1. Convergence and the eHealth Interoperability Framework
Benoit Abeloos DG Communications Networks, Content and Technology European Commission Unit, Health and Well-being Brussels, 20 March, 2013

2. Interoperability in the EC policy agenda
Action 77: Foster EU-wide standards, interoperability testing and certification of eHealth systems by 2015 through stakeholder dialogue
Digital Agenda for Europe
Formal, voluntary network of MS under Directive on patients’ rights in cross-border healthcare
Advisory body on eHealth issues including interoperability and standardisation
eHealth Network
eHealth Action Plan
eHealth Action Plan
Connecting Europe Facility
Large scale deployment of Digital Services
Part of the Multi Annual Financial Framework proposal
CEF Regulation in co-decision

3. Towards a single digital market in 2020
The need for an eHealth Interoperability Framework
CEF
Source: Digital Agenda for Europe ( )

4. Phase II of eHealth Interoperability Framework study
eHealth EIF Phase I
eHealth EIF Phase II
Jan
June
July
Dec 2013
Workshop
Study report including the methodological approach 1
The vision on the eHealth European Interoperability Framework (EIF) (including the legal, semantic, organisational and technical levels) 2
An assessment framework to assess profile development organisations and individual profiles 3
A first proposal for the population of the technical level of the eHealth EIF 4 4

5. Vision on eHealth EIF structure
Governance
Interoperability Levels
High-Level Use Cases
Legal Interoperability
Organisational Interoperability
Use case 1
Principles
Interoperability Agreements
Use case 2
Semantic Interoperability
Technical Interoperability
...

6. Vision on technical interoperability
eHealth European Interoperability Framework
International base standards and profile development
Use Case A
Profile 1
Profile 2
Profile 4
Profile 1
Use Case B
Profile 1
Profile 3
Profile 4
Base Standard 1
Profile 2
EU Cross-Border deployment under the CEF
Base Standard 2
(Extensions)
Use Case A1
Profile 1
Profile 2
Profile 4
Specific Profile
Base Standard 3
Profile 3
Base Standard 4
National/Regional eHealth Interoperability Project
(Extensions)
Use Case A2
Profile 1
Profile 2
Profile 4
Specific Profile
Base Standard 5
Profile 4
Local (e.g. Hospital) eHealth Interoperability Project
(Extensions)
Use Case B1
Profile 1
Profile 2
Profile 4
Specific Profile

7. The PDOs in scope for this study were IHE and Continua
IHE and Continua are international organizations developing and testing (technical) interoperability specifications in eHealth.
They represent organizations which have a good market penetration.
IHE and Continua
IHE has developed a use case based methodology which is being endorsed by the ISO: ISO TR IHE Global Standards Adoption Process.
History: M403 was already going to work on epSOS, hospital and telehealth use cases.
IHE and Continua profiles used in some national frameworks
Note
A profile combines and refines the use of a set of base standards to address a specific technical use case
A technical use case is a description of sequences of technical events that, taken together, lead to a system doing something useful
Note: PDO = Profile Development Organisation

8. The selected list of ten use cases covers a relevant excerpt of medical care provision
Cross-border Level
Medical care provision
National / Regional Level
UC 1
Pharmacy
Citizens at home & on the move
Inpatient medical care provision
Medical care provision
UC 2a/ 2b
Primary care physician
PC-based Care Mgt.
Pharmacy
Hospital IIIa
RIS
LIS
UC 8
UC 5a
Medical Specialist
Primary care physician
UC 6
UC 7
Mobile-based Care Mgt.
UC 5b
Hospital I
UC 9
Medical Specialist
RIS
LIS
Hospital IIIb
Sensor-based Care Mgt.
Rehabilitation
Hospital II
UC 3 + UC 4
UC 10
(2 hospital locations affiliated to same hospital mgt. organization)
Rehabilitation

9. Organisational criteria
The assessment framework is based on Annex II of the Regulation on European Standardisation
Annex II of Regulation of European Standardisation
Organisational criteria
Technical Specification criteria
Category ‘Type of organisation’
Category ‘Market Acceptance’
Category ‘Openness’
Category ‘Coherence ’
Category ‘Consensus’
Category ‘Availability’
Category ‘Relevance and Effectiveness’
Category ‘Transparency’
Category ‘Neutrality and Stability’
Category ‘Maintenance’
Category ‘Quality’
Category ‘Intellectual property rights ’

10. Conclusions of the study
IHE
No major non compliance
Rooms for improvements
Continua:
Original non compliances on transparency, openness and consensus
Continua Board approved changes in their process in Dec 2012
This will affect future specifications only

11. Governance of eHealth EIF
eHealth Network (MS, EC)
CEF Governance (MS, EC, industry)
eHealth Stakeholders Group
From 2012, permanent
From 2014, permanent
eHealth Governance Initiative
ICT standards multi-stakeholders platform (MS, EC, others)
Until 2014, project based
From 2013, permanent
eHealth standards
eGov standards
Internet standards
Other ICT standards
eHealth EIF project
7 IHE profiles were submitted to the ICT MSP in Feb 2013

12. The eHealth EIF study is only the start of a process to populate the eHealth EIF
Receiving feedback
Review by Commission, MS and stakeholders
New insights
Identification of specs by ICT MSP
Update of eHealth EIF

13. The next step is to populate the semantic level
Convergence between EU initiatives is needed…

14. Thank you!
Benoit Abeloos:

15. Backup slides

16. Use cases list Nr Level Use case 1 Cross-border
epSOS project : e-Prescription and e-Dispensation for cross-border information sharing for citizens travelling in Europe 2a
epSOS project : patient summaries for cross-border information sharing for citizens travelling in Europe 2b
epSOS project - patient having access to his or her patient summary. 3
National/Regional
Request and results (imaging results, diagnostic examinations) sharing workflow for radiology in inter-hospital setting on national/regional scale 4
Request and results (laboratory reports, test results) sharing workflow for laboratory in inter-hospital setting on national/regional scale 5a
Cross-Enterprise Sharing of Medical Summaries IHE Integration Profile: Ambulatory Specialist Referral 5b
Cross-Enterprise Sharing of Medical Summaries IHE Integration Profile: Acute Care Discharge to Ambulatory Care Environment 6
Intra-Hospital
Request and results (imaging diagnostics tests) distribution workflow for radiology in intra-hospital setting 7
Request and results (clinical laboratory tests) sharing workflow for laboratory in intra-hospital setting 8
Citizens at home and on the move.
Involvement of patient in documentation of his/her specific chronic disease and making it available via PC or web based applications to healthcare provider (e.g., diabetes, CVD, COPD, hypertension) 9
Involvement of patient in documentation of his/her specific chronic disease and making it available via mobile monitoring devices and mobile phones to healthcare provider (e.g., diabetes, CVD, COPD,…) 10
For ever-present care outside conventional care facilities, involving the interoperability necessary from sensor devices to monitor activity, e.g. of elderly people