Data has been exchanged even before European Health Data Space

The 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 summaries.

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.