Cross-border e-health data exchange in the EU
Data has been exchanged even before European Health Data Space
CC – 05/2022
creation of the European Health Data Space (EHDS) is the European Commission's
central health policy digitisation project. The goal of the EHDS is electronic
exchange of health data across borders. While the digitisation of health data
is still at the beginning in Germany, ten EU Member States are already
exchanging health data across borders.
Collaboration in eHealth network
In 2011, within the framework of the Patient Mobility Directive (2011/24/EU), the eHealth
network – eHN – was created.
In the eHN, the cooperation of EU Member States in cross-border electronic
exchange via the data infrastructure (eHDSI/MyHealth@EU) is coordinated. The
body is composed of the respective authorities responsible for eHealth in the
Member States – in Germany, this is the Federal Ministry of Health. Cooperation
in eHN has so far been voluntary.
MyHealth@EU becomes mandatory
The data infrastructure eHDSI was
launched in 2015 and transferred to the MyHealth@EU programme. The "Connecting Europe" facility supports infrastructure projects to
better connect the EU and its regions. Funding has also been provided by the EU4Health programme since 2021.
The Member States have long been working to create the
basis for the exchange of medical information in the EU. MyHealth@EU is
intended to facilitate secure, efficient and interoperable exchange of personal
health data within the EU.
In this context, national contact points
(NCPs) for eHealth form the interfaces to the respective national systems. The currently debated draft regulation on the
European Health Data Space (EHDS) for the use
of primary data should be based on the existing MyHealth@EU data infrastructure.
The existing electronic health services should allow interoperable exchange
across the board and supplementation with additional functions. Voluntary
collaboration is to become mandatory health data exchange.
Ten Member States already exchange health data
The first exchange of electronic prescriptions
and electronic medical records took place between Estonia and Finland in
January 2019. By 2025, all Member States should be connected to the MyHealth@EU
data infrastructure and be able to exchange e-prescriptions and digital patient
summaries. Ten Member States are now involved in practical exchanges in the
MyHealth@EU infrastructure. However, the intensity of the exchange varies. Only
Portugal is able to fully implement the exchange of e-prescriptions, thus the
electronic issuance and retrieval of a prescription, and digital patient
Other Member States, such as France, can receive digital patient
summaries but cannot send them. In addition, the number of pharmacies and
hospitals already connected to the data infrastructure varies from one Member
State to another. While all pharmacies and hospitals in Croatia are already
connected, only 15 percent of the total hospitals in the Czech Republic are.
For a detailed and interactive dashboard of participating Member States, as well as the number and access pathways of
e-prescriptions and digital patient summaries exchanged, please visit https://webgate.ec.europa.eu/santegis/eHDSI/
Germany wants to exchange digital patient summaries by 2023
Although Germany is a member of the eHealth
network, it is not yet actively involved in data exchange via MyHealth@EU. This
is primarily due to the domestic challenges of digitising health data and
introducing the electronic medical record, digital patient summaries and
e-prescription. However, Germany is currently planning to be able to exchange patient
summaries electronically across borders via MyHealth@EU at least by 2023/2024.
Starting 2023, the digital patient summary will gradually replace the card-based
application of electronic emergency data as well as the information provided by
insured persons on the existence and storage location of paper-based organ
donation declarations, healthcare proxies or living wills, which are also
stored on the electronic health card.
Some initial groundwork has been laid for
cross-border health data exchange. However, the voluntary collaboration in
MyHealth@EU is so far only about the exchange of e-prescriptions and digital
patient summaries. The EHDS will also allow for the gradual exchange of other
health data such as laboratory reports, medical imaging and discharge reports.
Whether all Member States will be ready for this from 2025 remains to be seen.
The same applies to the European Commission's self-declared goal of ensuring
that all EU citizens have access to their medical data, i.e. their electronic medical
records by 2030.