Magazine ed*
ed* No. 02/2017

Building a European eHealth infrastructure

ed* No. 02/2017 – Chapter 4

As a result of the growing mobility of insured persons, the European Commission wants infrastructures for electronic cross-border healthcare in the Member States to have been built by 2020. eHealth infrastructure is the keyword.  

Cross-border exchange of health data

As per the Directive on patients’ rights, the European Commission wants to use electronic services for health and long-term care across borders. The promise is of high-quality care at affordable prices and more innovation. The Commission sees the advantage of having interoperable electronic patient records and prescription systems, for example, when staying or living abroad.  

Electronic medical records  

Basic medical information is transferred electronically in the event a patient is treated in another Member State.  


Electronic prescriptions  

Electronic prescriptions make it easier to dispense medicines based on a prescription issued by a physician in another Member State.  


Better networking of specialised health services and data is also provided for by the European Reference Networks (ERN) for rare diseases.  


The level of maturity in the use of digital health services varies between countries depending on the legal framework, national data processing and the actual level of care. 


Vytenis Andriukaitis

Vytenis Andriukaitis European Commissioner for Health and Food Safety

“Digital technology has become part of the fabric of modern society, and the EU must be at the forefront in creating the right conditions for allowing digital developments to flourish. 52% of citizens wish to have electronic access to their health records. We must work harder to make this happen. The development of digital health services has enormous potential for better healthcare at an affordable cost. I’m counting on all stakeholders, particularly the health insurance institutions, to contribute to the transformation of the European healthcare systems.”

EU funding project: Connecting Europe Facility eHealth (CEF eHealth)

The European Commission actively supports the networking of national infrastructures. The Connecting Europe Facility (CEF) is a funding instrument which is used to establish sustainable trans-European networks. In the area of health, a stand-alone Digital Service Infrastructure (DSI) is being established to exchange health data. Member States can apply to receive funding for their projects.  


In addition to the promising idea of it being easier to use health services in other EU countries, it is crucial that national systems are not to be harmonised. Instead, “defined interoperability” between foreign structures will be created. Each Member State will set up a National Contact Point for eHealth (NCPeH) to do this.  


Germany’s contribution to promote digital progress

It is very important to take into consideration the specificities of German healthcare when introducing and permanently establishing the cross-border exchange of health data. This is because it is important to set up a German contact point for eHealth in such a way that is compatible with the German telematics infrastructure and is future-proof. The organisation responsible for the project in Germany is gematik. 


Germany’s first contribution to the initiative is to introduce an ePatient Record. This will benefit insured persons from other countries as German service providers will be able to access electronic patient records from abroad. Following this, it is planned that insured persons from Germany will have access to their electronic health records (e.g. emergency medical data) by 2020.  



Ultimately, building any cross-border network or interoperable system in national organisations leads to major adjustments. The way forward is progress with prudence and “healthy proportionality”, because only 5% of Europeans have medical treatment in another EU country.1 The low uptake of health benefits in other countries is even more pronounced when looking at German health insurance where the costs for medical services taken abroad represent only a relatively small proportion of the total expenditure of 200 billion euros. This might be due to the lack of foreign language-­skills or distance of the family. 


This is why the social insurance institutions are actively involved in the change process at European level in order to take advantage of the opportunities for even better care for insured persons and patients.