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Grant Agreement number: 101129187 — EST-2-MyHealth — EU4H-2022-DGA-MS-IBA2 FINANCIAL STATEMENT FOR “TERVISE JA HEAOLU INFOSÜSTEEMIDE KESKUS” FOR REPORTING PERIOD 1 Eligible1 costs (per budget category) EU contribution Revenues Direct costs Indirect costs EU contribution to eligible costs Total Income B. Total costs requested EU generated D. Other costs E. Indirect Funding Maximum EU Requested EU A. Personnel costs Subcontracting C. Purchase costs contribution by the action categories costs2 rate %3 contribution4 contribution costs A.1 A.4 SME B. C.1 Travel and subsistence C.2 Equipment C.3 Other D.1 Financial E. Indirect Employees (or owners and Subcontracting goods, works support to third costs equivalent) natural person and services parties A.2 Natural beneficiaries persons under direct contract A.3 Seconded persons Travel Accommodation Subsistence 5 5 Forms of Unit or Unit or Unit5 or Flat- Actual costs Unit costs5 Actual costs Actual costs Actual costs Actual costs funding actual costs actual costs actual costs rate costs6 e=flat-rate * f=a1 + a3 + (a1 + a3 + b b + c1a + c1 a1 a3 b c1a c1b c1c c2 c3 d1 + c1a + c1 U g=U * f h m n b + c1c + c2 b + c1c + c + c3 + d1 + e 2 + c3 + d1) TEHIK 65124.37 288632.73 0.00 0.00 0.00 0.00 0.00 0.00 24763.00 378520.10 80% 302816.08 302816.08 302816.08 The beneficiary/affiliated entity hereby confirms that: The information provided is complete, reliable and true. The costs and contributions declared are eligible (see Article 6). The costs and contributions can be substantiated by adequate records and supporting documentation that will be produced upon request or in the context of checks, reviews, audits and investigations (see Articles 19, 20 and 25). For the last reporting period: that all the revenues have been declared (see Article 22). Please declare all eligible costs and contribution, even if they exceed the amounts indicated in the estimated budget (see Annex 2). Only amounts that were declared in your individual financial statements can be taken into account lateron, in order to replace costs/contributions that are found to be ineligible. (1) See Article 6 for the eligibility conditions. All amounts must be expressed in EUR (see Article 21 for the conversion rules). (2) If you have also received an EU operating grant during this reporting period, you cannot claim indirect costs - unless you can demonstrate that the operating does not cover any costs of the action. This requires specific accounting tools. Please contact us immediately via the EU funding & Tenders Portal for details. (3) See Data Sheet for the funding rate(s). (4) This is the theoretical amount of EU contribution to costs that the system calculates automatically (by multiplying the reimbursement rates by the costs declared). The amount you request (in the ‘Requested EU contribution’) may be less. (5) See Annex 2a ‘Additional information on the estimated budget’ for the details (unit, cost per unit). (6) See Data Sheet for the flat-rate. [--TGSMark#signature-895885405_40_395--] 1  Digitally sealed by the European Commission Date: 2025.06.25 09:19:58 CEST This electronic receipt is a digitally signed version of the document submitted by your organisation. Both the content of the document and a set of metadata have been digitally sealed. This digital signature mechanism, using a public-private key pair mechanism, uniquely binds this eReceipt to the modules of the Funding & Tenders Portal of the European Commission, to the transaction for which it was generated and ensures its full integrity. Therefore a complete digitally signed trail of the transaction is available both for your organisation and for the issuer of the eReceipt. Any attempt to modify the content will lead to a break of the integrity of the electronic signature, which can be verified at any time by clicking on the eReceipt validation symbol. More info about eReceipts can be found in the FAQ page of the Funding & Tenders Portal. (https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/support/faq) Commission européenne/Europese Commissie, 1049 Bruxelles/Brussel, BELGIQUE/BELGIË - Tel. +32 22991111  3. DELIVERABLES Work New Due Delivery Deliverable Dissemination Deliverable Name Package Lead Beneficiary Type Due Date Date (if Date Status Comments No Level No delay) (actual) 31 January 31 January D1.1 Project guide WP1 TEHIK R PU APPROVED 2024 2024 Communication and 31 January 31 January D2.1 dissemination strategy WP2 TEHIK R PU APPROVED 2024 2024 plan MS Service 28 Dissemination, 28 February D2.2 WP2 TEHIK R PU February SUBMITTED Education and 2025 2025 Training Plan 30 30 D2.5 Project Website WP2 TEHIK DEC PU November November PENDING 2023 2023 Evaluation and 31 March 1 April D3.1 WP3 MSAE R PU APPROVED sustainability plan 2024 2024 eHMSEG decision 31 October 30 October D4.1 WP4 TEHIK R PU APPROVED M12 2024 2024 30 4 Service operation and D4.4 WP4 TEHIK R PU November December APPROVED maintenance plan 2023 2023 1  DISSEMINATION ACTIVITIES Definition: The public disclosure of the results by any appropriate means (other than resulting from protecting or exploiting the results), including by scientific publications in any medium. What? Who? Why? Dissemination activity name Type of dissemination Target audience Status (Max 200 characters) activity (Choose one or more items) Develop and validate new national FHIR allergy Industry, business partners, standards and clinical models with stakeholders. National authorities, Stakeholder meetings for allergy standard Meetings Enable Estonian healthcare providers to Ongoing Specific end user communities, efficiently implement and submit allergy data to Innovators the ENHIS Industry, business partners, Raising knowledge on the Patient Summary Meetings with Health Professionals about PS Meetings National authorities, Delivered service and how to use the service. Specific end user communities New national FHIR based allergy data exchange Industry, business partners, standards need written information about the Association’s media channels, mailing lists Other National authorities, launch. Ongoing Specific end user communities Implementing terminology standards for allergy data needs to be validated with stakeholders. Engage national authorities to validate new allergy standards for Patient Summary, Policy-makers meetings for allergy standard Meetings National authorities communicate project milestones, and address Ongoing risks. Keep them updated on industry agreements. Research communities, Digital availability ensures easy access for all Industry, business partners, stakeholders, boosting awareness and Dissemination of allergy business analysis Other Ongoing National authorities, accelerating adoption of business analysis, while Specific end user communities keeping specialists informed. Raise more knowledge on cross-border services, inform citizens about their rights and share Press release for cross-border services Other Citizens Ongoing information about new countries who have joined with the service. 