Overall Readiness Statement to Start New Service in Routine Operations

To the eHealth Network via eHMSEG Secretariat ( [email protected] ) Subject: Overall Readiness Statement to Start New Service in Routine Operations On behalf of Health and Welfare Information Systems Centre (HWISC) I declare that our National Contact Point for eHealth is ready to join the Cross-border eHealth Information Services providing the Patient Summary services as Countr y A in Wave 4 . This readiness and adherence of the National Contact Point for eHealth to legal, organizational, semantic and technical criteria is demonstrated by the successful outcome of testing and auditing: Outcome Summary Test Report Wave 4 , V erification of implementation of corrective actions Decision to start PET I undertake to notify the eHealth Network immediately of any change that could have a significant influence on the validity of the above statement. Therefore , I apply for joining the Cross-Border eHealth Information Services – Go Live. Tallinn, 10 . 05 .202 2 Sign ed digitally Margus Arm Director of Health and Welfare Information Systems Centre eHealth DSI Member State Expert Group Decision regarding Estonia NCPeH to be authorised to start the Production Environment Testing with service PS A and PS B Having analysed the audit and Pre-Production Testing of Estonia. eHMSEG considers the following functional findings f-4, and f-6 have a medium impact on the eHDSI, and finding f-8 have low impact on the eHDSI. eHMSEG has determined these findings can be resolved during routine operations. There are two findings from the initial audit, on which the auditors concluded that no further requests for information or other follow-up actions are needed. The eHMSEG takes note on the fact, that EE have not finished the conformance tests with three partners, due to the exceptional situation, which was the outburst of the COVID -19 pandemic. Having said so, the eHMSEG decides that EE NCPeH is authorised to start the Production Environment Testing of service PS A and PS B. In addition, findings f-4, f-6 and f-8 do not prevent NCPeH from starting routine operations, provided that all the Production Environment Tests sessions are fulfilled and there are no further findings impeding the go-live after these tests. Adopted by the eHMSEG on 15.06.2021  DG SANTE eHDSI Wave 4 Production Environment Testing (PET) ESTONIA (EE) NCPeH Outcomes Summary Report Document Control Page Settings Value Document Title: EE NCPeH Outcomes Summary Report Project Title: eHealth DSI Document Authors: eHDSI Solution Provider Doc. Version: State of Play as of 2nd of May, 2022 Status and concerned services: Wave 4 Pre-Production Testing for  Patient Summary (A) Sensitivity: Restricted to eHMSEG, eHDSI Owner, eHDSI Solution Provider Date: 02/05/2022 Link to the source Confluence https://webgate.ec.europa.eu/fpfis/wikis/x/muXzN 1 page: Table of Contents 1. Services under Preparation to GoLive (Production Environment Testing sessions) (Wave 4) ... 3 2. Coverage Completed during last Acceptance Test Event (Wave 4 Formal & Upgrade PPT) ...... 3 3. Outstanding findings ............................................................................................................ 4 4. Closed Findings, Observations, Production Testing Sessions .................................................. 8 Legend: PPT - Pre-production Formal / Upgrade Testing PET - Production Environment Testing Last updated: May 2, 2022 2  1. Services under Preparation to GoLive (Production Environment Testing sessions) (Wave 4) Partners in the Verification by the eDHSI SP. Planned Date of ID Production Environment Link to the Session page Findings / Observations during the GoLive for the Testing Session session for EE. services Conformance: no issues identified Functional: 2021-11-19 [EE (PS-A), LU  Findings: f-4, f-6, f-8, f-17 S-9 EE (PS A) - LU (PS B) (PS-B)] Production (new), f-18 (new) Environment Testing  Observations: o-2, o-3, o-4, o-5, o-6, o-8, o-21 Conformance: no issues identified 2021-11-24 [EE (PS-A), PT Functional: S-10 EE (PS A) - PT (PS B) (PS-B)] Production  Findings: f-4, f-6, f-8, f-17 Environment Testing (new), f-18 (new)  Observations: o-2, o-3, o-4, o-5, o-6, o-8, o-21 Conformance: no issues identified Functional: 2021-11-24 [EE (PS-A), FR  Findings: f-4, f-6, f-8, f-17 S-11 EE (PS A) - FR (PS B) (PS-B)] Production (new), f-18 (new) Environment Testing  Observations: o-2, o-3, o-4, o-5, o-6, o-8, o-21 2. Coverage Completed during last Acceptance Test Event (Wave 4 Formal & Upgrade PPT) Conformance Tests Required Conformance Service Available partners performed - WF with tests with partners partners Conformance testing PS-A (Conformance - min HR, CY, CZ, EE, FR, GR, HU, LU, MT, NL, HR, CY, CZ, EE, FR, GR, Yes 3 partners) PT, ES HU, LU, MT, NL, PT, ES PS-B (Conformance - min 3 HR, CY, CZ, EE, GR, IE, HR, CY, CZ, EE, GR, IE, LU, MT, PT, SI, ES Yes partners) LU, MT, PT, SI, ES eP-A (Conformance - min HR, CY, CZ, FI, GR, HU, HR, CY, CZ, FI, GR, HU, PL, PT, ES, SE Yes 3 partners) PL, PT, ES, SE 3  Conformance Tests Required Conformance Service Available partners performed - WF with tests with partners partners eP-B (Conformance - min HR, CY, CZ, FI, GR, HU, IE, LU, PL, PT, ES, HR, CY, CZ, FI, GR, HU, Yes 3 partners) SE IE, LU, PL, PT, ES, SE Required evaluations Service Available partners Evaluations submitted submitted Functional testing PS-A (Functional - own PS HR, CY, CZ, EE, FR, GR, HU, LU, MT, NL, service evaluated by HR, GR, HU Yes PT, ES partners) PS-B (Functional - PS from HR, CY, CZ, EE, GR, IE, LU, MT, PT, SI, ES HR, CZ, PT, SI Yes partners evaluated) eP-A (Functional - own eP docs evaluated by HR, CY, CZ, FI, GR, HU, PL, PT, ES, SE FI, PL, SE Yes partners) eP-B (Functional - eP docs HR, CY, CZ, FI, GR, HU, IE, LU, PL, PT, ES, FI, PL, SE Yes from partners evaluated) SE eP-A (Functional - eD docs HR, CY, CZ, FI, GR, HU, PL, PT, ES, SE FI, PL, SE Yes from partners evaluated) eP-B (Functional - own eD HR, CY, CZ, FI, GR, HU, IE, LU, PL, PT, ES, docs evaluated by FI, PL, SE Yes SE partners) 3. Outstanding findings Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider 4  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider In the PS Functional Requirements, the agent causing the allergic reaction is considered as 'basic', that is 16 Mar 2020 the reason why when missing, PPT W3, PS- and it has considered a A, Functional finding. According to ArtDecor its R 1..1, which 15 Mar 2021 in turn means that we are allowed to Solution Provider on 23 Mar PPT W4, PS- use nullFlavor="NI". Would it be better 2021: this situation can be A, Functional to remove the agent overall from considered as having a Estonian PS? medium impact, given that in 24 Sep 2021 Agent causing the allergic the original narrative part of f-4 the Section and in the Level 1 PET W3, PS- reaction not coded A, Functional 29 Mar 2021 PDF the information about the agent causing the allergic Allergy data was initially planned to be 19 Nov 2021 reaction is provided (in nationally available in 2020, but due to 24 Nov 2021 Estonian). A Health covid developments this has been PET W4, PS- Professional attending a postponed to 2022. A, Functional patient with an allergy would need to use a translation tool or, when possible and feasible (using a language understood by both), ask the patient or relative about that information. 16 Mar 2020 PPT W3, PS- Solution Provider on 23 Mar 29 Mar 2021 A, Functional Medication entries are 2021: this situation can be repeated three times. The Depending on the situation the doctors considered as having a 24 Aug 2021 situation happens as well in will still prescribe the prescriptions as medium impact. Health PET W3, PS- the narrative part and in the they have so far, so for the repeated professional can be confused f-6 A, Functional Level 1 PDF prescriptions it is expected to see 3 especially when the number of prescriptions with the same data, but distinct medications is high 19 Nov 2021 different prescription number. (mentioned for other PS test 24 Nov 2021 The same medicinal product Statistically, about half of the data that contained more PET W4, PS- repeated several times. prescriptions prescribed in Estonia are repetitions) and the start date A, Functional repeated prescriptions. is not indicated. 