European citizens travelling to countries within Europe may need to avail themselves of healthcare services in the country they are visiting. With technological advances, the European Commission and the acceding Member States have come together to work together on the digital transformation. In this sense, the European Digital Health Services were developed, with the integration of the Electronic Health Summary (Patient Summary) and Electronic Prescription and Dispensing (ePrescription/eDispensation), ensured in Portugal by SPMS – Shared Services of the Ministry of Health.
What are the goals of this cross-border health service?
The objectives of these services are:
- facilitate quick access to patient health information, healthcare professionals
- increase the accessibility of prescription dispensing in Member States
- contribute to patient safety by reducing the frequency of medical errors
Which countries are involved in this sharing of health data?
The sharing of e-health data takes place only in countries that have already joined cross-border health services. Two services are currently available:
- ePrescription/eDispensation:
- in Croatia (as a country of treatment/caregiver) for e-prescriptions issued in Finland, Estonia, Spain, Poland, the Czech Republic and Portugal
- in Estonia (as a country of treatment/caregiver) for e-prescriptions issued in Finland, Croatia, Poland, Spain and Portugal
- in Finland (as a country of treatment/caregiver) for e-prescriptions issued in Estonia, Croatia, Poland, Spain and Portugal
- in Spain (as a country of treatment (caregiver) for e-prescriptions issued in Croatia, Poland, Finland, Estonia, the Czech Republic and Portugal
- in Poland (as a treatment/caregiver country) for e-prescriptions issued in Estonia, Finland, Spain, the Czech Republic, Croatia, Greece and Portugal
- in the Czech Republic (as a country of treatment/caregiver) for e-prescriptions issued in Poland, Estonia, Spain and Portugal
- in Greece (as a country of treatment/caregiver) for e-prescriptions issued in Poland
- in Portugal (as a country of treatment/caregiver) for e-prescriptions issued in Finland, Estonia, Croatia, Spain and Poland
- access to the Electronic Health Summary (Patient Summary):
- in Luxembourg (as a country of treatment/carer) for citizens of the Czech Republic, Malta, Croatia, Estonia, Spain and Portugal
- in Malta (as a treatment/carer) for citizens of Croatia, Spain, Estonia and Portugal
- in Croatia (as a treatment/carer) for citizens of the Czech Republic, Malta, Spain, Estonia and Portugal
- in Portugal (as a treatment/carer) for citizens of Malta, Croatia, the Czech Republic, Spain, Estonia and Luxembourg
- in France (as a treatment/carer) for citizens of Malta, Croatia, the Czech Republic, Luxembourg, Estonia, Spain and Portugal
- in the Czech Republic (as a country of treatment/carer) for citizens of Malta, Croatia, Estonia, Spain and Portugal
- in Spain (as a treatment/carer) for citizens of Croatia, Luxembourg, Malta, Estonia, the Czech Republic, Greece and Portugal
- in the Netherlands (as a country of treatment/carer) for citizens of the Czech Republic, Luxembourg, Estonia, Malta, Spain and Portugal
- in Estonia (as a treatment/carer) for citizens of Spain, Croatia, Malta, Luxembourg and Portugal
- in Greece(as a country of treatment/carer) for citizens of Spain
It should be noted that in terms of the prescription of medicines, this project allows communication between the prescription and the dispensation, ensuring that each prescription is only dispensed once. This was not previously ensured under Directive 2012/52/EU, according to which users already had access to cross-border healthcare outside Portugal, but in which the electronic component was not 100%.
The first active service in Portugal was Patient Summary B with Malta. That is, the health professional will Portuguese be able to access the Electronic Health Summary if a Maltese citizen needs health care in Portugal, with prior consent. Thus, Malta is considered as Country A (country of affiliation) and Portugal as Country B (country of treatment/caregiver).
This service is available in national hospitals, which you can consult here. Soon, it will be available in other institutions.
Subsequently, it extended this Patient Summary consultation service to Portuguese citizens travelling to Estonia, Croatia, Luxembourg, France, the Czech Republic, Spain and the Netherlands.
