HIMSS and Health 2.0 European Conference

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We look forward to seeing you again 26-28 May 2020!

11-13 June, 2019 | Helsinki, Finland

The International Patient Summary: a story of synergy and cooperation in Standardization.

I’ve been involved in standardization activities since long time and I had the chance of cooperating with several organizations. One of the things that people hardly understand is why there are so many overlapping and sometimes competing standards. Let me start by saying that the presence of many Standard Developing Organizations (SDO) is an added value rather than a drawback, enriching the standards landscape with different perspectives and products and covering different aspects of the interoperability.

Moreover, even if SDOs’ cooperation is usually a common goal, sometimes it is difficult to achieve this result because of different business models (e.g. free vs pay-for-use standards); competing interests; hard to reconcile standardization processes; and so on. Having said that, I’m really glad to be involved in the standardization of the International Patient Summary (IPS) that is a great example of cooperation among SDOs. This is why, I believe, this project has been groundbreaking in its success.

What is(are) International Patient Summary standard(s)?

The idea of a standard for the International Patient Summary (a minimal and non-exhaustive summary initially designed for unscheduled/emergency care) has been discussed for long time and enforced in the Transatlantic eHealth/health IT Cooperation Roadmap (2015)[1] . Some standardization initiatives were started at that time, but in 2017, CEN/TC 251[2] and HL7 International agreed to collaborate on a common IPS set of standards. After only two years, tangible results have been achieved by both SDOs: the IPS dataset (EN 17269); the guideline for European implementation (TS 17288); the HL7 CDA IPS[3] and HL7 IPS FHIR[4] Implementation Guides. But this has been just the begin: new products (e.g. SNOMED CT IPS free set) and new SDOs (e.g. ISO/TC 215, IHE) are joining the IPS standards ecosystem.

Why the SDOs’ cooperation has been successful for IPS ?

  • clear goal and well defined and agreed boundaries: each SDO worked on specific, non-overlapping, but inter-related products.
  • Attention to stakeholders’ needs: all teams have as common goal guiding and serving adoption of the IPS standards, and not just the publication of its own standards.
  • Focus on concrete achievable and timely results, with limited effort on trying to resolve the formal cross-SDOs collaboration issues. For example, to avoid issues with joint ballots and publications; we agreed to have formally independent standardization projects, working however hardly together to keep them coherent and not overlapping.
  • Leadership commitment, personal engagement and cross-participation. I believe that the personal attitude of the people involved has been the main success factor of this project. People has been personally engaged to achieve this common objective, continuously supported by the SDOs’ leadership. In fact, even if there are independent SDO’s projects, they have been managed as a single common project, with a continuous cross-feeding across the teams, facilitated by mutual participation.
  • Government funding, support and coordination actions. The European Commission has played an important role in the IPS standardization process, not only sustaining SDOs activities with ONC, but funding supporting projects, as Trillium II, on creating an IPS  Global Community of Practice for Digital Health Innovation; evaluating suitable governance processes; establishing cooperation with related European initiative (e.g. eHDSI under CEF).

Can SDOs do more?

Obviously Yes, this is only the first step.

The IPS ecosystem requires the engagement of more actors (SDOs, stakeholders) and needs more products and services to better support stakeholders. I believe that this is the right direction, in fact, new SDOs are approaching this project, e.g. a new work item proposal has been approved to move the IPS dataset from CEN/TC 251 in ISO/TC 215; new artefacts are going to be produced (e.g. a computable representation the IPS dataset); new players are engaged in the standardization process, an IPS Global Community for Digital Health Innovation has been for example launched by the Trillium II project… and more has to come…

Check out the Trillium II award ceremony for the most innovative use of the IPS and the official launch of the Global Community of Practice for the IPS, at the HIMSS Europe Conference spotlight stage on Thursday June 13, at 14:50

Giorgio Cangioli

Member of the CEN/TC 251 IPS team, co-lead HL7 FHIR IPS project, member Trillium II executive committee


[1] http://ec.europa.eu/information_society/newsroom/image/document/2016-30/eu_us_roadmap_16674.pdf

[2] http://www.ehealth-standards.eu/en/projects/international-patient-summary-ips-project/

[3] https://www.hl7.org/implement/standards/product_brief.cfm?product_id=483

[4] https://build.fhir.org/ig/HL7/fhir-ips/

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