1 COMMUNICATION ACTIVITIES Communication Activity How? Communication Description Who? Target audience Outcome Status Name channel For TEHIK colleagues useful Knowledge is shared, conclusions information exchange about are made on the success of the Internal communicaton about overall lessons learned, Specific end user communities EVENT project in comparison to the ONGOING allergy standard suggestions for others in similar previous attempted allergy project, next steps. projects Public and users are informed Press-releases for national about the new allergy data Press releases about allergy communication about release of standard and exchange. Citizens Citizens PRESS_RELEASE ONGOING standard new allery data exchange can be sure their allergy data in standard and solution. different health systems is up to date and same. Social media update from TEHIK Citizens can be sure their allergy Social media updates about to inform about release of new Citizens SOCIAL_MEDIA data in different health systems is ONGOING allergy standard allery data exchange standard up to date and same. and solution. Up to date information about the new allergy data exchange Public is informed and in TEHIK standard, the project and Updating TEHIK websites about teabekeskus new allergy standard ONGOING deadlines in websites: Citizens WEBSITE allergy standard and related implementation guides https://www.tehik.ee/ location is published and https://teabekeskus.tehik.ee/et Using TEHIK andmekorraldus Allergy information is entered by mailing lists to communicate about Industry, business partners Targeted mailing-lists about health specialists in high quality National authorities NEWSLETTER ONGOING allergy standard release of new allery data and without errors due to new Specific end user communities exchange standard. standard. To raise awareness of the project Citizens Creating a web page for the Public and partners are aware of and let everyone interested know Industry, business partners WEBSITE DELIVERED project the project about the objectives Civil society Press releases for raising overall Press releases about cross-border awareness of cross border Growth in the usage of the cross- services, especially when opening Citizens PRESS_RELEASE ONGOING services border services services with new countries. Communication: Communication on projects is a strategically planned process that starts at the outset of the action and continues throughout its entire lifetime, aimed at promoting the action and its results. It requires strategic and targeted measures for communicating about (i) the action and (ii) its results to a multitude of audiences, including the media and the public and possibly engaging in a two-way exchange. ** We would advise to give clear guidance of what we expect. It would be very specific Key performance indicators similar to what is suggested by DG COMM for our corporate communication https://myintracomm.ec.europa.eu/corp/comm/Evaluation/SiteAssets/Pages/Do-You-Need-Methodological-Guidance/Communication%20Network%20indicators%20.pdf 2 FINANCIAL SUPPORT TO THIRD PARTIES Sub-Calls Number Number Call Call of of Call Budget Call budget publication closure URL to F&T portal Call status received awarded reference awarded date date proposal proposal s s Total: 0.00 € 0.00 € Awarded Beneficiaries Call Organisation Funding PIC Legal name Country Funding paid(€) Comment reference type awarded(€) Total: 0.00 € 0.00 € 3 EVENTS AND TRAININGS Events and trainings (including workshops, conferences, etc.) Description Attendees Participant Non- Event No Duration Femal binar name Name Type Area Location Male Total (days) e y 4  Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 TECHNICAL REPORT (PART B) COVER PAGE Part B of the Technical Report must be downloaded from the Portal Technical Report (Part B)/Termination Report screen, completed and then assembled and re-uploaded as PDF on that screen. PROJECT Project number: [101129187] Project name: [Estonia towards MyHealth@EU] Project acronym: [EST-2-MyHealth] REPORTING PERIOD Please note that you must report on the entire reporting period. RP number: [1] Duration: from [01/11/2023] to [31/04/2025] TABLE OF CONTENTS TECHNICAL REPORT (PART B) ............................................................................................................................................ 1 COVER PAGE ....................................................................................................................................................................... 1 1. OVERVIEW OF THE PROGRESS .................................................................................................................................... 2 1.1 Summary of work performed and achievements, results and impacts ........................................................................ 2 1.2 Consortium set-up ........................................................................................................................................................ 3 1.3 Project teams, staff and experts .................................................................................................................................. 3 1.4 Consortium management and decision-making........................................................................................................... 4 1.5 Project management, quality assurance and monitoring and evaluation strategy ....................................................... 4 1.6 Cost effectiveness and financial management ............................................................................................................ 4 1.7 Risk management ........................................................................................................................................................ 4 1.8 Impact .......................................................................................................................................................................... 5 1.9 Communication, dissemination and visibility................................................................................................................ 5 1.10 Sustainability and continuation .................................................................................................................................. 5 1.11 Follow-up to EU recommendations ............................................................................................................................ 6 2. WORK PLAN, WORK PACKAGES, ACTIVITIES, RESOURCES AND TIMING ............................................................. 7 2.1 Work packages, activities, resources and timing ......................................................................................................... 7 Work Package 1 .......................................................................................................................................................... 7 Work Package 2 .......................................................................................................................................................... 9 Work Package 3 ........................................................................................................................................................ 10 Work Package 4 ........................................................................................................................................................ 11 Subcontracting .......................................................................................................................................................... 13 Timetable .................................................................................................................................................................. 14 3. OTHER ............................................................................................................................................................................ 16 3.1 Ethics ......................................................................................................................................................................... 16 3.2 Security ...................................................................................................................................................................... 16 4. DECLARATIONS ............................................................................................................................................................ 16 Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 #@PER-REP-EU4H@# #@PRO-GRE-PG@# [This document is tagged. Do not delete the tags; they are needed for the processing.] 