New CEN standard TS 17288 ‘The International Patient Summary: Guideline for European Implementation’

In particular, EN 17269:2019 ‘The International Patient Summary’ normalised a dataset from a guideline developed and revised by the eHealth Network (eHN) in 2016.  The eHN produced ‘Specific Guidelines for Electronic Exchange of Health Data under the Cross-border Directive 2011/24/EU’ using the earlier experiences of epSOS pilot project that included 27 Member States of Europe.  EN 17269 then, is a reference model that facilitates conformant, derived models for implementation purposes. The International Patient Summary (IPS) project provides a single, standardised and sustainable template for useful and usable content for both planned and unplanned care across the globe, thus supporting continuity of care for all.

The IPS Dataset aims to be minimal and concise: the standard common core is intended to be relevant and understandable to any attending clinician at the point of care.  It is explicitly designed to be easily extensible, so as to enable specialised data to be added when required for particular health conditions.  Furthermore, the scope of the IPS Dataset makes it clear that it can be readily used in a number of scenarios that include both unscheduled and scheduled care in both cross-border and within-border situations. The latter provides flexibility in its application, be that local, national, regional or global.  More generally, the IPS is also intended to be of value to cross-boundary situations, such as those caused by organisational or information systems used by different healthcare providers. In addition to the standards flexibility, EN 17269 defines a set of data blocks that can be reused for other clinical applications, if required.

Based on this framework, the second – and more recent - standard of the series, CEN/TS 17288:2020 ‘The International Patient Summary - Guideline for European Implementation’, recognises that cross-border applications are a special case, one that requires more attention because they span different jurisdictions. The target audience is primarily software developers and project implementation teams, but policy makers and SDOs have a role in assuring that the guideline is relevant to particular constituencies.

Whereas EN 17269 formally specified the eHN dataset and the associated rules, the IPS Section for cross-border functions was left light, a place holder rather than a section with detailed content.  This was deliberate, because even across the European Region, individual Member States have different policies and laws for healthcare, and hence different requirements. Since the intention of the IPS is to deliver an international standard, the differences in requirements would increase and be inhibiting, if not unmanageable.  In this context, CEN/TS 17288 is intended to support the European implementation of IPS by delivering a guideline.  European policy, directives, organisational and professional culture, and a diverse marketplace require implementation guidance that is technically relevant and contextually sensitive. CEN/TS 17288 describes these implementation aspects from the European perspective, using the Refined eHealth European Interoperability Framework (ReEIF) to structure the content in a way that is familiar to the European audience. When EN 17269 is adopted by ISO, CEN/TS 17288 may provide a template for other regions around the world to support their own implementation of a global IPS.

These two standards were developed by CEN/TC 251 , whose Secretariat is held by NEN, the Dutch Standardization Body, thanks to support and funding from the European Commission.