In short, the project enables patients to be in full control of the usage and the routes of their health data. The central instrument, being laid in “patients’ hands” is the Smart EHR (S-EHR), leveraging a set of new protocols for secure and cross border exchange of health data. A S-EHR may securely store the health history of a person on his/her mobile device. At choice of the person, it may be complemented by the usage of the S-EHR Cloud service, for preserving the personal health data on a cloud repository managed directly by the citizen. The S-EHR is able to communicate with applications of health care operators and researchers of different countries via highly secure channels of two kinds: local (based on a Device to Device protocol that does not use the Internet), remote (using Internet based protocols).
The concertation of these tools is exemplified (and implemented) by three scenarios:
- Scenario 1 – Device to Device (offline) data sharing
- Scenario 2 – Emergency consultation of health data in the S-EHR cloud
- Scenario 3 – Consultation by researchers of integrated and anonymised data
Scenario 1 – Device to Device (offline) data sharing
A patient, suffering from heart failure and arrythmia is abroad. While experiencing shortness of breath and unregular heartbeats he/she contacts a local specialist for a consultation.
Health data, previously imported on the S-EHR from an EHR in the home country, are shared directly (device to device) from the S-EHR on the patient’s mobile device to the device of the medical doctor. In the country of the current stay, the patient authorises, using the S-EHR mobile app, the doctor to access to elements (e.g. allergies, adverse drug reactions) of his/her health data. The doctor accesses this shared data from an “HCP app” able to make use of the device to device protocol. The doctor establishes a treatment on these grounds and any prescription is transferred in the S-EHR of the patient. Once the patient has left, the doctor has no access to further, additional information from the S-EHR.
Scenario 2 – Emergency consultation of health data in the S-EHR cloud
A 56 years old male patient is abroad and complains nausea, vomiting and mild abdominal pain. He is transferred by an ambulance to a local emergency department. The condition deteriorates, the patient is in a confusional state and requires prompt treatment.
The patient brings with him an identity token for emergency use. The Health Care Professionals (HCPs) use an HCP App that verifies their identity and their professional role using the national identity provider. Then – using the emergency token of the patient – the HCPs are granted access to the emergency dataset, stored in the S-EHR Cloud of the patient. The access is traced as using “emergency mode”, recording the credentials of the health professionals. The health data of the patient are retrieved from the S-EHR cloud, translated into the local language and local terminology to support a risk-free diagnosis and treatment of the patient.
Scenario 3 – Consultation by researchers of integrated and anonymised data
A research centre performs a research about the incidence and risk factors for a medical condition in the general community. The research protocol requires the prospective collection of anonymised health data for 2 years after the patient enrolment and a retrospective evaluation of his data up to 5 years before enrolment.
An advertising campaign from the research centre invites people to donate specific health data. Using information present in the promotional material (e.g. a QR code) the S-EHR mobile app retrieves and shows the type of health data requested, the level of anonymisation and verifies that the citizen health data match the entry criteria of the research protocol. The citizen decides if to donate the health data, restricting their usage to that specific research initiative, sending data on his past medical history and as well new data, monthly for 2 years. Authorized researchers receive the health data on their analysis tools by means of a specific remote protocol (“research protocol”) for donating health data.
Infrastructure Building Blocks: software components and interfaces to be specified and/or prototyped by the project
The project will release an open specification for allowing different S-EHRs, of citizens, and different applications, of researchers and HCPs of different countries, developed by different vendors, to securely exchange health data using the InteropEHRate protocols. To facilitate the creation of a new ecosystem of applications based on this open specification, InteropEHRate will also release a reference implementation of the following key elements:
- S-EHR mobile app: the prototype of a S-EHR, i.e. of a personal mobile app able to store in a secure way any health data about a single citizen, produced by the citizen itself or by the HCPs. The S-EHR mobile app will be able to exchange health data with HCPs and researchers of different countries using the InteropEHRate protocols.
- S-EHR cloud: the prototype of a service, managed directly be the citizen, able to store on the cloud the personal health data of the citizen, collected by the S-EHR mobile app. A citizen may choose to use the S-EHR mobile app without using the corresponding S-EHR cloud.
- InteropEHRate Health Services (IHS): a set of service components, reusable by any healthcare organization, offering the implementation of the InteropEHRate protocols for the exchange of health data between S-EHRs and HCP Apps, i.e. between citizens and HCPs. The IHS will exploit existing infrastructures for cross border identification of citizens and will assure the respect of strong security requirements.
- HCP Web App example of a typical application exploiting the IHS and used by Health Care Professionals to read from and write on the S-EHR of their patients, with their consent, any relevant health data.
- InteropEHRate Research Services (IRS): a set of service components, reusable by any research centre, offering the implementation of the InteropEHRate protocols, for demanding to the citizens and receiving from their S-EHRs, health data donated for research purposes.