1. OVERVIEW OF THE PROGRESS 1.1 Summary of work performed and achievements, results and impacts [OPTION 1 by default (all except OG): Work performed and main achievements Short summary of progress towards the project objectives. Highlight significant activities and achievements. Provide clear and measureable details. Analyse the outcome of the project (so far) and its (actual and expected) impact (on target groups, change, innovation etc.), including a description of the European dimension and added value. For the Final Report, include the conclusions of the action. Report on objectives not fully achieved or not on schedule. Do not simply cut and paste the project summary (filled in online on the Summary for Publication screen). Contrary to the summary, this section is for reporting to the EU and will not be published. The main objective of this project has been ensuring stable routine operations and necessary further developments of the already operational NCPeH. Main achievements under the proposed action have been so far: - Bringing Patient Summary service to a new platform – main developments have ended, and procurement finished. However, there is still a need for additional testing and follow-up developments which are currently taking place. When the solution gets deployed live it will mean a more reliable and sustainable service for the citizens and ease the continuous upgrade process for developers. The major upgrade of the Estonian Health Information System is still in progress as there are also other services besides Patient Summary that need to be brought to the new platform together. - Improving national allergy related data exchange standards - Estonia is currently in the analysis stage and developments are set to begin at the end of 2025. Meetings with stakeholders have been held and will continue. According to the plan the allergy data should be seen on Estonian patients PS-s in 2026, which will help foreign doctors to access important health data of Estonian patients and will ensure the information about allergies is complete. - Implementing upgrades to the new versions of MyHealth@EU artefacts adopted yearly by the eHMSEG and participating in yearly test events - In the Spring of 2024 Estonia participated in the formal and upgrade test event for OpenNCP Wave 7. As a result, we were able to successfully upgrade our services to the new wave in Autumn of 2024 with all other Member States and got to continue routine operations with ePrescription and Patient Summary services. Through all of 2024 while being in routine operations, Estonia opened services with new country pairs – Greece, Latvia, Lithuania, Czechia, Finland. During Spring 2025 Estonia took part in the next test event and is currently in the process of fixing the issues found during testing and preparing to go live in the following Autumn. There are plans to open services with new joining countries. All of this has meant that Estonia has successfully implemented the yearly upgrades and kept the services running. With that, the usage of the services has grown, Estonian citizens get access to a more reliable healthcare abroad and foreign citizens receive better healthcare in Estonia. - Translation of the Orphanet rare diseases nomenclature – procurement preparation has taken more time as Estonia had to agree with international coordinating which processes are essential for this specific project. Procurement is set to take place this year and translation process will begin. This will make ORPHAcodes available in Estonian language to Estonian health professionals and when included on the patient summaries of foreign patients’ Estonian health professionals can understand the information in their own language, again making healthcare safer for foreign patients. Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 #§PRO-GRE-PG§# #@CON-SOR-CS@# ] #§PRO-GRE-PG§# #@CON-SOR-CS@# ] 1.2 Consortium set-up Participants Report on changes in the consortium composition (including structural, legal or management changes, if any). See Technical Report (Part A). Consortium cooperation and division of roles (if applicable) Report on changes in the way the participants work together (Beneficiaries, Affiliated Entities, Associated Partners, etc.). 1.3 Project teams, staff and experts Project teams and staff Report and explain deviations from Annex 1 of the Grant Agreement regarding the organisation of staff or project teams. Provide CVs of key actors that had to be replaced (if required). Due to several staffing changes during the reporting period, there have been deviations from the staff originally listed in Annex I of the Grant Agreement. The following table summarises these changes. Name and function Organisation New person Reason for change Date of in Annex 1 Change Katre Pruul, project TEHIK Aurelia Mihk Resignation from October 2023 manager organisation Andre Lehis, project TEHIK Andry Silla Resignation from October 2023 manager organisation Greete Mõttus, TEHIK Marilin Prants Resignation to September project manager another project 2024 Jeremin Freed TEHIK Klaus Martin Vare Resignation to January 2025 Meister, technical another project personnel Ingrid Hanst, TEHIK Erle Imala Reassigned to March 2024 technical personnel another project Hedvig Soone, TEHIK Carmen Mäe Resignation to September technical personnel another project 2024 Kerli Linna, technical TEHIK Carmen Mäe Resignation to September personnel another project 2024 The change with the biggest impact to the project has perhaps been the resignation of Katre Pruul and with that a new member Aurelia Mihk joining in her place in TEHIK. However, with the help and support from MSAE expert Jaanika Merilo and other TEHIK experts the project has been able to continue as planned and no major deviations from the original project plan have occurred. There have also been Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 changes to other project managers and technical personnel, but these changes have not generated any gaps where certain roles weren’t filled and that has meant the project was able to continue normally. 1.4 Consortium management and decision-making Consortium management and decision-making (if applicable) Report on important changes in the management or decision-making mechanisms. Insert text #§CON-SOR-CS§# #@PRJ-MGT-PM@# 1.5 Project management, quality assurance and monitoring and evaluation strategy Project management, quality assurance and monitoring and evaluation strategy Report on changes to the overall project management concept, quality assurance and monitoring and evaluation strategy (if any). Insert text #§PRJ-MGT-PM§# #@FIN-MGT-FM@# 1.6 Cost effectiveness and financial management Cost effectiveness and financial management (n/a for Lump Sum Grants) Inform about significant budget overruns or important changes in the financial management (if any). In the beginning of the project there were three subcontracts planned. S1.2 included both PS new platform development subcontracting and national allergy data exchange standard creation subcontracting. Since they are both their own projects and taking place at slightly different times, it was decided that there is a need for two separate subcontracts and therefore the budget between these projects was divided as well. That meant that procurement for PS developments started with a budget of 110 000€. However, as the scope grew, this budget was not enough, and it was decided that some remaining important developments can be financed under S1.1 (developments for cross-border services to ensure their availability) and some of it under our national budget. It did not seem reasonable to cut the budget for allergy as it is known to be a bigger project which needs all its allocated budget. It is foreseen that not all S1.1 will be used strictly for S1.1. Additionally, the subcontracting partners for both S1.1 and S1.2 were the same, which made it possible to continue the work right away, only under a different contract. Otherwise, a need for a new subcontract would’ve risen and that would also bring uncertainty about the new contract partner and might delay the project. As the Patient Summary platform developments are still ongoing, then it is not possible to conclude how big the exceeding amount will be yet. Under S1.1 there was 10 000€ allocated to platform developments, out of which 9447.03€ have been used. #§FIN-MGT-FM§# #@RSK-MGT-RM@# 1.7 Risk management Critical risks and risk management strategy Report on the state of play concerning the risks and risk mitigation measures (if any). Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 See Technical Report (Part A). #§RSK-MGT-RM§# #@IMP-ACT-IA@# 1.8 Impact Impact Report on changes in your impact analysis/strategy (if any) and the effects on the project/need for adaptations. Insert text #§IMP-ACT-IA§# #@COM-DIS-VIS-CDV@# 1.9 Communication, dissemination and visibility Communication, dissemination and visibility of funding Report on the communication and dissemination activities undertaken (to whom, which format, how many, etc.). Describe how the visibility of EU funding was ensured. If you described your project on your website(s) and/or social media accounts, please provide the links. Most of the communication for operational cross-border services has been previously performed and Estonia has mainly continued to raise awareness of the services. There are also many activities planned regarding the allergy project specifically, as this will have the biggest impact nationally on our health professionals. For Estonian citizens allergy data to be present on their patient summaries, the health professionals must be informed about the new standards and how to use them. TEHIK website already has a dedicated page about cross-border data exchange for the whole public. Information about the current project and funding was added to the page and as we’re reaching the important milestones the page is expected to be updated - https://www.tehik.ee/piiriulene-andmevahetus. TEHIK has also created a separate page for the allergy data exchange project to the whole public and end-user organizations - https://www.tehik.ee/allergiaandmed. TEHIK has recently opened a new web page Teabekeskus, all information will be transferred to this page as well, available to the whole public and relevant end-user organizations - https://teabekeskus.tehik.ee/et/teenused/tis-teenused/piiriulene-terviseandmete-andmevahetus. A more specific page for EST-2-MyHealth project will be added by TEHIK. For Allergy data exchange standard several dissemination meetings have been held with medics from different fields: family doctors, allergists, nurses, emergency doctors etc. Regarding cross-border services in general, meetings with family doctors and hospital developers were held by TEHIK to raise awareness of the Patient Summary service. There were two meetings where the service was introduced. TEHIK has sent out several press releases when opening services with new joining countries. There is a mailing list for pharmacies and important information regarding the identification of patients and important information has been shared. Visibility of EU funding has been ensured by adding a funded by the European Union emblem and specifying the action is co-funded. See also Technical Report (Part A). #§COM-DIS-VIS-CDV§# #@SUS-CON-SC@# 1.10 Sustainability and continuation Sustainability, long-term impact and continuation Report on changes in your sustainability analysis/strategy (if any). For the Final Report, describe the follow-up of the project after the end of the EU grant. How will the results be used or further developed. Describe the strategy to ensure sustainability of results and long-term impact. Comment on possible synergies/complementarities with other (EU funded) activities (if any). Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 Insert text #§SUS-CON-SC§# #@FOL-UP-FU@# 1.11 Follow-up to EU recommendations Follow-up to EU recommendations Highlight corrective actions taken as a result of EU monitoring activities (including follow-up to EU project reviews, if any). List each recommendation/comment and explain how they have been followed up. Insert text #§FOL-UP-FU§# Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 #@WRK-PLA-WP@# 2. WORK PLAN, WORK PACKAGES, ACTIVITIES, RESOURCES AND TIMING 2.1 Work packages, activities, resources and timing WORK PACKAGES Work Package 1 Work Package 1: [Management and coordination] Activities Report on the implementation status of the activities that were to be implemented during the reporting period and explain deviations from Annex 1 of the Grant Agreement. In case an activity was not implemented or a deliverable not produced, please explain why. Task No Task Name Implemented? Justification (continuous (Yes/No/Partially) (explain what was done and by whom; explain what was not done and why not; numbering linked to indicate how you intend to handle the situation and new timing; indicate if it was a one- WP) off issue or how you intend to avoid similar issues in the future) T1.1 Participation in the Yes Aurelia Mihk has been an active member of the eHMSEG, followed the European MyHealth@EU annual activities and has participated in the eHMSEG regular meetings. governance framework and activities In addition, she has participated in the following work groups: • ePrescription Task Force • Patient Summary Task Force • KPI Task Force • Service Desk Task Force Jaanika Merilo has been an active member of the eHN and taken part of the regular meetings and activites. T1.2 Consortium Operating Yes Project has a designated Confluence space maintained by TEHIK, where the Procedures Definition project plan has been published and all relevant information about the project can be found. All team members have access to the space and can modify the page as needed. Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 T1.3 Coordination of the project Yes Regular meetings have been held between TEHIK and MSAE to monitor the management progress of the project. Deliverables and reports have been put together by TEHIK and MSAE project managers. T1.4 Consortium meeting Yes Kick off meeting was carried out by TEHIK and MSAE back in November 2023. The timeline of the developments was agreed upon by participants and the main starting point was agreed to be the first of January 2024. Regular meetings did not start before the Autumn of 2024, as this was when the developments and sub-projects were set to begin, they are led by Aurelia Mihk. The only exception were regular cross-border developments which were led by Aurelia Mihk, weekly meetings have taken place since the beginning of the project. MSAE and TEHIK project managers did meet before the official meetings in 2024 began and kept track of the overall progress. T1.5 Legal management Yes TEHIK and MSAE legal teams are aware of the project and no legal issues have been identified so far. Other issues Insert text Mention and explain unexpected events and adjustments that had to be made. Explain impact on other tasks, available resources and planning/timing. Milestones and deliverables (outputs/outcomes) See Technical Report (Part A). Budget implementation — Use of resources (deviations) (n/a for Lump Sum Grants) (n/a for Additional Prefinancing Report) Explain deviations from the budget planning (i.e. differences between actual and planned use of resources, especially for personnel). Include explanations on transfers of cost categories in the estimated budget (if applicable) Don’t forget to attach the detailed cost reporting table (if any). Insert text Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 Other issues Insert text Work Package 2 Work Package 2: [Dissemination, training