5  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider Date of onset of medication is considered a 'basic' element in 16 Mar 2020 06 May 2021 the PS Functional PPT W3, PS-A, Requirements. We discussed the topic internally and Functional Solution Provider on 23 Mar eventually HWISC feels that there is no right way to present the data (time, 2021: this situation can be 24 Aug 2021 considered as having a when the prescription was issued isn't PET W3, PS-A, minor impact, especially when Onset date of medication not really correct and the time it was f-8 Functional providing the date of onset of present dispensed is also not correct). Since „The agreed data elements must the health problem for which 19 Nov 2021 the medication is prescribed. be sent by each NCPeH, even if there is 24 Nov 2021 no content available (exceptional values Only in some situations, it PET W4, PS-A, are allowed)“ we should be fine, since would be more relevant: e.g. Functional we are sending the element itself and recent prescriptions causing using UNK. an adverse reaction, to evaluate a lack of efficacy of a treatment. 6  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider Solution Provider on 25 Jan 2022: this finding considered as having medium impact on eHDSI. Translated information about medical devices could be very useful during an emergency. It is a reality that such information might not be even readily available nationally during an emergency contact, therefore, the attending physician would be careful 19 Nov 2021 when ordering/interpreting an 24 Nov 2021 No coded information for the imaging test with which an PET W4, PS-A, Medical Device in the entry, Since increasing the value sets is a task implant might interfere. f-17 Functional information in Estonian in the for eHDSI, then NCPeH can not provide narrative and in the Level 1 an action plan for this. 30 new SNOMED CT concepts PDF are included in the value set of eHDSIMedicalDevice for Wave 5: CP-eHealthDSI-049: Extend eHDSIMedicalDevice Value Set. In total, there are 100 codes for medical devices in the value set. In addition, the reviewing of concepts in this Value Set is planning during the next STF Semantic WG meeting on 03 Feb 2022. MSs can provide their proposals for the SNOMED GPS extensions until the end of February 2022. 7  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider Solution Provider on 25 Jan 2022 : this finding considered as having medium impact on eHDSI. Translated information about surgical procedures could be very useful during an emergency (e.g. knowing a past surgery referring to the implantation of a medical device or to the transplantation of an organ). It is a reality that such information might not be even readily available nationally during an emergency contact, therefore, the attending 19 Nov 2021 No coded information for the physician would be careful 24 Nov 2021 Surgical procedures in the Since increasing the value sets is a task when ordering/interpreting an f-18 PET W4, PS-A, entry, information in Estonian for eHDSI, then NCPeH can not provide imaging test with which an Functional in the narrative and in the an action plan for this. implant might interfere. Level 1 PDF 519 new SNOMED CT concepts for surgical procedures were included in the value set of eHDSIProcedure for Wave 4: CP-eHealthDSI-053: Extend the value set for procedures. In total, there are 621 codes for surgical procedures in the value set. Also the reviewing of concepts in this Value Set is planning during the next STF Semantic WG meeting on 03 Feb 2022. MSs can provide their proposals for the SNOMED GPS extensions until the end of February 2022. 