The document discusses the Trillium Bridge II project, which aims to reinforce and scale up EU-US cooperation on patient summaries. It will do this by (1) developing and testing interoperability assets for patient summary components, (2) extending the scope of patient summaries beyond emergency care to include new use cases, and (3) creating an EU-US interoperability roadmap and governance for international patient summary standards. The project brings together stakeholders from standards development organizations, health systems, and industry to support global digital health innovation through cooperation on patient summaries.

1. Reinforcing the Bridges and Scaling up
EU/USCooperation on Patient Summary
Trillium II
This project has received funding from the
European Union’s Horizon 2020 research
and innovation programme under grant
agreement No 727745

2. 2
HL7 Foundation: who we are..
HL7 the best and most widely-used
eHealth standards since 1986
HL7 v2, Clinical Document Architecture, HL7 FHIR
19 National Affiliates in Europe (~38 wordwide)
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European Funded Research Projects
eHGI, Antilope, Semantic Healthnet,
Trillium Bridge, Expand, Trillium-II
PHC34: ASSESS CT, OpenMedicine, eStandards
Annual HL7 in Europe Newsletter
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eHealth policy & Research
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EFMI council (2012-): eHealth Week
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HIMSS Europe
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HL7 Vision: A world in which everyone can securely access and use the right health data when and where they need it.
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US cooperation on Patient Summaries
May 11, 2017
eHealthWeek2017

3. www.estandards-project.eu
Vision of eStandards
eHealth Standards and Profiles in Action for Europe and Beyond
Vision of the global eHealth ecosystem
 people need navigation tools for safe and informed health care
 interoperability assets fuel creativity, entrepreneurship, and
innovation
eStandards will:
 nurture digital health innovation
 strengthen Europe’s voice & impact
 enable co-creation and trusted provider-user relationships
May 11, 2017
eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US cooperation on
Patient Summaries
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4. www.estandards-project.eu
Innovation is where standards are most needed: to unlock data
Today:
• Massive health data accumulated in silo EHR systems serving documentation purposes. We need to
move from passive documentation to active use of information and knowledge creation: activation!
• Patient summaries defined at the macro level: cross-border exchange for emergency or unplanned
care at a national level. Move to meso and micro level to address communities and individuals.
• Standards and profiles address a predefined exchange of information. Move to flexible use of
available content and structure, recognizing the role of national, regional or local jurisdiction
Shaping the future:
• Focus on the top level: systems of innovation.
May 11, 2017
eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US cooperation on
Patient Summaries
Systems of record – documentation systems -EHRs
Systems of differentiation – profile based data exchange
Systems of innovation – unlock data and user experience
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5. www.estandards-project.eu
Cooperative use of standards: co-creation, governance, alignment
• Co-create
– to make it real using standards
• Governance
– to make it scale to large-scale
deployment
• Alignment
– to make it stay in a sustainable way
May 11, 2017
eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US cooperation on Patient
Summaries
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Unplanned
and
Emergency
Care
Patient
Summary
Chronic
Disease
Management
Medication
identification
Rare
Diseases
Information
Models

6. This requires cooperative use of eStandards across the life cycle
May 11, 2017
eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US cooperation on Patient
Summaries
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Co- creation
Governance
Alignment
To develop, deliver, test and deploy standards sets
which are properly adapted to a dynamic healthcare
system, we need a constant flow of interaction
between three types of activities:
 Co-creation between all relevant stakeholders
 to make it real using standards
 A supportive and appropriate governance system
 to make it scale toward large-scale
deployment
 The flexibility to adapt and align as needs and
requirements change
 to make it stay in a sustainable way

7. May 11, 2017
eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US cooperation on Patient
Summaries
Several viewpoints inform the creation of roadmap elements
Identification of Needs taking
perspectives into account
Necessary Artefacts and
components part of the EIF
Actions to be taken
Trust & Flow
 Knowledge innovation
 Information exchange
 Data capture
 Generic Requirements
 State of the Art
 Development Needs
Phases in the
Health Informatics
Standards Life Cycle
Base Standards
Use Case based
Standards Sets
Assurance and
Testing
Live
Deployment
Feedback and
Maintenance
Tooling and
Education
Forums and
Monitoring
eStandards
eHealth
DSI
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8. Standards Organizations:
Health Systems and Associated Competence centers:
Dissemination and Networking:
Development and Evaluation:
Other Parties

