International patient summary (IPS) standards consistently adapted and localized to serve the needs of specific use cases are essential to attaining of vision of the patient summary as a social good and human right. The Trillium Bridge project (2013-2015) compared patient summary standards and specification in Europe and the United states and demonstrated the technical feasibility of exchanging electronic health record summaries across the Atlantic in the context of emergency or unplanned care abroad. Reflecting on its results, the Trillium Bridge consortium reached a broadly endorsed recommendation: “Advance an International Patient Summary standard to enable people to access and share their health information for emergency or unplanned care anywhere and as needed starting with immunizations, allergies, medications, clinical problems, past operations and implants.”
Trillium II builds on the recommendations of Trillium Bridge and places IPS standards at the core of a global community for digital health innovation with the aim to advance patient safety & trust by bridging the gap between strategic intent and capability to deliver interoperability at a global scale.
Trillium-II continues the efforts of Trillium Bridge to achieve progress on its recommended actions and advance adoption of the International patient summary supported by broadly and consistently implemented standards. Starting point for Trillium-II is establishing its global community fostering the practice of digital health innovation. Concrete community actions aim to bridge, harmonize, evaluate and guide existing and emerging patient summary initiatives, leading the way toward one international patient summary standard.
Basically, the project aims to:
- Improve international interoperability of Health systems in Europe, the United States, and globally
- Accelerate adoption of interoperability standards in eHealth with validated open source interoperability assets and tools sharing experiences and lessons learned among standards organizations and patient initiatives
- Identify key use cases for secure, seamless sharing of patient summaries at personal and population levels.
Link to standardization initiatives
The topic of the patient summary is quite popular among international and European standards developing organizations. Supporting initiatives are with ISO, CEN, and HL7 with value sets originating in SNOMED, LOINC, EUCM, ATC, ICDx, etc. Standards sets activities in (JIC) and bundles (ISO) aim to advance the concept of profiles, initially introduced by IHE and further explored by HL7 FHIR. Aligning these initiatives through communication and awareness activities is one of the key challenges for Trillium II.
Global community for digital health innovation practice
Besides standardization activities, regional and national competence centers engage in use case specification in the context of regional or national eHealth projects. Connecting these initiatives to standardization to highlight best practices and share resources where possible is another aspiration for Trillium II. This is where the global community for digital health innovation practice comes to play a key role.
The purpose of the Global community for digital health innovation practice (GC-DHIP) is to identify relevant projects and use cases of interest that will help validate and promote the use of international patient summary standards in demonstrations, readiness exercises, and other pilot projects.
Founding members of GC-DHIP are members of the Trillium-II consortium that have committed to pilot project demonstrations. Additional organizations and pilot projects implementing patient summaries will be invited to join. eHealth programs of Luxenburg (eSante), Catalonia, Spain (TicSalut), Denmark (MedCom), Portugal (SPMS), Sequoia (US), HSPC (US) are part of the steering committee of GC-DHIP and Henrique Martins, is the first chairman. The community has also close connections to the eHealth Digital Services Infrastructure services established under the Connected Europe Facility.