4. Closed Findings, Observations, Production Testing Sessions The closed findings, observations and Production Testing sessions can be found at the following link: https://webgate.ec.europa.eu/fpfis/wikis/x/qOXzN 8  Ref. Ares(2021)2833831 - 28/04/2021 EUROPEAN COMMISSION DIRECTORATE-GENERAL FOR HEALTH AND FOOD SAFETY Health and food audits and analysis Director Grange SANTE.F5 JJ/mmoc Subject: Verification of implementation of corrective actions Audit of Estonia carried out from 4 June to 16 October 2020 in order to assess the National Contact Point for eHealth's readiness for joining the Cross-Border eHealth Information Service Network for the new services Patient Summary country A and Patient Summary country B Ref.: DG(SANTE) 2020-7091 Dear Ms Reinhold, I am writing to inform you that the audit team has now verified the implementation of the actions taken in response to the recommendations made following the above-mentioned audit. I am pleased to inform you that the audit team has concluded that all recommendations (except for Nos 1 to 3) have been satisfactorily addressed. The audit team has proposed no further request for information or other follow-up actions in relation to recommendations Nos 1 to 3, for the reasons indicated in the attached table. Yours sincerely, (e-signed) María Pilar Aguar Fernández Director Enclosure: Annex Ms Katrin Reinhold Director Health and Welfare Information Systems Centre (HWISC) Veerenni 13/Uus-Tatari 25 10134 Tallinn Estonia European Commission, Grange, Dunsany, Co. Meath C15 DA39, Ireland - Office: GRAN 01/113 Tel.: direct line (+353 46) 9061 788, internal n°: 70788, switchboard: (+353 46) 9061 700. Fax: (+353 46) 9061 705  To the eHealth Network via eHMSEG Secretariat ([email protected]) Subject: Overall Readiness Statement to Start New Service in Routine Operations On behalf of Health and Welfare Information Systems Centre (HWISC) I declare that our National Contact Point for eHealth is ready to join the Cross-border eHealth Information Services providing the Patient Summary services as Country A in Wave 4. This readiness and adherence of the National Contact Point for eHealth to legal, organizational, semantic and technical criteria is demonstrated by the successful outcome of testing and auditing: 1. Outcome Summary Test Report Wave 4, 2. Verification of implementation of corrective actions 3. Decision to start PET I undertake to notify the eHealth Network immediately of any change that could have a significant influence on the validity of the above statement. Therefore, I apply for joining the Cross-Border eHealth Information Services – Go Live. Tallinn, 10.05.2022 Signed digitally Margus Arm Director of Health and Welfare Information Systems Centre To the eHealth Network via eHMSEG Secretariat ( [email protected] ) Subject: Overall Readiness Statement to Start New Service in Routine Operations On behalf of Health and Welfare Information Systems Centre (HWISC) I declare that our National Contact Point for eHealth is ready to join the Cross-border eHealth Information Services providing the Patient Summary services as Countr y A in Wave 4 . This readiness and adherence of the National Contact Point for eHealth to legal, organizational, semantic and technical criteria is demonstrated by the successful outcome of testing and auditing: Outcome Summary Test Report Wave 4 , V erification of implementation of corrective actions Decision to start PET I undertake to notify the eHealth Network immediately of any change that could have a significant influence on the validity of the above statement. Therefore , I apply for joining the Cross-Border eHealth Information Services – Go Live. Tallinn, 10 . 