Finally, it made available the Electronic Dispensing of medicines service, in the following ways:
- Portuguese citizens who need to dispense medicines in Estonia, Finland, Croatia, Spain, Poland and the Czech Republic
- Finnish, Croatian, Spanish, Estonian and Polish citizens who need to dispense medicines in Portugal
Note: This information is being continuously updated and soon the services will be extended to other institutions and countries.
Does my doctor have a say in the choice of country?
No, the doctor has no say in the choice of country.
In what context is it possible to access information for cross-border healthcare?
The information in the Electronic Health Summary is available in the provision of unplanned health care in the Health Institutions defined by the country of treatment (Country B).
For electronic medication dispensing services, existing drug prescriptions made in Portugal (country of origin/affiliation) may be dispensed in this context.
Is all medicines covered in the electronic dispensing service?
No. The cross-border dispensing does not apply to non-prescription medicines and medicines that have not been prescribed on e-prescription. In addition, some groups of medicines may not be available for cross-border dispensing, namely: psychotropic and/or narcotic drugs and compounded medicines.
Does this service apply in acute illness situations when I am abroad?
These services are available for situations of acute illness in the case of the Electronic Health Summary (Patient Summary) when the user needs to go to a health institution, as well as for situations in which the user does not have access to their medication, in the case of electronic dispensing, either because they forgot it in the country of origin or because they did not have access to it during the trip.
What information (personal health data) is transferred to other countries?
The information in the Health Summary that carries over to the other countries is as follows:
- Identification of the user (user number, name, date of birth, address, email, telephone contacts and gender)
- Health Unit and Family Doctor
- allergies
- Chronic medication
- Vaccines
- Medical and nursing diagnoses
- Medical Procedures
- Medical Devices
It should be noted that Medical and Nursing Diagnoses; Medical Procedures and Medical Devices depend on the approval of the healthcare professional to be disseminated.
In the case of e-prescription services, the data that transits to other countries corresponds to the data of the electronic medical prescriptions that the user presents available for dispensing, however cross-border pharmacies only access the prescription information after the access and dispensing PIN code is made available. When the user presents himself at the cross-border pharmacy and identifies himself, the country of origin sends the following data:
- name
- User number
- Date of birth
- dwelling
- sex
Subsequently, to access the prescription data, namely, prescription number, prescribed medications, identification of the place of prescription and identification of the doctor, the pharmacist will have to enter the access and dispensing code provided by the user.
On which platforms and institutions is my information available?
The Electronic Health Summary service will be available at Health Institutions defined by the country of treatment.
The Electronic Prescription (eP) and Electronic Dispensing (eD) service will be available in participating pharmacies in member states that already have the service in operation. It should be noted that there may be regional limitations within each member state, as is the case in Spain.
Can I change or request the modification of this data – Health Summary and Electronic Prescriptions?
The change in the health data of the Health Summary can only be done by the family doctor and/or attending doctor, in the area of the Electronic Health Record professional. However, the health professional has a very limited action, being able to only indicate which relevant records are included in the summary at the level of Medical and Nursing Diagnoses; Medical Procedures and Medical Devices. Not having access to add Medical and Nursing Diagnoses; Medical Procedures and Medical Devices without them being registered in the databases of the information producing systems (in this case National Registry of Users – RNU).
In the case of electronic prescriptions, it is not possible to change the data.
Do I have to have a special visa to use these services (tourist, student, etc.)?
No. However, the sharing of the Health Summary is only available to Portuguese citizens (regardless of the country of residence) and in such cases, after authorization in the personal area of the SNS 24 portal for sharing health data.
In turn, access to electronic prescription and dispensing services is only available to Portuguese citizens (regardless of country of residence) who have an SNS number and after authorization at the personal area of the SNS 24 portal for sharing health data.
What can I do if I'm traveling and I see a constraint in accessing my health information?
If you notice any constraint in your Health Summary or in your Electronic Prescription, you can contact SNS 24 at 808242424. For a personalized analysis, indicate your SNS user number; Full name and date of birth.
Source: Ministry of Health Shared Services (SPMS)