establishing the business case for sharing personal health

Establishing the business case for sharing personal health data across borders: the VALUeHEALTH project results

Dipak Kalra, EuroRec

on behalf of the VALUeHEALTH Consortium

© HIMSS Europe GmbH

EHEALTH DSI

2

Core services:

• e-Identification

• e-Signature

• e-Delivery

• e-Invoicing

• Cyber security

• eHealth services

• OpenNCP platform

• national interfaces

• country B portal

• security services

• semantic services

Generic services:

• national connectors to the

core services

• portals

• terminology translations

National/local

services:

• eHealth systems and

services that

• create and export

conformant data

• import and use

received data

• manage patient and

user identification

x28

European Commission

EC pump priming

= CEF investment

National health and care

systems

National eHealth

investments

National

pump priming

investments

eHealth DSI

Need to be sustained and extended

beyond 2020 to support

cross-border planned and unplanned care



national health care needs



cross-border planned and unplanned care

© HIMSS Europe GmbH 3

WHAT HAVE WE SOUGHT TO ACHIEVE ?

In relation to cross-border care:

▪ Support use cases for first CEF call (shared patient summary and e-

prescriptions) ➢ Improved quality and safety of care

▪ Support for planned activity ➢ Improved continuity of care

▪ Impact on national infrastructures to enable cross-border use cases


USE CASE SELECTION CRITERIA

• Impact on patient care

–Potential positive impact on individual patients

–Potential positive impact on number of individuals (patients, family, carers)

–Potential impact on health professionals

• Impact on health systems and services

–Improved health outcomes

–Improved health system productivity

–Reduced healthcare costs

–Improved access (to services)

• Policy alignment

–Applicability across all 28 countries

–Legal achievability

–Political acceptance

• Informatics and health ICT alignment

–Technical & semantic feasibility

–Capital costs avoided/contained

–Market stimulation

–Existing experience

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REFERENCE (BUSINESS USE) CASE

eHealth DSI

"Safe Prescribing"

(illustrating the need and value of interoperability for optimising

the safe prescribing of the appropriate medication to the

right patient, at the right dose, at the right time, including in

complex cases of co-morbidity and polypharmacy)

"Integrated Care"


local care coordination, home monitoring, cross-border

unplanned care, cross-border specialty referral for

interventions)

"Integrated Specialty Care" (ERN)


cross-border specialty referral for complex diagnosis and

treatment)

Optimal and Efficient Management of DIABETES with Interoperable Solutions


DIABETES SHARED CARE SCENARIOS

• Unplanned care: a person with diabetes needs unplanned treatment/medication while visiting country B. His/her health record data are located in country A.

• Planned care: a person with diabetes needs planned care in country B. His/her cumulative health record data are located in country A.

• Transfer of care (or cross-border specialist referral): a person with diabetes is moving home to country B. His/her data recorded were previously located in country A.

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IRIA: A PT DIABETIC TYPE 1 PATIENT, NEEDS EMERGENCY CARE

IN LONDON

7

OCC Real time monitoring

Alerts

NI- PS, ePr

OCC: Operational co-ordination center

NI: National Infrastructure


EVOLUTION – FINANCING

FOCUSING ON GENERATING SUSTAINABLE GROWTH

8

Uniform Rules

• Core and generic services

• Co-financing EC and MS

CEF

Post CEF

Source: eSENS Project Long Term Governance Model, 2017

© HIMSS Europe GmbH 9

VALUE PROPOSITIONS

(drivers for interoperability)

Incentivise care services for

• timely diagnosis, safe prescribing, and seamless

care

• improving patients’ health outcomes, patient safety

and population health

• increasing the efficiency of health systems (resource

optimisation)

Accelerate the development and use of interoperable digital

eHealth and mHealth solutions

Scale up population level research (e.g. big health data,

biomarkers, rare diseases)

Facilitate MS co-operation on the eHealth agenda and

support the provision of cross-border healthcare

(unplanned care, planned care)


OPTIMISING MULTI-STAKEHOLDER VALUE CHAINS

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EHEALTH CAPABILITY REFERENCE MODEL