05 .202 2 Sign ed digitally Margus Arm Director of Health and Welfare Information Systems Centre eHealth DSI Member State Expert Group Decision regarding Estonia NCPeH to be authorised to start the Production Environment Testing with service PS A and PS B Having analysed the audit and Pre-Production Testing of Estonia. eHMSEG considers the following functional findings f-4, and f-6 have a medium impact on the eHDSI, and finding f-8 have low impact on the eHDSI. eHMSEG has determined these findings can be resolved during routine operations. There are two findings from the initial audit, on which the auditors concluded that no further requests for information or other follow-up actions are needed. The eHMSEG takes note on the fact, that EE have not finished the conformance tests with three partners, due to the exceptional situation, which was the outburst of the COVID -19 pandemic. Having said so, the eHMSEG decides that EE NCPeH is authorised to start the Production Environment Testing of service PS A and PS B. In addition, findings f-4, f-6 and f-8 do not prevent NCPeH from starting routine operations, provided that all the Production Environment Tests sessions are fulfilled and there are no further findings impeding the go-live after these tests. Adopted by the eHMSEG on 15.06.2021  DG SANTE eHDSI Wave 4 Production Environment Testing (PET) ESTONIA (EE) NCPeH Outcomes Summary Report Document Control Page Settings Value Document Title: EE NCPeH Outcomes Summary Report Project Title: eHealth DSI Document Authors: eHDSI Solution Provider Doc. Version: State of Play as of 2nd of May, 2022 Status and concerned services: Wave 4 Pre-Production Testing for  Patient Summary (A) Sensitivity: Restricted to eHMSEG, eHDSI Owner, eHDSI Solution Provider Date: 02/05/2022 Link to the source Confluence https://webgate.ec.europa.eu/fpfis/wikis/x/muXzN 1 page: Table of Contents 1. Services under Preparation to GoLive (Production Environment Testing sessions) (Wave 4) ... 3 2. Coverage Completed during last Acceptance Test Event (Wave 4 Formal & Upgrade PPT) ...... 3 3. Outstanding findings ............................................................................................................ 4 4. Closed Findings, Observations, Production Testing Sessions .................................................. 8 Legend: PPT - Pre-production Formal / Upgrade Testing PET - Production Environment Testing Last updated: May 2, 2022 2  1. Services under Preparation to GoLive (Production Environment Testing sessions) (Wave 4) Partners in the Verification by the eDHSI SP. Planned Date of ID Production Environment Link to the Session page Findings / Observations during the GoLive for the Testing Session session for EE. services Conformance: no issues identified Functional: 2021-11-19 [EE (PS-A), LU  Findings: f-4, f-6, f-8, f-17 S-9 EE (PS A) - LU (PS B) (PS-B)] Production (new), f-18 (new) Environment Testing  Observations: o-2, o-3, o-4, o-5, o-6, o-8, o-21 Conformance: no issues identified 2021-11-24 [EE (PS-A), PT Functional: S-10 EE (PS A) - PT (PS B) (PS-B)] Production  Findings: f-4, f-6, f-8, f-17 Environment Testing (new), f-18 (new)  Observations: o-2, o-3, o-4, o-5, o-6, o-8, o-21 Conformance: no issues identified Functional: 2021-11-24 [EE (PS-A), FR  Findings: f-4, f-6, f-8, f-17 S-11 EE (PS A) - FR (PS B) (PS-B)] Production (new), f-18 (new) Environment Testing  Observations: o-2, o-3, o-4, o-5, o-6, o-8, o-21 2. Coverage Completed during last Acceptance Test Event (Wave 4 Formal & Upgrade PPT) Conformance Tests Required Conformance Service Available partners performed - WF with tests with partners partners Conformance testing PS-A (Conformance - min HR, CY, CZ, EE, FR, GR, HU, LU, MT, NL, HR, CY, CZ, EE, FR, GR, Yes 3 partners) PT, ES HU, LU, MT, NL, PT, ES PS-B (Conformance - min 3 HR, CY, CZ, EE, GR, IE, HR, CY, CZ, EE, GR, IE, LU, MT, PT, SI, ES Yes partners) LU, MT, PT, SI, ES eP-A (Conformance - min HR, CY, CZ, FI, GR, HU, HR, CY, CZ, FI, GR, HU, PL, PT, ES, SE Yes 3 partners) PL, PT, ES, SE 3  Conformance Tests Required Conformance Service Available partners performed - WF with tests with partners partners eP-B (Conformance - min HR, CY, CZ, FI, GR, HU, IE, LU, PL, PT, ES, HR, CY, CZ, FI, GR, HU, Yes 3 partners) SE IE, LU, PL, PT, ES, SE Required evaluations Service Available partners Evaluations submitted submitted Functional testing PS-A (Functional - own PS HR, CY, CZ, EE, FR, GR, HU, LU, MT, NL, service evaluated by HR, GR, HU Yes PT, ES partners) PS-B (Functional - PS from HR, CY, CZ, EE, GR, IE, LU, MT, PT, SI, ES