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Table of Contents



Purpose

The purpose of this page is to provide basic information to health professionals participating in the end-to-end functional testing about the different steps in the process of accessing patient's data when this access is needed in a cross-border context for providing healthcare in an emergency department (Patient Summary) or when requested to dispense a medicine in a pharmacy (ePresccription) in Country B.

ePrescription

The HP and the patient seeking a dispensation are at the point of care (pharmacy) in Country B: the HP needs to access the available prescriptions from Country A for that patient.

This use case comprises the following steps:

  1. The HP is unequivocally identified and authenticated in his local system, according to his profile/role.
  2. The patient identifies himself.
  3. The HP checks the identification provided.
  4. Once the patient has been univocally identified through the Health Portal, the HP can request the prescriptions available for that patient.
  5. Before any information is presented to the HP, the patient has to give his consent - this consent must be informed, specific, and freely given.
  6. The list of available prescriptions from Country A is presented to the HP and the patient*. These prescriptions are provided by Country A according to its national rules, i.e. only prescriptions that can be dispensed in Country A at that moment are available for dispensation in Country B.
  7. If there are no available prescriptions, the HP will be informed of that circumstance.
  8. The HP selects the ePrescription to be displayed.
  9. If the ePrescription has more than one item, the ePrescription items list is shown.
  10. The HP selects the medicine to be dispensed: it is described by the ative ingredient, strength, dose form, package size, and route of administration, translated into Country B language.
  11. A copy of the original prescription from Country A can be shown to the HP if needed (PDF version).
  12. HP and patient agree on the prescription, for this both need to understand the information presented to them.
  13. If the exact medicinal produt exits in Country B (with the same package size), the HP clicks on dispense.
  14. If package size and/or brand name is different in Country B, the HP clicks on substitution and updates the information accordingly - if susbtitution is allowed brand name and package size can be modified, otherwise, only package size can be susbtituted.
  15. The information about the dispensed medicine is sent to Country A.

Alternatively, it could happen that the patient identity cannot be properly validated in Country A, medicinal product does not exist in Country B (no medicinal product in Country B has the same active ingredient + strength + pharmaceutical dose form), the dispenser may not have sufficient information to suport the dispensation or decides not to dispense in view of safety reasons. These situations should be communicated to the patient.

 Workflow (DRAFT v0.10 )

 

*NCPeH in Country A will check before providing any data whether the first patient consent to participate in the eHDSI Project has been given. Even though, while in Country B, it might be possible for a patient to give consent to access his data in Country A. See the Patient's Consent page for more details.

The ePrescription service

The ePrescription service comprises the ordering of a prescription using a software application, the electronic transmission of that prescription from the prescriber to the dispenser, the electronic recording of the dispensed medicine, and the electronic transmission of the dispensed medicine information from the dispenser to the prescriber.

It is made up of an electronic prescription and the corresponding electronic dispensation:

  • ePrescription is defined as prescribing medicines using software by a HP legally authorised to do so, for dispensing at a pharmacy once it has been electronically transmitted.
  • eDispensation is defined as the act of electronically retrieving a prescription and giving out the medicine to the patient as indicated in the corresponding ePrescription. Once the medicine is dispensed, the dispenser shall report electronically the information about the dispensed medicine.





Patient Summary

The HP and the patient seeking assistance are at the point of care in Country B: the HP needs to access essential health information about the patient from Country A.

This use case comprises the following steps:

  1. The HP is unequivocally identified and authenticated in his local system, according to his profile/role.
  2. The patient identifies himself.
  3. The HP checks the identification provided.
  4. Once the patient has been univocally identified through the Health Portal, the HP can consult his information.
  5. Before any information is presented to the HP, the patient has to give his consent - this consent must be informed, specific, and freely given*.
  6. The information from Country A is shown to the HP** in a structured way, i.e. in structured modular data groups sorted under the correct nesting headlines; each of those data groups contains related items of information with a unified meaning of fields (e.g. field 'Active Problems' is properly translated to Country B). The information display to the HP in Country B is understable to him (i.e. translated into Country B language).
  7. A copy of the original information from Country A can be shown to the HP if needed (PDF version).

Alternatively, it could happen that the patient identity cannot be properly validated in Country A or that a Patient Summary does not exist either in Country A. These situations should be communicated to the patient.


Workflow (DRAFT v0.10 )

*This second consent may be omitted if it is necessary to protect the vital interest of the patient or another person in the emergency case where the patient (data subject) is physically or legally incapable of giving his consent.

**NCPeH in Country A will check before providing any data whether the first patient consent to participate in the eHDSI Project has been given. Even though, while in Country B, it might be possible for a patient to give consent to access his data in Country A. See the Patient's Consent page for more details.

The Patient Summary service

The primary purpose of an electronic Patient Summay in the eHDSI project is to provide HP with a dataset of key health information at the point of care during unscheduled care and planned care, having its maximal impact in the unscheduled case.

A Patient Summary is understood to be a reduced set of patient's data, which would provide a HP with essential information needed at the point of care in case of unexpected or unscheduled care (emergency, accident, ...) and in case of planned care (citizen movement, cross-organisational care path, ...), being its main purpose, as indicated above, the unscheduled care case.

In brief, it is a summary containing all the important information but being easy and quick to read by a HP in a short time frame.

The Patient Summary does not provide a detailed medical history or details of the clinical conditions, or the full set of the prescriptions and medicines dispensed. Such detailed and complete data are usually contained in Electronic Health Records.

Use case example

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