Transatlantic e Health Health It Cooperation Roadmap

March, 2013
Transatlantic eHealth/health IT Cooperation Roadmap

Vision
To support an innovative collaborative community of public- and private-sector entities, including
suppliers of eHealth solutions, working toward the shared objective of developing, deploying, and using
eHealth science and technology to empower individuals, support care, improve clinical outcomes,
enhance patient safety and improve the health of populations.
Executive Summary
Health related information and communication technology (most usually referenced as eHealth in
Europe and health IT in the US) is an important and growing sector in the United States and the
European Union. It is a rapidly developing and highly innovative area. It has considerable potential to
promote individual and community health while fostering innovation and economic growth.
Both the United States and the European Union are currently working to encourage more effective use of
ICT and ICT in general, in delivery of health services, including disease prevention and health promotion.
The Transatlantic Economic Council has therefore decided to make a critical contribution to this
development by promoting interoperability of health related information and communication technology
(eHealth/health IT) products and services, gaining improved mobility and consistent proficiency
recognition for a professional workforce, and by helping to prevent unnecessary regulatory divergences.
We have decided to implement specific cooperative action plans for the following high-priority areas:
Advancing eHealth/health IT Interoperability we will collaborate to accelerate progress towards the
widespread deployment and routine use of internationally recognized standards that would support
transnational interoperability of electronic health information and communication technology; and
eHealth/health IT Workforce Development we will work together to identify approaches to achieving
our common goals for achieving a robust supply of highly proficient eHealth/health IT professionals and
assuring health care, public health, and allied professional workforces have the eSkills needed to make
optimum use of their available eHealth/health information technology. Equally, we will identify and
address any competency and knowledge deficiencies among all staff in healthcare delivery, management,
administration and support to ensure universal application of ICT solutions in health services.
The cooperative action plans anticipate robust participation by relevant experts and stakeholders, across
the public, private and academic sectors. The public sector participants expect to confer with academic
stakeholders, and to convene, catalyze and support creative collaborations among capable and willing
private and academic sector participants, while offering guidance consistent with their policymaking
responsibilities. All participants, and particularly the private-sector participants, in specific projects and
initiatives under the action plans will identify solutions consistent with best practices in relevant fields
(such as information science and workforce development).
Over time, we expect to update the priority action plans to reflect progress made and new opportunities
identified in the course of their implementation. We also recognize that, as work progresses and
circumstances evolve, we may later want to develop cooperative action plans for additional areas and
1
potentially involving additional participating public- and private-sector entities and/or different roles for
entities also participating in the eHealth/health IT Interoperability and Workforce Development
cooperative action plans.
Advancing eHealth/health IT Interoperability Action Plan

Challenge
To promote individual and community health in a global environment, and enable a robust and innovative ecosystem of eHealth/health
IT that supports the electronic exchange of human- and machine-readable health, clinical, medical and management information to
advance the health of individuals and communities, we must maintain and enhance inter-governmental cooperation and also
collaboration between governments and the private sector. The Memorandum of Understanding between The United States
Department of Health and Human Services and The European Commission on Cooperation Surrounding Health Related Information
and Communication Technologies (MOU) was signed in December, 2010, to demonstrate our shared dedication to cooperation
addressing these challenges. Exploration of specific potential activities and approaches to implementing transatlantic interoperability,
consistent with the principles and vision described in HHS-EC MOU require careful and inclusive analysis. This action plan articulates
early, concrete steps toward the transatlantic interoperability and health IT workforce goals.
Scope Statement
This action plan focuses on activities to advance the goals for cooperation around health related information and communication
technology, as commemorated by the HHS-EC MOU, and with a specific emphasis on two areas identified in the MOU as having
immediate importance and potential:
1. international interoperability of Electronic Health Records information, to include semantic interoperability, syntactic
interoperability, patient and healthcare provider mediated data exchange (including identification, privacy and security issues
surrounding exchange of health data); and
2. cooperation around the shared challenges related to eHealth/health IT workforce and eHealth proficiencies.
Action plan
Public, academic and private-sector stakeholders from the EU and US are invited to participate in this potential collaboration. Virtual
meetings and other online communications tools will be utilized to build a collaborative environment supporting participants
engagement. This Collaboration Roadmap is being accompanied by an immediate Call for Stakeholder Engagement. Stakeholders will
be invited to engage in the identified work stream(s) of interest to them.
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Goals/Objectives
Deliverables/Action
International interoperability of electronic health

