PRIMARY USE CASE IMPLEMENTATION OF INTERNATIONAL PATIENT SUMMARY ON openEHR PLATFORM

Abstract

The International Patient Summary (IPS) comprises the essential clinical data that must be available in case an European citizen needs unscheduled or urgent health care while abroad. The implementation of cross- border exchange of IPS is among the highest priorities of the European commission. Detailed functional requirements and use cases have been elaborated in addition to a new IPS standard in recent years as part of the efforts for enabling interoperability in information exchange and continuity of care. This paper presents a practicable approach and a solution to the problem of achieving semantic interoperability among the IPS sources in the European union. A novelty approach in this paper is first to design and analyze the business process of the primary use case and after that to propose a solution. It allows to identify several activities that are out of the scope in the existing documents and at the same time require special attention at the stage of software implementation. The proposed solution makes use of the openEHR information model to represent the IPS standard dataset in terms of archetypes. This way we preserve the semantic context in clinical concepts as well as introduce interoperability among data providers. Moreover, it overcomes the severe drawback of the message paradigm, where every two communicating parties must apply transformation of existing data that is specific to their needs. The discussion considers a computer experiment with real data employing a fully functional web application for IPS cross-border exchange. business process model. The computer experiments show that the web application precisely executes the sequence of activities in the BPMN model. Moreover, the application reads and writes electronic health records of a patient’s IPS, whose data structure follows the current EN 17269:2019 standard for this document. The experimental results demonstrate that the electronic health records satisfy both the dual information model of openEHR and the IPS standard EN 17269:2019. We show that the Medication summary section on these records encapsulates detailed semantic context describing each previously prescribed medication.