and support] Activities Report on the implementation status of the activities that were to be implemented during the reporting period and explain deviations from Annex 1 of the Grant Agreement. In case an activity was not implemented or a deliverable not produced, please explain why. Task No Task Name Implemented? Justification (continuous (Yes/No/Partially) (explain what was done and by whom; explain what was not done and why not; numbering linked to indicate how you intend to handle the situation and new timing; indicate if it was a one- WP) off issue or how you intend to avoid similar issues in the future) T2.1 Communication and Yes Dedicated Confluence page has been created by TEHIK and Communication dissemination Strategy Plan was delivered to EU on time. Communication strategy and its execution with Communication, Dissemination and Training plan was put together by TEHIK reports and MSAE. T2.2 Health professional Partially Health care professionals have been continuously informed about the cross- dissemination and border services (e.g. when opening services with new countries) and press education releases have been sent from TEHIK according to the communication plan. Presentations have been made by TEHIK to Health Professionals to raise awareness about Patient Summary. For Allergy data exchange standard several dissemination meetings have been held with medics from different fields: family doctors, allergists, nurses, emergency doctors etc, by TEHIK. T2.3 Citizen dissemination and Yes TEHIK web page has been updated by TEHIK with relevant information motivation about the project and new services – project web page has been kept up to date. Other issues Insert text Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 Mention and explain unexpected events and adjustments that had to be made. Explain impact on other tasks, available resources and planning/timing. Milestones and deliverables (outputs/outcomes) See Technical Report (Part A). Budget implementation — Use of resources (deviations) (n/a for Lump Sum Grants) (n/a for Additional Prefinancing Report) Explain deviations from the budget planning (i.e. differences between actual and planned use of resources, especially for personnel). Include explanations on transfers of cost categories in the estimated budget (if applicable) Don’t forget to attach the detailed cost reporting table (if any). Insert text Other issues Insert text Work Package 3 Work Package 3: [Evaluation and sustainability] Activities Report on the implementation status of the activities that were to be implemented during the reporting period and explain deviations from Annex 1 of the Grant Agreement. In case an activity was not implemented or a deliverable not produced, please explain why. Task No Task Name Implemented? Justification (continuous (Yes/No/Partially) (explain what was done and by whom; explain what was not done and why not; numbering linked to indicate how you intend to handle the situation and new timing; indicate if it was a one- WP) off issue or how you intend to avoid similar issues in the future) Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 T3.1 Evaluation and Yes Evaluation and sustainability plan was composed by MSAE and TEHIK. sustainability plan T3.2 Mid-term evaluation report No To be implemented in the next reporting period. T3.3 Final evaluation report No To be implemented in the next reporting period. Other issues Insert text Mention and explain unexpected events and adjustments that had to be made. Explain impact on other tasks, available resources and planning/timing. Milestones and deliverables (outputs/outcomes) See Technical Report (Part A). Budget implementation — Use of resources (deviations) (n/a for Lump Sum Grants) (n/a for Additional Prefinancing Report) Explain deviations from the budget planning (i.e. differences between actual and planned use of resources, especially for personnel). Include explanations on transfers of cost categories in the estimated budget (if applicable) Don’t forget to attach the detailed cost reporting table (if any). Insert text Other issues Insert text Work Package 4 Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 Work Package 4: [Maintenance and development] Activities Report on the implementation status of the activities that were to be implemented during the reporting period and explain deviations from Annex 1 of the Grant Agreement. In case an activity was not implemented or a deliverable not produced, please explain why. Task No Task Name Implemented? Justification (continuous (Yes/No/Partially) (explain what was done and by whom; explain what was not done and why not; numbering linked to indicate how you intend to handle the situation and new timing; indicate if it was a one- WP) off issue or how you intend to avoid similar issues in the future) T4.1 Implement upgrades to the Yes Estonia took part of the annual Upgrade Pre-Production Testing in Spring new versions of 2024 and Spring 2025; test event participation was led by TEHIK and MyHealth@EU artefacts Estonia received the eHMSEG decision to continue routine operations in adopted yearly by the 2024. eHMSEG and participate in Annual Upgrade Pre- Production Testing T4.2 Data availability, alignment Partially TEHIK and MSAE started a project to improve data availability of the allergy with eHN guidelines and section on Patient Summary, project is led by Marilin Prants. Stakeholder other service interest has not been as high as expected and in addition, this task has improvements taken more time due to high workload of the staff members. However, team members have considered that there is a sufficient time buffer, allowing project managers to plan accordingly so the outcome can still be achieved. The task to bring Patient Summary service to a microservice was led by Andry Silla and while the procurement is finished, there are still tasks that will continue. Additional need for developments came out during testing and to go live with the new platform, there is a need to wait for dependant services to be ready, so everything would work together seamlessly. TEHIK has been in contact with INSERM to understand the rules of translating the ORPHACode nomenclature. It took more timeas expected and the official translation is yet to start, However TEHIK is currently preparing for the procurement, and the translation is set to begin in the second part of 2025. Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 T4.3 Planning and reporting on Yes Service operation and maintenance report was put together by TEHIK and service operation and MSAE. maintenance Other issues Insert text Mention and explain unexpected events and adjustments that had to be made. Explain impact on other tasks, available resources and planning/timing. Milestones and deliverables (outputs/outcomes) See Technical Report (Part A). Budget implementation — Use of resources (deviations) (n/a for Lump Sum Grants) (n/a for Additional Prefinancing Report) Explain deviations from the budget planning (i.e. differences between actual and planned use of resources, especially for personnel). Include explanations on transfers of cost categories in the estimated budget (if applicable) Don’t forget to attach the detailed cost reporting table (if any). Insert text Other issues Insert text Subcontracting Subcontracting (new subcontracts) (n/a for Lump Sum Grants) (n/a for Additional Prefinancing Report) Report on new subcontracts. Explain the specific circumstances that caused the need for a subcontract Include only subcontracts that are best-value-for-money and for which there is no conflict of interest. Keep in mind that subcontracting is not possible for key coordinator tasks and may normally not cover a major part of the action. Subcontract Subcontract name Description Costs Justification Best-value-for- number (EUR) (why did subcontracting money become necessary?) Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 (continuous (subcontracted action (including task number and BEN/AE (how did you ensure numbering linked to tasks) to which it is linked) it?) WP) S1.5 S1.6 … S2.5 S2.6 … Other issues Insert text If subcontracting for the project rises above 30% of the total eligible costs during the project implementation, give specific reasons. Mention and explain other issues, if needed. Timetable Timetable (projects of more than 2 years) Report on deviations from Annex 1 of the Grant Agreement. Fill in the planned implementation in beige and the deviations in red. Adapt and repeat lines/columns as necessary. Starting date: 01.11.2023 ACTIVITY YEAR 1 YEAR 2 YEAR 3 YEAR 4 YEAR 5 YEAR 6 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 Task 2.1 Health professional dissemination and education #§WRK-PLA-WP§# Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 #@ETH-ICS-EI@# 3. OTHER 3.1 Ethics Ethics If your Application Form contains a section on ethics, report on any changes to ethics issues identified in Annex 1 of the Grant Agreement (if any). Insert text #§ETH-ICS-EI§# #@SEC-URI-SU@# 3.2 Security Security If your Application Form contains a section on security, report on any changes to security issues identified in Annex 1 of the Grant Agreement (if any). Insert text #§SEC-URI-SU§# #@DEC-LAR-DL@# 4. DECLARATIONS [OPTION 1 by default (all except OG): Double funding Information concerning other EU grants for this project Please note that there is a strict prohibition of double funding from the EU budget (except YES/NO under EU Synergies actions). We confirm that to our best knowledge neither the project as a whole nor any parts of it Yes benefit/have benefitted from any other EU grant (including EU funding managed by authorities in EU Member States or other funding bodies (e.g. EU Regional Funds, EU Agricultural Funds, tc). If NO, explain and provide details We confirm that to our best knowledge neither the project as a whole nor any parts of it are Yes (nor will be) submitted for any other EU grant (including EU funding managed by authorities in EU Member States or other funding bodies (e.g. EU Regional Funds, EU Agricultural Funds, etc). If NO, explain and provide details. #§DEC-LAR-DL§# ] HISTORY OF CHANGES PUBLICATION VERSION CHANGE DATE 1.0 01.04.2021 Initial version (new MFF). 2.0 02.06.2025 Aurelia Mihk – draft version Project: [insert number] — [insert acronym] — [insert call identifier] EU Grants: Periodic report/Additional prefinancing report/Beneficiary termination report (EU4H): V1.0 – 01.04.2022 2.2 16.06.2025 Aurelia Mihk - integrated changes according to comments made by team members. P1.9 added information about allergy communication, linked relevant web pages.  Critical implementation risks and mitigation actions Foreseen Risks Foreseen risks The table shows the risks already listed in Annex 1 of the Grant Agreement (read-only). Risk No Description Work Package No(s) Proposed Mitigation Measures Previous work has been done during the preparation of the Project. General management procedures have Progress starting too late and the project been designed to detect any deviation from the initial plan 1 resulting in poor delivery and project WP1 and an experienced and robust management team will outcome (Likelihood: low, Impact: high) lead the project. The kick-off meeting has been carefully designed to coherently launch all the simultaneous activities. The coordinator will keep abreast of the ongoing work, promote mutual sharing of updates within the consortium and provide guidance to the consortium members in order to avoid delays. Responsibilities and procedures Deliverables or official notifications to HADEA will be clearly defined and implemented by partners 2 WP1 submitted late (Likelihood: low, Impact: low) under the coordinator’s, WP leaders’, task leaders’ supervision. The coordinator will also check the status of any deliverable to be sent to HaDEA 15 days before the deadline. Any delay will be communicated and justified beforehand, indicating the actual date of submission. The budget has been carefully designed, discussed Financial deviations/ Budget issues that and agreed with all partners. A financial manager 3 do not allow for activities to be carried out WP1 will lead the evaluation and monitoring of the use (Likelihood: medium, Impact: medium) of resources and its justification by all partners. Coordination and constant monitoring carried out by WP1 will help prevent this issue. Attention will also be paid to WP members do not deliver inputs to other 4 WP3,WP4,WP2,WP1 building a strong relationship and trust among project WPs in time (Likelihood: high, Impact: low) members. This can be reached, for example, by means of face-to-face meetings that will take place during the project. Holidays, personal issues, COVID-19 pandemic WP members make sure that they have a person in their 5 WP3,WP4,WP2,WP1 or any other health issues that cause some team who can cover, at least partly, their participation 1 Foreseen risks The table shows the risks already listed in Annex 1 of the Grant Agreement (read-only). Risk No Description Work Package No(s) Proposed Mitigation Measures WP members to be missing for a certain in the project. WP leaders and task leaders create period of time (Likelihood: low, Impact: low) back-up contact lists for having replacements in place. Presence of an independent quality reviewer Reports and deliverables do not meet that is external to the core team and who has required standards of written English 6 WP3,WP4,WP2,WP1 extensive professional experience in drafting reports and/or presentation, data visualization, for the EC and national authorities is seeked; clarity (Likelihood: low, Impact: low) Strong collaboration with WP2 needs to be held Problems with (sub)contracting due Preparing conditional (public) 7 to delays in (public) procurement WP4 procurement and/or framework contracts (Likelihood: medium, Impact: high) Difficulty in setting up meetings, mainly due WP team members will make all efforts to adjust 8 to unavailability of all relevant parties in any WP3,WP4,WP2,WP1 other commitments and ensure the presence given time (Likelihood: low, Impact: low) Communication will be crucial to deliver outputs of the Losing leadership over outsourced desired quality within the desired timeframe. High- 9 WP4 activities (Likelihood: low, Impact: high) quality handover of partial tasks and monitoring must be carried out, in order to avoid losing quality and timeliness. Project managers create possible back-up lists of A key expert unexpectedly leaves the team experts in their within their Competent Authorities/ 10 WP3,WP4,WP2,WP1 (Likelihood: medium, Impact: medium) Affiliated Entities, so that another expert can be promptly involved if needed until a new person is hired. The CA and AE will ensure that communication with stakeholders is efficient and respects the Stakeholder fatigue, lack of incentive with stakeholders time and effort. As such web-based tools 11 encaging with the consortium or providing WP4 will be used to enable engagement at times most feedback. (Likelihood: high, Impact: high) convenient, and incentives such as acknowledgment of contributions will be considered were necessary. 