records information, to include semantic
interoperability, syntactic interoperability, and
patient mediated data exchange (including
privacy and security issues surrounding exchange
of health data)
1. EU and US Action Plan for International

Interoperability
Milestones/Due Dates
Initial Cooperation Roadmap (including executive

summary, scope statements for the work streams, action
plan and deliverables). We expect the roadmap to be a
living document with regular updates to reflect changing
needs, capabilities and markets situations
February 28, 2013
Announce the collaboration to known to be and/or

potentially interested in developing specifications and or
pilot demonstrations of international information
exchange and invite them to participate
February 28, 2013
Create online social collaboration tools for transparency

and community engagement
March 25, 2013
2. Interoperable Electronic Health Records

Create initial set of use cases, based on community and
stakeholder input
May 31, 2013
Compare existing US and EU vocabularies,

terminologies and clinical models to identify areas of
overlap and commonality
July 15, 2013
Identify available resources and opportunities for

aligning them (technology and standards to support
ongoing collaboration with vocabularies, modeling, and
interoperability)
August 2, 2013
Goals/Objectives
Deliverables/Action
Agree on specifications, standards and architecture for

the pilot
September 2, 2013
Compare the data/document structures used in the US

and EU by comparing the consolidated CDA (C-CDA)
and the exchange standards used in epSOS
December 20, 2013
Define project teams, leaders and resources to pilot
December 20, 2013
Based on candidate pilot sites, identify potential

demonstration sites for early pilots
January 31, 2013
Compare existing US and EU legal, policy and

organizational frameworks regarding eIdentification of
patients and healthcare providers, data privacy, security
and exchange to identify potential barriers to piloting
March 28, 2014
Define framework requirements for semantic

infrastructure and services
May 30, 2014
Analysis of initial draft of shared clinical models and

their metadata alignment
September 26, 2014
Finalize pilots
September 26, 2014
Cooperation around the shared challenges related 1. EU and US Action Plan for Health IT Workforce
to eHealth/health IT workforce and eHealth
Roadmap (including executive summary, scope
proficiencies
statements for the work streams, action plan and
deliverables). We expect the roadmap to be a living
document with regular updates to reflect changing
markets
February 28, 2013
Goals/Objectives
Deliverables/Action
Announce the collaboration to identified and interested

stakeholders
February 28, 2013
Create online social collaboration tool
March 25, 2013
Organize an additional Stakeholder meeting (online)
April 12, 2013
Appropriate arrangements for healthcare professionals

and all staff in healthcare delivery, management,
administration and support to access professional
development services
May 31, 2013
Identify champions
May 31, 2013
2. Skilled eHealth/health IT workforce and eHealth

proficiencies
Assessment of the scope, scale and characteristics of the
healthcare workforce in the US and EU current status
and future trends in terms of eHealth capabilities
May 31, 2013
Assessment of healthcare settings in the US and EU

current status and future trends
April 26, 2013
Role based competencies, curricula for chosen scenarios

in the US and EU: Perform analysis of competencies
required by the diverse care workforce (a)
professionals in the field; (b) academic track for new
professionals (pre-service) and those transitioning from
other health disciplines and from mainstream ICT into
the health sector (c) all staff in healthcare delivery,
management, administration and support
July 12, 2013
Goals/Objectives
Deliverables/Action
Identify or create curricula that addresses the
competencies identified in the US and EU
August 26, 2013
In the case of the EU consideration to be given to basing