9. innovative collaborative community
empower
support
advance
enhance
improve
May 11, 2017 eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US
cooperation on Patient Summaries

10. Achievements of Trillium Bridge 2013-2015
• Gap analysis
- Compared patient summary specifications in EU/US
- Shared clinical elements: problems, medications, allergies
• Interoperability Assets
- Established a terminology prototype CTS-2 service: http://extension.phast.fr/STS_UI
- Developed Transformer of Patient summaries: http://informatics.mayo.edu/trillium-bridge
- Mediated Differences in EU/US IHE XCPD/XCA profiles for Patient Identity and Document Query/Retrieve
• Validation activities: 4 EU countries/ Kaiser Permanente
- EU/US Marketplace; HIMSS 2015; IHE Europe Connectathon 2015, eHealthWeek 2014,15
• Feasibility study:
- Reflected upon standards, cross-vendor integration, incentives, clinical research,
security and privacy, innovative business models, education
Recommendation:
“Advance an International Patient Summary (IPS) standard
to enable people to access and share their health information
for emergency or unplanned care anywhere and as needed.
At minimum the IPS should include immunizations, allergies,
medications, clinical problems, past operations and implants.”

11. Global Community
social value
• Bridge patient summary initiatives
Governance
learning resources
mobile Health
Patient Summaries
May 11, 2017 eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US
cooperation on Patient Summaries

12. vaccinations
medications
encounters
Identification allergies
Implantable
devicesProblems
Health team
Security
preferences
Health team
Security
preferences
problems

13. stakeholder groups to identify needs
key enablers and success
educational and training material

14. May 11, 2017 eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US
cooperation on Patient Summaries

16. Scaling-up the use of patient summaries
Emergency
• Emergency response teams
May 11, 2017 eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US
cooperation on Patient Summaries
Trillium-II’s ambition touches the person through their personal hub and the
community through an aggregating dashboard making the most of our
data-driven economy.

17. OHI
Industry Support
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Healthcare Information and
Management Systems Society
SNOMED International
Standards Development Organizations
• ISO/TC215 – Worldwide standards for Health
Informatics
• Joint Initiative Council – collaborative of international
health IT SDO’s
• IHE International – world leader in healthcare
interoperability standards
• HL7 - standards for the exchange, integration,
sharing, and retrieval of electronic health information
• GS1 – world leader in identification standards
Source modified: Mike Neusam

19. 19
WP6: Testing events,
demos, Pilots and
Readiness Exercise
WP1: Management & Administration, Communication and Liaison
WP7: Dissemination,
Market Outreach,
and sustainability
WP2: Assembling Interoperability Assets for
Patient Summary Components (M1-M24)
WP5: EU/US Interoperability
Roadmap,
Open innovation and IPS standards
governance
WP4: Context, role and
adoption of the patient
summary in the global
ecosystem
WP3: Extending the Scope beyond
Emergency and Unplanned Care
(M4-M30)
Allergies
(SPMS)
Gap Analysis (HL7) & Configuration
Canvas (GNOMON)
Implementation Guidance (GNOMON)
Medications, Impl.
devices (PHAST)Problems & Procedures
(TicSalut)
Vaccinations
(THL)
Imaging
(OFFIS)Lab results
(PHAST/IHE)
Encounters
(GNOMON)
New Use Cases & assets (HL7)
Security & Privacy Guidance
(SRDC)
Other
(HL7)
M8
M12
M14
M8
M12
M15
Global Community of Digital Health Innovation Practice
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20. mhm@medcom.dk
euoffice@HL7.org
May 11, 2017 eHealthWeek2017 Malta
Trillium Bridge II: Reimforcing Bridges & Scaling-up EU-US
cooperation on Patient Summaries
EvaluateBridge
HarmonizeGuide