11

Technical

Information

Legal and Regulatory

Policy Market development,

new business

models,

and incentives

Privacy, quality and

safety policies

Legislative and

regulatory

framework

Financing,

Resource allocation,

reimbursement

models

eHealth leadership,

policy and strategy

EU & National Stake-

holder collaboration

Fostering standards

adoption Monitoring,

evaluation

Mobile and fixed

Electronic

Communication

Infrastructures

ICT processing

and storage

services

Access to ICT

Networks,

equipment and

facilities

Patient identification

and patient data

discovery

Data structures and

value sets for EHR,

EMR, PHR, other

Clinical terminologies

and classifications

and codifications

Data and

knowledge

management tools

Data

interoperability

and accessibility

Data bases and

Registries

HCP Authorisation,

authentication and rights

management

Consent management

and access control

ICT Professional

and technical

support; Training

Compliance

Applications Health care

management

Individual EHR

Health service

delivery

Health

information

Diagnostics

Acute / primary

Public health

Emergency Workforce

Pharmacy Finance, HR Planning

Hosting Directory services

Governance



Market development,

new business

models,

and incentives

Privacy, quality

and safety policies

Legislative and

regulatory

framework

Financing,


reimbursement

models

eHealth leadership,

policy and strategy



Fostering standards


evaluation

Mobile and

fixed Electronic

Communication

Infrastructures

ICT processing

and storage

services

Access to ICT

Networks,

equipment and

facilities


and patient data

discovery

Data structures and

value sets

EHR, EMR, PHR,

other

Clinical

terminologies and

classifications and

codifications

Data and

knowledge

management tools

Data interoperability

and accessibility

Data bases

and Registries

HCP Authorisation,

authentication and

rights management

Consent management

and access control

ICT Professional

and technical

support; Training

Compliance

Health care

management

Individual EHR

Health service

delivery

Health

information

Diagnostics

Care plans

Public health

Emergency Workforce



Governance

Intended

Outcomes:

quality of

care,

continuity of

care

New capability

Capability already in

place

Enhanced capability

Technical

Information

Applications


Policy



Technical

Information

Market development,

new business

models,

and incentives

Privacy, quality

and safety policies

Legislative and

regulatory

framework

Financing,


reimbursement

models

eHealth leadership,

policy and strategy



Fostering standards


evaluation

Mobile and

fixed Electronic

Communication

Infrastructures

ICT processing

and storage

services

Access to ICT

Networks,

equipment and

facilities


and patient data

discovery

Data structures and

value sets

EHR, EMR, PHR,

other

Clinical

terminologies and

classifications and

codifications

Data and

knowledge

management tools

Data interoperability

and accessibility

Data bases

and Registries

HCP Authorisation,

authentication and

rights management

Consent management

and access control

ICT Professional

and technical

support; Training

Compliance

Applications Health care

management

Individual EHR

Health service

delivery

Health

information

Diagnostics

Care Plans

Public health

Emergency Workforce



Governance New capability

Capablity already in

place

Enhanced capability


Policy

Intended

Outcomes:

quality of

care,

continuity of

care


VALUEHEALTH PROPOSALS FOR THE SUSTAINABILITY OF EHDSI

SERVICES

1. Legally establish a stand-alone entity, or eHealth business unit within a

nominated entity, within the ambit of the EC and the Member States.

2. Provision its operational mandate, at minimum to maintain the existing

eHealth DSI. This will include updating semantic assets and other services

(including knowledge services such as ontology, cross-mappings, algorithms

and rules) as needed on a regular basis.

3. Ensure this entity has sufficient start-up financial underpinning and access to

growth capital to enable it to reach self sustainability through the following

proposed enhanced services.

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SERVICES

4. Increase the number of patients for whom the services provide benefit, by extending

the patient summary to include supplementary long-term condition summaries for the

(~10) most prevalent conditions and by developing additional services (such as the

healthcare encounter report service).

5. Increase the number of care scenarios for which the services provide benefit by

further extending the structural and semantic content of patient summaries so as to

provide for cross-specialist consultations within European Reference Networks.

6. Generate value and stimulate the health ICT market by enabling third-party access to

eHealth DSI services, through standardised secure APIs, with the purpose of enabling

the growth of apps and services to professionals, patients and other stakeholders.

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SERVICES

7. Generate value through brokering secure query access services that derive

authorised aggregated statistics across multiple nationally-held repositories of

patient summary data, to approved research organisations such as

pharmaceutical firms and the medical device industry.

8. Add further value to Member States and international public organisations by

developing public health and benchmarking dashboards derived from multiple

nationally-held repositories of patient summary data.

9. Collect cost and benefit information from Member States, especially about the

enhanced services.

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http://www.valuehealth.eu

Thank you! Dipak Kalra

on behalf of the VALUeHEALTH Consortium

establishing the business case for sharing personal health

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