1. Medication in Patient Summaries
openMedicine FDA 2016
Silver Springs, June 21st, 2016

2. openMedicine Workshop Washington
Patient has the right
to get for him the most appropriate care when being cross-border:
=>Directive on the patient’s rights in cross border healthcare (article 14 (2) (b) (i))
This includes
Availability of the relevant patient data at the point of care
Correct treatment (medication)
21/06/2016
openMedicine Workshop Washington

3. Scope of “the” patient summary
Scope defines the content
Different summaries possible in parallel
Emergency or unexpected care
Sharing of data for cooperating practices
Pathology specific patient dossier: multidisciplinary diabetes dossier
Patient Migration File.....
eHealth network defined a “basic and extended Patient Summary dataset”
Basic Dataset : “minimum required”
Extended Dataset
21/06/2016
openMedicine Workshop Washington

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Principles
Concise
Only what’s needed to provide unexpected care
One and only one patient summary
Cacaphony
Ideally the GP , record holder
Duration
Until “next”
archived in case of being consulted
Confidentiality
21/06/2016
openMedicine Workshop Washington

5. Essential / Extended Dataset in epSOS
Essential dataset
" a set of essential health information that needs to be sent from a clinical point of view in order to be able to deliver safe care to the patient”
mandatory
Extended dataset
“ the minimum amount of recommended health information from a clinical point of view that needs to be exchanged between member states”
whenever possible
Missing “basic” attributes in clinical data…
e.a. procedure ID, invalidityID
mandatory => how mandatory ?
21/06/2016
openMedicine Workshop Washington

6. Comments on the dataset
Healthcare alert
Basic !
The alert has no sense, well the risk
Normalised identifier.. Does not exist!
Past problems
Miss the notion of “relevant” or “meaningful”
Strange concept, mostly not present
Surgical procedures (split 6 months + /-)
Concept “relevant”
“Major” only required for ‘recent’ procedures
21/06/2016
openMedicine Workshop Washington

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Medication summary
21/06/2016
openMedicine Workshop Washington

8. Comments on the medication section
What do we need to know I differentlyn “emergency”?
Do we need the medication presented differently compared to the EHR?
Duration: is not always known
Identification only by active substance:
Valuable option for cross border usage
What with fytotherapy, homeopathy,…?
How to identify multi-component product?
Do we need the administration regimen?
Can we make it with a DDD?
If qty different per intake…(progressive, degressive schema)
21/06/2016
openMedicine Workshop Washington

9. Comments on the dataset in epSOS (2)
Coded ID is mentioned for each element:
frequently not existing or not available in system of origin
Codes absolutely required in case of a cross border usage
Upgrade of a pre-existing PS
No !!
“crushing” & archive of consulted PS
21/06/2016
openMedicine Workshop Washington

10. Exploitation / Management issues
Complementary services needed
Patient Consent
Safe “data boxes”
Locator services
Regional HUBs
Central Metahub
Access management
Therapeutic link
Hit Rate
Quality issue
21/06/2016
openMedicine Workshop Washington