2 Unforeseen Risks Unforeseen risks Risk No Description Work Package No(s) Proposed Mitigation Measures Implementation of the cross-border Patient Summary microservice on the new platform is The work on the prerequisite microservices for the Patient part of a broader transition to a microservices Summary implementation is already in progress and, platform and is therefore highly dependent on according to plans, is scheduled to be completed before other microservices that are in the process the deadline for the Patient Summary rollout. In addition, of being rolled out in the live environment. If U1 WP4 the same team responsible for implementing the new significant obstacles arise in the prerequisite microservices platform is handling the rollout of the new work or if changes in national priorities cause Patient Summary service. This allows the team, within a shift in the work schedule, this could hinder its capabilities, to manage priorities and the order of meeting the planned deadline for launching tasks to ensure that the project is completed on time. the new Patient Summary microservice. (Likelihood: Medium, Impact: Medium) National priorities may change and may not align with the goals of the current project. For example if priorities change and other MSAE will help steering political U2 projects from the Government are deemed more WP4 priorities to align with the current project. critical than the creation of the new data allergy standards, then it could lead to delays and cause a poor outcome. (Likelihood:Low, Impact: High) 3 State of play State of play Continuous Reporting (Critical Risks screen) - Give the state of play of the risks that were identified in Annex 1 of the Grant Agreement (and new risks that materialised during project implementation) and add new mitigation measures, if needed. Risk No Period Did you apply risk mitigation measures? Did your risk materialise? Comments Although some tasks began later than initially scheduled due to various factors, 1 1 Yes Yes project managers proactively adjusted the timeline and resources to ensure the overall outcome would not be affected. 2 1 Yes No Financial manager and project managers have monitored the use of resources and made 3 1 Yes No adjustments if needed, meaning the overall budget has not exceeded and all activites so far have been carried out as planned. Coordination and monitoring in WP1 4 1 Yes No has meant the risk has not realized. Members have been missing for a certain amount of time due to holidays and health issues, however members have replacements and back-ups for critical tasks who could 5 1 Yes Yes cover them. In situations where coverage was insufficient or not possible, the team utilized time buffers to ensure that any delays would not impact overall outcomes. 6 1 Yes No 7 1 Yes No 8 1 Yes No 4 State of play Continuous Reporting (Critical Risks screen) - Give the state of play of the risks that were identified in Annex 1 of the Grant Agreement (and new risks that materialised during project implementation) and add new mitigation measures, if needed. Risk No Period Did you apply risk mitigation measures? Did your risk materialise? Comments 9 1 Yes No During the reporting period several key experts did leave the team. However suitable 10 1 Yes Yes replacement experts had been identified and onboarded. As a result, there was no disruption in the implementation of project activities. There has been some lack of incentive from stakeholders regarding the creation of new allergy related data exchange standards, however web-based tools (web questionnaires) have been used and MSAE 11 1 Yes Yes has helped to communicate the need for the change to stakeholders. Stakeholders have been doubtful of the national impact, however thorough communication is expected to help mitigate these issues. U1 1 Yes No U2 1 Yes No 5  LIST OF MILESTONES Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) 1 Kick-off meeting – fixed WP1 TEHIK Description - Definition 30/11/2023 13/11/2023 Yes date and agenda of the date and agenda of a meeting aimed at launching the project. Means of Verification - Date and agenda of the kick-off meeting fixed 2 Governance WP1 TEHIK Description - 30/9/2026 No Participation Governance participation, including the activities undergone at European level concerning the governance of service maintenance Means of Verification - Deliverable - Project Guide 3 Communication and WP2 TEHIK Description: 31/1/2024 31/1/2024 Yes dissemination strategy Communication strategy is compiled and its execution with reports, includes project content management system. Means of verification: Deliverable 1 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) - Communication and dissemination strategy plan 4 Planning of MS WP2 TEHIK Description: Service 28/2/2025 28/2/2025 Yes Service Dissemination, dissemination, education Education and Training and training schedule with activities, milestones and tasks. It provides a prospective vision on the tasks to be made in order to create awareness and prepare users towards the use of services. Means of verification: Deliverable - MS Service Dissemination, Education and Training Plan 5 Reporting of MS WP2 TEHIK Description: Mid-term 31/1/2026 No Service Dissemination, progress report on the Education and Training education and training Monitoring (Midterm) activity, containing MS Service Dissemination, Education and Training Monitoring. Means of verification: Deliverable - MS Service Dissemination, 2 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) Education and Training Monitoring Report (Midterm) 6 Reporting of MS WP2 TEHIK Description: Final 31/10/2026 No Service Dissemination, progress reporting on the Education and Training education and training Monitoring (Final)) activity, containing MS Service Dissemination, Education and Training Monitoring would be included in the overall evaluation report foreseen under WP1. Means of verification: Deliverable - MS Service Dissemination, Education and Training Monitoring Report (Final) 7 Draft evaluation and WP3 MSAE Description: The 31/1/2024 21/1/2024 Yes sustainability plan evaluation and available sustainability plan draft with indicators for the project and each WP will be available for the consortium, EC and public Means of verificaiton: Draft has been circulated 3 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) for comments and amending, resulting in Evaluation and sustainability plan 8 Draft mid-term WP3 MSAE Description: The 30/4/2025 3/6/2025 Yes evaluation and evaluation and sustainability report is sustainability report available draft with assessment of the project and each WP will be available for the consortium, EC and public Means of verification: Draft has been circulated for comments and amending, resulting in Mid-term evaluation and sustainability report 9 Draft final evaluation WP3 TEHIK Description: The 31/8/2026 No and sustainability report evaluation and available sustainability report draft with the final assessment of the project and each WP will be available for the consortium, EC and public Means of verification: Draft has been circulated for comments and 4 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) amending, resulting in Final evaluation and sustainability report 10 Decision on continuation WP4 TEHIK Description: Annual 31/10/2024 31/10/2024 Yes of routine operations decision taken by M12 eHMSEG, based on the Outcome Summary report provided by the Solution Provider Means of verification: Deliverable eHMSEG decision M12 11 Decision on continuation WP4 TEHIK Description: Annual 31/10/2025 No of routine operations decision taken by M24 eHMSEG, based on the Outcome Summary report provided by the Solution Provider Means of verification: Deliverable eHMSEG decision M24 12 Reporting on service WP4 TEHIK Description: Reporting 30/9/2026 No improvements will include a description of the performed improvements affecting data availability and other service improvements. Means of 5 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) verification: Deliverable Service improvement report 13 Translation of the WP4 TEHIK Description: Translation 30/9/2026 No Orphanet rare disease of the Orphanet rare nomenclature disease nomenclature (ORPHAcode) as a new value set, which has been added to the MyHealth@EU Master Valueset Catalogue. Means of verification: Deliverable Service improvement report 14 Upgrades implemented WP4 TEHIK Description: Implement 30/9/2026 No to the new versions