HR, CZ, PT, SI Yes partners evaluated) eP-A (Functional - own eP docs evaluated by HR, CY, CZ, FI, GR, HU, PL, PT, ES, SE FI, PL, SE Yes partners) eP-B (Functional - eP docs HR, CY, CZ, FI, GR, HU, IE, LU, PL, PT, ES, FI, PL, SE Yes from partners evaluated) SE eP-A (Functional - eD docs HR, CY, CZ, FI, GR, HU, PL, PT, ES, SE FI, PL, SE Yes from partners evaluated) eP-B (Functional - own eD HR, CY, CZ, FI, GR, HU, IE, LU, PL, PT, ES, docs evaluated by FI, PL, SE Yes SE partners) 3. Outstanding findings Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider 4  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider In the PS Functional Requirements, the agent causing the allergic reaction is considered as 'basic', that is 16 Mar 2020 the reason why when missing, PPT W3, PS- and it has considered a A, Functional finding. According to ArtDecor its R 1..1, which 15 Mar 2021 in turn means that we are allowed to Solution Provider on 23 Mar PPT W4, PS- use nullFlavor="NI". Would it be better 2021: this situation can be A, Functional to remove the agent overall from considered as having a Estonian PS? medium impact, given that in 24 Sep 2021 Agent causing the allergic the original narrative part of f-4 the Section and in the Level 1 PET W3, PS- reaction not coded A, Functional 29 Mar 2021 PDF the information about the agent causing the allergic Allergy data was initially planned to be 19 Nov 2021 reaction is provided (in nationally available in 2020, but due to 24 Nov 2021 Estonian). A Health covid developments this has been PET W4, PS- Professional attending a postponed to 2022. A, Functional patient with an allergy would need to use a translation tool or, when possible and feasible (using a language understood by both), ask the patient or relative about that information. 16 Mar 2020 PPT W3, PS- Solution Provider on 23 Mar 29 Mar 2021 A, Functional Medication entries are 2021: this situation can be repeated three times. The Depending on the situation the doctors considered as having a 24 Aug 2021 situation happens as well in will still prescribe the prescriptions as medium impact. Health PET W3, PS- the narrative part and in the they have so far, so for the repeated professional can be confused f-6 A, Functional Level 1 PDF prescriptions it is expected to see 3 especially when the number of prescriptions with the same data, but distinct medications is high 19 Nov 2021 different prescription number. (mentioned for other PS test 24 Nov 2021 The same medicinal product Statistically, about half of the data that contained more PET W4, PS- repeated several times. prescriptions prescribed in Estonia are repetitions) and the start date A, Functional repeated prescriptions. is not indicated. 5  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider Date of onset of medication is considered a 'basic' element in 16 Mar 2020 06 May 2021 the PS Functional PPT W3, PS-A, Requirements. We discussed the topic internally and Functional Solution Provider on 23 Mar eventually HWISC feels that there is no right way to present the data (time, 2021: this situation can be 24 Aug 2021 considered as having a when the prescription was issued isn't PET W3, PS-A, minor impact, especially when Onset date of medication not really correct and the time it was f-8 Functional providing the date of onset of present dispensed is also not correct). Since „The agreed data elements must the health problem for which 19 Nov 2021 the medication is prescribed. be sent by each NCPeH, even if there is 24 Nov 2021 no content available (exceptional values Only in some situations, it PET W4, PS-A, are allowed)“ we should be fine, since would be more relevant: e.g. Functional we are sending the element itself and recent prescriptions causing using UNK. an adverse reaction, to evaluate a lack of efficacy of a treatment. 