Finland and Estonia pioneering cross-border health services

On January 21, digital exchange of prescriptions and patient summaries became a reality between Finland and Estonia, the first two countries pioneering the use of e-prescriptions across borders.  As such, the first EU patients will be able to use digital prescriptions issued by their home doctor when visiting a pharmacy in another EU country: Finnish patients are now able to go to a pharmacy in Estonia and retrieve medicine prescribed electronically by their doctor in Finland.

Movement of people across the EU is increasing more and more, reason why in 2011 the European institutions adopted the Cross-Border Healthcare Directive (2011/24/EU), ensuring the continuity of care for European citizens across borders. This gives Member States the possibility to exchange health data in a secure, efficient and interoperable way.

The following two electronic cross-border health services are currently progressively introduced in all European countries:

• ePrescription (and eDispensation) allows citizens in Europe to retrieve their medication in a pharmacy located in another European country, thanks to the online transfer of their electronic prescription from their country of affiliation (hereafter referred to as the country of residence) to their country of travel. Your country of residence is informed about the medicine you retrieve in the country of travel (eDispensation).

• Patient Summary provides information on important health related aspects such as your allergies, current medication, previous illness, surgeries, etc. It will form part of a larger collection of health data called European Health Record, whose implementation across Europe is planned at a later stage. The digital Patient Summary is meant to provide doctors with essential information in their own language concerning the patient, when the patient comes from another EU country and there may be a linguistic barrier. On a longer term, not only the basic medical information of the Patient Summary, but the full Health Record should become available across the EU.

The ePrescriptions and Patient Summaries can be exchanged between EU countries thanks to the new eHealth Digital Service Infrastructure, which connects the eHealth national services among them to exchange health data.

According to the European Commission, 22 Member States are part of the eHealth Digital Service Infrastructure and are expected to exchange ePrescriptions and Patient Summaries by the end of 2021. Additionally, 10 Member States (Finland, Estonia, Czechia, Luxembourg, Portugal, Croatia, Malta, Cyprus, Greece and Belgium) may start these exchanges by the end of 2019.

Exchange of health data across borders gets a boost from the Commission

The European Commission has announced the publication of a roadmap where it presents a Recommendation to establish a Format for a European Electronic Health Record (EHR) Exchange. 

This Recommendation follows a 2017 public consultation which revealed that all stakeholders believe that the lack of interoperability between the Electronic Health records is a great obstacle to seamless access to health data. Civil society, professional groups, trade bodies and researchers are welcome to give their input to the Commission’s roadmap until December 20.

According to the document, the Recommendation which may come into force early next year, will most likely cover aspects such as:

• Inviting Member States to put in place strategies and where needed adapt their legislative framework to promote secure access, including cross-border, to their Electronic Health Records;

• Recommendations to Member States regarding the adoption and further evolution of common technical specifications (including established protocols and data formats) for a European Electronic Health Record exchange format enabling cross-border access to health data;

• Proposing a way of working between Member States, relevant stakeholders and the European Commission to continuously improve and develop specifications and standards, implement the exchange format for Electronic Health Record and monitor uptake across the EU.