of upgrades to the MyHealth@EU artefacts new versions of adopted yearly MyHealth@EU artefacts adopted yearly by the eHMSEG and participate in yearly formal and upgrade test events. Means of verification: deliverable Service improvement report 15 Patient Summary service WP4 TEHIK Description: Bringing 30/9/2026 No platform updates Patient Summary service by to a new 6 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) platform, which will enable a more reliable service and create better opportunities for any updates in the future. Means of verification: Deliverable Service improvement report 16 Planning of service WP4 TEHIK Description: Operation 30/11/2023 4/12/2023 Yes operation and and maintenance plan maintenance will include current needs and foreseeable expenditures related to daily operations, provision of customer support, software updates, hardware costs and costs for staff involved in the NCPeH operations. It will also include a description of the planned data quality improvements and other service improvements. Means of verification: Deliverable Service operation and maintenance plan 17 Reporting on service WP4 TEHIK Description: Reporting 30/9/2026 No 7 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) operation and will include effective maintenance expenditure covering daily operations, provision of customer support, software updates, hardware costs and costs for staff involved in the NCPeH operations. Means of verification: Deliverable Service operation and maintenance report 18 Project webpage update WP2 TEHIK Description: TEHIK 31/10/2026 No website's relevant webpage is being updated during the project. Means of verification: Project webpage has been updated according to the Communication and dissemination strategy plan 19 Report on specific WP3 TEHIK Description: During the 31/10/2026 No action-level indicators project KPIs are being monitored and reported as MyHealth@EU Monitoring Framework requires Means of 8 Milestones Continuous Reporting (Milestones screen) — Update the status (and add new due date for late milestones, together with an explanation for the delay). In the Comments, please indicate if the milestone was achieved as planned or not. MS Milestone Name Work Lead Beneficiary Means of Verification Due New Due Delivery Achieved Comments No Package Date Date (if Date No delay) (actual) verification: report is made on the latest version of the KPIs as defined in the MyHealth@EU Monitoring Framework 9  1. PROJECT SUMMARY Context and overall objectives The objective of this project will be to ensure stable routine operations and necessary further development of the already operational NCPeH. Currently, the services deployed at the NCPeH are Patient Summary (in routine operations since August 2022) and ePrescriptions (in routine operations since January 2019). Under the proposed action, the NCPeH will: - Ensure stable operations of the deployed MyHealth@EU services, more especially the Patient Summary service by bringing it to a new platform, which will enable a more reliable service and create better opportunities for any updates in the future. Estonia is currently in progress of major update to national Health Information System, which means that old national e-health services are being moved to a new platform as microservices. Under this objective, the Patient Summary service will also be brought to the new platform as a microservice which, in addition to being a more reliable service, will also allow to make continuous upgrades easier. - Improve the national allergy related data exchange standards to ensure allergy data for Patient Summary, which is currently incomplete. New national FHIR based standards will be created according to dataset, which will be agreed on between different national stakeholders. This will enable all Estonian health care providers to implement the new standards and start providing allergy related information to the National Health Information System (ENHIS). As Patient Summary is automatically composed of the data in ENHIS, it will also enable the necessary information in the Patient Summary service. The allergies and intolerances data section is considered part of the basic sections meaning that it must be present in a Patient Summary document. The missing data in this section for an Estonian Patient Summary is currently evaluated as finding and is in need for improvement. - Implement upgrades to the new versions of MyHealth@EU artefacts adopted yearly by the eHMSEG and participate in yearly formal and upgrade test events. - Translation of the Orphanet rare disease nomenclature (ORPHAcode) as a new value set, which has been added to the MyHealth@EU Master Valueset Catalogue. This would allow to display the information coming from other NCPeH in Estonian to Estonian health care professionals. The translation will be done in collaboration with Estonian rare diseases expert centre. The value set is currently planned to be translated in possible amount as, according to rare disease experts, not all codes can be translated/are reasonable to be translated. Out of scope for this proposed action, but perhaps an effect of it is that the translation of ORPHAcode nomenclature would create an opportunity to move forward with the implementation of using the codes in national health data exchange in the future, which would allow for this information to be added to Patient Summary as well. Work performed and main achievements During the project's duration Estonia has ensured the stable operations of cross-border ePrescription and Patient Summary services. Developments for bringing the Patient Summary service to the new microservice platform have finished and the procurement contract has ended. However there are still 1 some development tasks that need to be done before this solution can be deployed live. Developments have been tested in our test environment and work will continue. During autumn 2024 Estonia upgraded all cross-border systems to a new version (Wave 7) in live environment with other Member States and has continued to provide all four services to public and healthcare professionals. Estonia also took part in the MyHealth@EU Wave 8 Spring Test Session with all live services successfully and will finish all follow-up activities in order to successfully upgrade the services to Wave 8 in production during autumn 2025. The work has started to improve national allergy standards. Analysis has been done and the validation with allergy and healthcare experts is currently ongoing to finalize the analysis and start developments. Estonia has been in contact with Estonian rare diseases experts in order to start the ORPHA codes translating process. The administrative part with the International Orpha Coordinating Team has been agreed upon and TEHIK will organize a procurement soon. Results and impacts Patient Summary service has been brought to a micro service platform in test environment, as there are still more developments needed then there haven't been an impact in production environment yet. However it's expected to make future updates easier and make the service more reliable overall as Estonia keeps working towards creating a new generation health information system in order to guarantee sustainable support of the health care sector. Estonia has upgraded its ePrescription and Patient Summary services according to the MyHealth@EU standards. New services have been opened with other joining Member States, such as Latvia and Lithuania, and thanks to this, the usage of these services continues to grow among citizens. 2  2. List of Participants PARTICIPANTS Latest Legal Data Beneficiaries screens — Overview of the Consortium changes. Number Role Short name Legal name Country PIC Entry date Exit date 1 COO MSAE SOTSIAALMINISTEERIUM Estonia 998429731 TERVISE JA HEAOLU 1.1 AE TEHIK Estonia 895885405 INFOSÜSTEEMIDE KESKUS 1