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Inventory of Patient Summaries in the EU & US: Use Cases, Projects

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Inventory of Patient Summaries in the EU & US: Use Cases, Projects Trillium Bridge Bridging Patient Summaries across the Atlantic WP 5 – Policy Convergence Draft strategy briefs Version: 1.0 Date of Issue: September 1, 2015 FP7-610756 Trillium Bridge Draft Strategy Briefs 2 Document Information Deliverable name (dc:title): Draft strategy briefs Deliverable No. (dc:identifier) 5.1, Final Work Package WP5: Policy Convergence Date of Issue (dc:date.issued): September 1, 2015 Status Proposed final draft for consortium review Version (dc:relation.hasVersion) 3 Replace (dc:relation.replaces): n/a File Name FP7-SA610756-Trillium_Draft_Strategy_Briefs.docx Nature1 (dc:type) R Disseminiation Level2 PU (dc:accessRights) Name Organisation Responsibile (dc:publisher): Dipak Kalra EuroRec Responsibile (dc:publisher): Author (dc:contributor.creator): Autore (dc: contributor.creator): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): Contributor (dc:contributor): 4 1 Please indicate the nature of the deliverable using one of the following codes:R = Report, P = Prototype, D = Demonstrator, O = Other 2 Please indicate the dissemination level using one of the following codes: PU = Public PP = Restricted to other programme participants (including the Commission Services). RE = Restricted to a group specified by the consortium (including the Commission Services). CO = Confidential, only for members of the consortium (including the Commission Services). V1.0 –1/09/2015 Page 2 of 61 FP7-610756 Trillium Bridge Draft Strategy Briefs 6 Document History Date Vers. Editor Change Status 28/02/2015 0.1 Dipak Kalra Initialization Draft 30/3/2015 0.2 Dipak Kalra Updated to summarise the workshop, Draft update some templates and to add an annex with the workshop agenda 30/3/2015 0.2 Dipak Kalra Additional annex reformatting the Draft plus material out of templates 31/3/2015 0.3 Dipak Kalra and Catherine Updating further templates following the Final draft Chronaki workshop, updated Approach section 1/9/2015 1.0 Dipak Karla Update of the Executive Summary Final 8 Please note that the template contents and many discussion contributions were produced by many of the consortium members on both sides of the Atlantic. 10 V1.0 –1/09/2015 Page 3 of 61 FP7-610756 Trillium Bridge Draft Strategy Briefs 12 Table of Contents 1 EXECUTIVE SUMMARY ............................................................................................................................. 5 14 2 BACKGROUND ........................................................................................................................................... 6 3 APPROACH ................................................................................................................................................. 7 16 4 STRUCTURE OF THE TEMPLATE FOR CAPTURING DETAILS OF EACH POLICY AREA .................. 9 5 TOPIC AREA TEMPLATES: EDUCATION...............................................................................................11 18 6 TOPIC AREA TEMPLATE: INCENTIVES .................................................................................................16 7 TOPIC AREA TEMPLATE: INNOVATION ................................................................................................20 20 8 TOPIC AREA TEMPLATES: FUTURE STANDARDISATION .................................................................24 9 TOPIC AREA TEMPLATE: CROSS-VENDOR INTEGRATION ...............................................................30 22 10 TOPIC AREA TEMPLATE: PRIVACY AND SECURITY ........................................................................35 11 TOPIC AREA TEMPLATE: RESEARCH ................................................................................................40 24 12 ANNEX 1: DETAILED NOTES OF THE E-CONSULTATION WITH EXPERTS ....................................44 13 ANNEX 2: AGENDA AND PARTICPANT LIST FOR THE MARCH BRUSSELS WORKSHOP ...........58 26 V1.0 –1/09/2015 Page 4 of 61 FP7-610756 Trillium Bridge Draft Strategy Briefs 28 1 Executive Summary 30 This report is the second release version of the first deliverable from work package 5 of the Trillium Bridge project: D5.1. This work package considers the areas of strategic change and collaboration 32 will be needed to catalyse the wide-scale adoption and use of shared health summaries to support unscheduled (including emergency) patient care on both sides of the Atlantic. 