these curricula on the European e-Competence
Framework, a component of the long term e-skills
agenda (e-skills for the 21st Century) of the European
Union supported by the European Commission and the
Council of Ministers
Definition and agreement of common standards of
competence and professionalism that identify fitness to
practice health informatics and accreditation of
professionals
November 25, 2013
Development of occupational codes for health IT

professionals in the US and EU
Explore internship opportunities in the US and EU
January 27, 2014
Explore new models of education/employer collaboration

to facilitate continued development of programs to meet
employment needs in the US and EU and ensure that all
healthcare staff maintain competence levels through
recognized program of certified continuous professional
development
January 27, 2014
Outcome indicators for interoperable Electronic Health Records and other relevant documentation that supports effective decision making:
Identify Project Champions

Development of use cases/user stories
Perform Vocabulary Analysis
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Perform Infrastructure Alignment

Perform Patient Mediated Exchange Analysis
Perform Healthcare provider Mediated Exchange analysis
Perform Analysis of Clinical Models
Perform policy analysis (eIdentification, health data privacy and security).
Semantic and syntactic mapping of scenario related health data
Pilots
Outcome indicators for development of skilled eHealth/health IT workforce and eHealth proficiencies:
Identify Project Champions

Completed analysis of competencies required by the diverse healthcare and eHealth/health IT workforce (a) professionals in the field,
(b) academic track for new professionals (pre-service) and those transitioning from other health disciplines and from mainstream ICT into
the health sector and (c) all staff in healthcare delivery, management, administration and support
Identify and create curricula that address the competencies identified in the US and EU
Provide appropriate arrangements for healthcare professionals and all staff in healthcare delivery, management, administration and support
to access professional development services
Identify and develop procedures to recognize individuals whose competence is developed and maintained through non-academic,
experiential and mentoring routes, and through short, non-academic courses addressing subsets of criteria that make up a particular
competence
Ensure recognition of Health Informatics as a distinct profession
Explore new models of education/employer collaboration to facilitate continued development of programs to meet employment needs in
the US and EU
Pilots illustrating innovative ways to update current content with an open repository of case studies, scenarios and educational materials

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March, 2013

Transatlantic eHealth/health IT Cooperation Roadmap

Advancing eHealth/health IT Interoperability Action Plan

International interoperability of electronic health

1. EU and US Action Plan for International

Initial Cooperation Roadmap (including executive

February 28, 2013

Announce the collaboration to known to be and/or

February 28, 2013

Create online social collaboration tools for transparency

March 25, 2013

2. Interoperable Electronic Health Records

May 31, 2013

Compare existing US and EU vocabularies,

July 15, 2013

Identify available resources and opportunities for

Agree on specifications, standards and architecture for

Compare the data/document structures used in the US

December 20, 2013

Define project teams, leaders and resources to pilot

December 20, 2013

Based on candidate pilot sites, identify potential

January 31, 2013

Compare existing US and EU legal, policy and

March 28, 2014

Define framework requirements for semantic

May 30, 2014

Analysis of initial draft of shared clinical models and

September 26, 2014

September 26, 2014

February 28, 2013

Announce the collaboration to identified and interested

February 28, 2013

Create online social collaboration tool

March 25, 2013

Organize an additional Stakeholder meeting (online)

April 12, 2013

Appropriate arrangements for healthcare professionals

May 31, 2013

May 31, 2013

2. Skilled eHealth/health IT workforce and eHealth

May 31, 2013

Assessment of healthcare settings in the US and EU

April 26, 2013

Role based competencies, curricula for chosen scenarios

July 12, 2013

In the case of the EU consideration to be given to basing

November 25, 2013

Development of occupational codes for health IT

January 27, 2014

Explore new models of education/employer collaboration

January 27, 2014

Identify Project Champions

Perform Infrastructure Alignment

Identify Project Champions

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