Cross-border interoperability of Electronic Health Records

The European journey towards fully operational and interoperable EHRs has been and, as our new study reveals, will continue to be a long one. Developments across Member States are heterogeneous and EU efforts to harmonise and streamline efforts are important or very important to 67% of country representatives and half of country representatives reported it had a strong or very strong impact on national EHR developments. Further key findings from the newly published report on EHR interoperability in the EU include:

– 18 countries indicate that data sharing of EHRs across national borders is permitted by law.
– 17 countries have implemented an interoperability strategy focusing on semantics through a national terminology centre
– Viewing test results is the most common EHR service, followed by prescription and appointment services
– 7 countries do not have cybersecurity and data protection expertise within their competent authority for eHealth.
– 16 countries have financial penalties or subsidies coupled to the implementation of EHR systems.
– In 6 countries EHR systems are supported by distributed ledger technologies.
– Less than half of the countries have an EHR system infrastructure using cloud services.
– The pharmacy sector in Europe is almost completely connected to national EHR systems in over 50% of study countries
– In most countries, the amount of clearly structured electronic health data is low

In addition to providing a broad picture on the state-of-play on EHR interoperability and a reusable survey tool for future monitoring rounds, the report confirms that the eHealth Network has had limited impact on addressing the barriers to access to health data for both primary and secondary purposes. It can be confirmed that the nonbinding nature of eHealth Network guidelines, which recommended the uptake of interoperability standards, has not had visible impacts in Member States. The data collected furthermore show that, in general, electronic health records have not yet become a reality across the whole of the EU and many patients cannot easily access and use them or transmit their data between healthcare sectors and providers. Sharing data when moving across borders hence remains a vision and even less so a reality.

The study, conducted by empirica and Open Evidence, surveyed and analysed the development of interoperable Electronic Health Records and the use of data in the EU27 + UK and Norway. Independent and experienced national experts and national EU representatives to the eHealth Network participated to provide their insights.

The full report is available online.