34 The work package is targeting the development of adoption strategies, and to propose 36 recommendations for policy convergence between the US and the EU to facilitate these adoption strategies. Seven key topics are identified as being the most important areas in which adoption 38 strategies may be needed: 40 Education Innovation 42 Incentives Future standardisation 44 Cross vendor integration Privacy and security 46 Research 48 This deliverable reports the investigations into the principal challenges that may need to be 50 addressed for such scaling up, under these seven topic areas, and some candidate approaches are proposed. These are presented as a series of templates, at present each having some 52 incomplete sections that will be populated in the coming weeks. 54 This release version reflects the main conclusions to date of initial project meetings and lessons learned so far during Trillium Bridge, specific e-consultations with transatlantic experts on these 56 seven topic areas, and the outcomes of a transatlantic workshop held on 23rd and 24th March, in Brussels. The outcomes from that workshop are still being consolidated, so this deliverable 58 represents a work in progress on that content, which will be revised and republished in Deliverable 5.2. 60 The work in this deliverable will be updated during April and May 2015 through further online 62 consultation with relevant domain experts. Through this consultation process a set of recommended adoption strategies and areas for policy convergence will be proposed. They will be 64 presented and discussed during the eHealth week conference in May 2015, in Riga. The final consensus agreement on these adoption strategies and recommendations will be published as the 66 second and final work package 5 deliverable: D5.2. V1.0 –1/09/2015 Page 5 of 61 FP7-610756 Trillium Bridge Draft Strategy Briefs 68 2 Background 70 It is recognised that it is challenging to deliver safe and effective care to patients presenting to a general practitioner or emergency department in a context where there is no background health 72 information on the patient. Medical summaries, sometimes given to patients to carry on paper when they travel, and at other times sent urgently by fax, have long been used as a method of 74 quickly informing an emergency care provider of the salient facts to enable them to make safe and optimal decisions. On the other hand, many unscheduled care encounters are handled in the 76 absence of any such summary information, and many healthcare providers are used to dealing with clinical situations where they have to infer all that they need to know, including scenarios in 78 which a patient is unconscious or unable to give a clear account, and where there be no relative or other carer to provide this information. 80 Clinically led developments of standardised medical summary specifications have been published 82 over many years, in different countries and by different specialties, the most widely known being the ASTM Continuity of Care Record (CCR). The CCR is a generic medical summary intended to 84 convey salient information when handing over the care of a patient from one organisation to another, such as when a patient is discharged from hospital. Standards bodies such as HL7 have 86 developed technical representations of this summary that can be exchanged as electronic messages. There have been subsequent but divergent activities in the US and the EU to formalise 88 the representation of an emergency care summary that can be used to inform an unscheduled clinical encounter. Recognising that there is value in transatlantic collaboration to support 90 emergency care scenarios when European patients travel to the US and vice versa, the Trillium Bridge project has brought together informatics experts and representatives from key standards 92 bodies to create a bridging translation between these summary specifications. That work has been reported in project deliverables from the packages 2, 3 and 4. 94 Work package 5 takes as its starting hypothesis that this bridging has been successfully specified 96 and is ready to be implemented by the vendors of EHR systems and other eHealth infrastructure components and services. It basically ask the question "What else is needed in order for this 98 bridging specification to be widely adopted and incorporated into products, deployed across Europe and the US, successfully used by healthcare organisations to generate meaningful 100 summaries, for receiving healthcare providers to trust and make good use of that summary information, and for all stakeholders to be comfortable with the protections in place over these 102 information flows." looking to the future, this work package also asks "What are the implications of the learning from this project and the experience of developing standards for health summaries, for 104 the future of health informatics standardisation, and what are the future areas of research that still need to be explored."
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