e-Confirmation pilot takes the next step towards seamless healthcare in the EU

A new e-SENS e-Health pilot brings EU citizens one step closer to having guaranteed easy access to health care when travelling in EU Member States and  EEA countries, even when they cannot present a European Health Insurance Card (EHIC).

Estonia and the Netherlands are the first countries in Europe to test specific e-SENS online processes which allow health insurance entitlements of visiting citizens to be checked - in real time – by communicating with that citizen’s own Member State. According to Tanel Ross, CEO of the Health Insurance Fund in Estonia, this can not only facilitate access to medical care but can also enable doctors to invoice digitally for treatment of their non-resident patients.

Digital invoicing will contribute to shortening the throughput time of achieving cross-border financial settlement within healthcare, a process that at present can take up to two years or more in the current paper based process. “It is important to emphasize, that the end goal of innovation or use of modern IT-technologies in health care is not merely a new practice or a new device, but rather improved health care for every patient for better wellbeing and health for all of us,” he said. “Now we have taken one step forward in achieving that goal.”

Tests carried out, which simulated a real business environment, showed successful handling of
e-Confirmation requests and various payloads from Health Care Providers’ systems in Estonia and the Netherlands. This solution, enabling electronic confirmation of a citizen’s health care entitlement, is based on e-SENS e-Delivery, e-Documents and e-Signature technology. It makes provisioning, package, signing and transportation of documents possible, based on the concept of a ‘four-corner’ model where end entities exchange messages - secured by advanced seal - via gateway intermediaries.

Enshrined in EU law is the entitlement of citizens to health care in any member state, under the same conditions, and at the same cost, as citizens of that state. Currently, in order to access this care without paying, the visiting citizen is obliged in all cases to present either an EHIC card indicating his or her entitlements, or apply by phone/fax for a paper based Provisional Replacement Certificate (PRC), that provides evidence of entitlement as well. The new e-SENS pilot proves that electronic confirmation of patients’ insurance, based only on a portable document such as a passport or ID card presented by the patient, can become a reality soon. A health care provider will able to log in to the system, which firstly validates whether the professional is authorized to request an insurance confirmation. Following a successful assessment, the patient’s insurance data can be requested, including the desired period of validity. Where the citizen appears to be currently insured, his health insurance organization will issue - in real time - an electronic version of the PRC.

In real terms, for EU citizens, the e-SENS pilot means that when visiting another member state in future, they can receive health care more easily, even without EHIC or payment concerns. The
e-Confirmation service can offer seamless online insurance verification, on top of the EHIC, which is used offline. This shows significant value to Europeans as over 60% of them do not actually carry an EHIC. For the health care provider, the service will ensure that payment will be made by the relevant competent institution in the provider’s home Member State, reducing red-tape.

The successful testing performed by Estonia and the Netherlands within e-SENS proves digital cross-border communication is feasible. Building on this experience, the e-Confirmation team of e-SENS took the decision to set up a task force aiming at engaging partners from more Member States interested to implement e-Confirmation solution. John Stevens, the head of the new task force, asks all Member States health insurance organisations and healthcare providers to join this effort: „Let’s commonly make this service happen in real life now, for the sake of our citizens and clients in need of healthcare abroad“. This e-Confirmation pilot is part of the ambitious endeavour of the EU public and private entities to test new online services in domains such as health but also business,  procurement and justice across EU. The eventual goal is to reap the full potential of the Digital Single Market by making national systems interoperable through the use of cross-domain IT ‘building blocks’.