross-border care 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 9 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 10. Access to eHealth services • Local Services • Hospitals ENTITLEMENTS E.g. EHRs, e-Prescriptions, What you can do • GPs Letters of discharge, 112 … • Pharmacies epSOS • MS Patients Health professionals ROLE • Regional N.C.P. What you do • Local Health Insurance Status Netc@rds Interface • MS IDENTIFIER • EU eID Who you are STORK 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 10 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
- 11. Pour de plus amples informations epSOS Netc@rds http://www.epsos.eu http://netcards-project.com STORK https://www.eid-stork.eu/ Agenda Digital pour l’ Europe http://ec.europa.eu/digital-agenda site internet « ICT for Health » de la Commission européenne http://ec.europa.eu/ehealth Etudes: http://ec.europa.eu/information_society/activities/health/studies/published/index_en.htm Sur les médias sociaux @ehealthInfso on twitter, facebook and youtube eHealth Infso Daily http://paper.li/eHealthInfso/1317734444 eHealth Week 2012 http://ec.europa.eu/ehealthweek 12ème Conférence Annuelle « Cartes Santé 2012 » Présentation de : Céline Deswarte 11 - Dii - Paris, les 06 et 07 décembre 2011 Policy Officer
Hinweis der Redaktion
- Importance: développer des niveaux adéquats de protection des données des patients
- As of 1 June 2004 the eye-readable EHIC has become a proof of entitlement to healthcare abroad within EU/EEA countries. The idea underpinning this EU co-funded project under the e-TEN programme, is to build upon this achievement facilitating the ‘electronification’ of EHIC and ease cross-border administrative transactions.Thus, any “mobile” European citizen with his/her card and in need of non-planned medical treatment abroad can benefit from the NETC@RDS service. Netc@rds enable health practitioners to check foreign patients’ entitlement to healthcare and it is based on a General Agreement between Health Insurance Organisations (HIO) Participating actors – about 30 partnering organisations in total: … Technical/research institutes or standardisation bodies acting on behalf of health insurance organisations
- Key Steps: 1. The patient presents his/her EHIC or national/regional health insurance card to the Healthcare provider (HCP). 2. HCP will read administrative data from the EHIC or national health insurance card using an Optical Card Reader or a Smart Card Reader 3. Eligibility is then verified within a few seconds by checking the administrative data via two NETC@RDS portals against the database of the relevant health insurance authority. National service portals and databases : accessed from authorised and identified health professionals and certificates are stored in different devices depending on national schemes (e.g. workstation hard disks, health professional cards, USB keys). The electronic data set is processed and used as a proof of entitlement and guarantee of cross-border reimbursement.
- There are benefits measurable on several levels, linked to each of the various impacted stakeholders’ operational domain: Healthcare professionals: Able to focus on their job (delivery of care) and reduction of administrative duties Patients: Can receive the needed treatment timely; are granted entitlement like at home; are not being bored by forms, dedicated cards, cash payment, etc. Health Insurance: Can have a satisfied customer; can accrue more cost effective procedures: e.g. no calls for E111 and no paper based reimbursement; no errors in data. The Netc@rds project was officially terminated in 2011. However, about 7 countries are defining how to continue the project beyond EU funding / for greater sustainability.
- Using their national electronic identities (e.g. smart card), citizens can easily access basic public services (social insurance, taxation, certificates, etc.) from abroad. STORK works towards the establishment of an interoperable platform to assist mutual recognition of eIDs across national borders . It includes 32 partners and about 12 business organisations as subcontractors. The project tests some of the most useful services for EU citizens, such as working or studying in other EU countries (e.g. requesting official certificates); The project interacts with other key EU initiatives in order to maximise the usefulness of eID services. Specifically in the domain of eHealth, STORK has conducted as part of its working programme an evaluation of links and coordination opportunities with: [email_address] : electronic EHIC, in fact, is a logical candidate to be used as ELECTRONIC PATIENT IDENTIFICATION in eHealth. epSOS : for the evaluation of which a liaison called “STORK meets epSOS (STepS)” was established. The important link between STORK and epSOS is clear given that secure identification and authentication plays a crucial role in the eHealth domain. The goal is to identify GAPS and how these can be addressed.
- Today, there are around 30 million eIDs used in the EU (e.g. smart/chip cards, mobile phones, e-readers). They are used for multiple purposes, in different sectors for both public and private services. The challenge is that all MS have their own eID infrastructure . This means that there is a very varied scenario: Different MS use different ways for citizen identification; The identifier for a service may often not be used outside of the issuing country; Different identifiers are used in different sectors and/or by different service providers. The idea underlying STORK is to keep these existing national systems or infrastructures and only enhance (without changing) national solutions. Interoperability is added on top of the existing infrastructure (exactly like epSOS). STORK is to be intended as an ENABLER for different service domains (eGovernment, eHealth, etc.) and thus sector-independent or sector-neutral. The citizen accesses the services using his national eID and the STORK platform obtains the required guarantee and authentication from the national government. In this instance, data is only exchanged between MS and not shared. Privacy guarantee: USER always controls data to be sent and is required to give explicit consent before information is sent out to the service provider; Platform does not STORE any personal data , so no data can be lost either.
- Clearly, in eHealth secure access and authentication of the user is the key building block to provide any eHealth service . Electronic identification and authentication is already in use in several MS for both access of patients to online healthcare services and exchange of data with healthcare providers which are part of the National Health Service. However there’s a need to enable use also abroad not just at home, to realise cross-border care. However, differently than what happens with most eGovernment services, in the case of healthcare, the user does not JUST need to identify himself for WHO HE IS , but also in terms of ‘attribute’, e.g. the ROLE he/she plays (e.g. nurse, health practitioner, patient). This is needed in addition to the basic eID data. The potential link between the three projects envisions: Use of national eIDs as a Healthcare sector entry point Facilitate interoperability of national solutions , developing interfaces and proxy solutions to enable communication between systems; Use of ‘additional attributes’ linked to the role of the person (e.g. health professional) in order to ensure authorised access to transferred data; Access to the different eHealth services (e.g. e-prescriptions) and thus to patient-related health information. We see, in particular, the high potential for synergies between the LSPs STORK and epSOS , how? - STORK has established a cross-border framework which enables the authentication of foreign eIDs; - epSOS wishes to enable both secure access to patient health information and transfer of data to healthcare providers. For both functionalities epSOS needs identification and authentication of the id of the person + authentication of the ROLE of the person to verify rights of access to data. First field tests undertaken by STORK and epSOS demonstrate that these functionalities are achievable between the two networks BUT More work is needed to tackle gaps and fine-tune potential solutions.