HEALTHeID

From business to the use case

HEALTHeID is a project born from the European Commission proposal to support countries in integrating Electronic Identification, Authentication and Trust Services (eIDAS) with cross-border services with the aim of improving the quality of services provided to EU citizens.

Set up by a consortium of European countries, HEALTHeID aims at the cross-border identification and authentication of citizens, enabling digital access to health records and services in Europe.

Electronic identification is a key mechanism to ensure the security of digital transactions, especially when it comes to health data. Therefore, HEALTHeID aims to improve the health system for citizens and professionals in the European context.

Relying on eIDAS policy framework for eHealth, HEALTHeID is anchored on:

eIDAS Regulation – promotes a standard where the citizens may identify and authenticate themselves using their national eID credentials via a trust network of national eIDAS nodes; once identified and authenticated, the patient may access cross border on-line services and control his own health data. 

GDPR – General Data Protection Regulation, based on the subject’s consent to personal data processing, is applicable to HEALTHeID in as far as on-line services made available to the person/patient are concerned.

Directive 2011/24, Article 14 – establishes the mechanisms for cooperation and exchange of information among Member States working within a voluntary network, i.e. the eHealth Network, connecting national authorities responsible for eHealth designated by the MS.

Additionally, EC “Communication on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society” set the following priorities:

  1. Citizens’ secure access to electronic health records and the possibility to share their records across borders, and the use of e-prescriptions;
  2. Supporting data infrastructure, to advance research, disease prevention and personalised health and care in key areas included rare, infectious and complex diseases;
  3. Facilitating feedback and interaction between patients and healthcare providers, to support prevention and citizen empowerment as well as quality and patient-centred care, focussing on chronic diseases and on a better understanding of the outcomes of healthcare systems.

 1. Compliance with eIDAS Regulation – exhausting possibilities for a viable solution within its provisions.

2. Privacy by design – respecting GDPR requirements, its enabling legal basis for access to health data and individual’s rights protection.

3. Security – ensure protection against security breaches and preserve the Level of Assurance (LoA) of patient authentication throughout the whole process.

4.  Patient Empowerment – enhance citizen experience regarding own health data access and control.

5. Scalability – The solution must have the least impact on the current deployment of eHDSI, even though taking a longer-term perspective.

6. Availability – The approach must balance digital patient empowerment against accessibility by segments of population, exploiting widely used technologies by EU citizens (smartphones, connected devices) and considering alternatives for minority situations.

1. Adopt a coherent protocol profile to interact with the national eIDAS connector.

2. Have established a trust relationship with the national eIDAS connector. 

3. Provide an interface for the insertion of the patient identifier. 

4. Use the retrieved identification data to complete the patient identifier. 

5. Adopt authentication schemes coherent with the LoA used in the eIDAS cross-border authentication scheme. 

6. Provide an interface for the communication of the patient identifier towards the NCPeH component.

7. Ensure lawful processing of personal data presenting the user information about the foreseen use of the data, and the context of use (e.g. specific healthcare encounter).

8. Provide an interface for the patient to provide an informed consent.

9. Provide adequate input/output interfaces to allow patient use of personal devices (e.g. smartphones).

Why is HEALTHeD dealing with online patient-oriented services? 

Because when a person electronically identified towards a service provider is to receive an online service by that service provider eIDAS electronic identification becomes crucial.

How did HEALTHeID proceed in creating patient oriented online services for demonstration purposes?   

HEALTHeID explored how the concept of eIDAS based electronic identification could be transferred to the current cross border context of Patient Summary and ePrescription services and reached that:

1.   Following GDPR patients must be informed on the purpose of data processing through a Patient/Privacy Information Notice (PIN). Therefore, providing an online PIN service is relevant to all MS;

2.   Identification attributes provided by the Country of Affiliation (Country A) may not include a patient identifier. Consequently, providing a functionality for patient entering own identifier must be a second online service to certain MS;

3.   Patient providing online consent in country B is an additional service, yet identified that would be relevant to certain MS as well.

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