6  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider Solution Provider on 25 Jan 2022: this finding considered as having medium impact on eHDSI. Translated information about medical devices could be very useful during an emergency. It is a reality that such information might not be even readily available nationally during an emergency contact, therefore, the attending physician would be careful 19 Nov 2021 when ordering/interpreting an 24 Nov 2021 No coded information for the imaging test with which an PET W4, PS-A, Medical Device in the entry, Since increasing the value sets is a task implant might interfere. f-17 Functional information in Estonian in the for eHDSI, then NCPeH can not provide narrative and in the Level 1 an action plan for this. 30 new SNOMED CT concepts PDF are included in the value set of eHDSIMedicalDevice for Wave 5: CP-eHealthDSI-049: Extend eHDSIMedicalDevice Value Set. In total, there are 100 codes for medical devices in the value set. In addition, the reviewing of concepts in this Value Set is planning during the next STF Semantic WG meeting on 03 Feb 2022. MSs can provide their proposals for the SNOMED GPS extensions until the end of February 2022. 7  Service & Test Comments and/or Action Plan by the Comments by the eHDSI ID Finding Event NCPeH Solution Provider Solution Provider on 25 Jan 2022 : this finding considered as having medium impact on eHDSI. Translated information about surgical procedures could be very useful during an emergency (e.g. knowing a past surgery referring to the implantation of a medical device or to the transplantation of an organ). It is a reality that such information might not be even readily available nationally during an emergency contact, therefore, the attending 19 Nov 2021 No coded information for the physician would be careful 24 Nov 2021 Surgical procedures in the Since increasing the value sets is a task when ordering/interpreting an f-18 PET W4, PS-A, entry, information in Estonian for eHDSI, then NCPeH can not provide imaging test with which an Functional in the narrative and in the an action plan for this. implant might interfere. Level 1 PDF 519 new SNOMED CT concepts for surgical procedures were included in the value set of eHDSIProcedure for Wave 4: CP-eHealthDSI-053: Extend the value set for procedures. In total, there are 621 codes for surgical procedures in the value set. Also the reviewing of concepts in this Value Set is planning during the next STF Semantic WG meeting on 03 Feb 2022. MSs can provide their proposals for the SNOMED GPS extensions until the end of February 2022. 4. Closed Findings, Observations, Production Testing Sessions The closed findings, observations and Production Testing sessions can be found at the following link: https://webgate.ec.europa.eu/fpfis/wikis/x/qOXzN 8  Ref. Ares(2021)2833831 - 28/04/2021 EUROPEAN COMMISSION DIRECTORATE-GENERAL FOR HEALTH AND FOOD SAFETY Health and food audits and analysis Director Grange SANTE.F5 JJ/mmoc Subject: Verification of implementation of corrective actions Audit of Estonia carried out from 4 June to 16 October 2020 in order to assess the National Contact Point for eHealth's readiness for joining the Cross-Border eHealth Information Service Network for the new services Patient Summary country A and Patient Summary country B Ref.: DG(SANTE) 2020-7091 Dear Ms Reinhold, I am writing to inform you that the audit team has now verified the implementation of the actions taken in response to the recommendations made following the above-mentioned audit. I am pleased to inform you that the audit team has concluded that all recommendations (except for Nos 1 to 3) have been satisfactorily addressed. The audit team has proposed no further request for information or other follow-up actions in relation to recommendations Nos 1 to 3, for the reasons indicated in the attached table. Yours sincerely, (e-signed) María Pilar Aguar Fernández Director Enclosure: Annex Ms Katrin Reinhold Director Health and Welfare Information Systems Centre (HWISC) Veerenni 13/Uus-Tatari 25 10134 Tallinn Estonia European Commission, Grange, Dunsany, Co. Meath C15 DA39, Ireland - Office: GRAN 01/113 Tel.: direct line (+353 46) 9061 788, internal n°: 70788, switchboard: (+353 46) 9061 700. Fax: (+353 46) 9061 705