OpenNCP is a novel open source framework that enables secure access to patient health information across European healthcare systems. It provides a set of components like data discovery, trust services, and transformation services to support cross-border e-Health services defined by the epSOS project, including access to patient summaries and electronic prescriptions. OpenNCP has been adopted by many European countries and tested across multiple IHE Connectathons. Its open community develops and maintains the components using agile methodologies.

1. OpenNCP
a novel framework to foster
cross-border e-Health services
Presenter: Kostas Karkaletsis

2. Definition of epSOS
.. to develop a practical eHealth
framework and infrastructure
[based on existing national
infrastructures] that will enable
secure access to patient health
information, particularly with
respect to a basic Patient
Summary and ePrescription,
between European
healthcare systems.

3. How the story starts
The political goal of cross-border health care provisioning in
the European Union (EU), clearly stated in the EC Directive
2011/24 on patient rights in cross border health care
lSet up of the EU e-Health Interoperability Framework
lFunding of pilots for health data exchange

4. Physician Scenario
●An italian tourist visits a greek island in
summer and needs to go to the hospital
oDoctor can have access to the “Patient
Summary” documents of this patient
oDoctor, can write an encounter report and
inform back the Italian systems

5. Pharmacist Scenario
●The tourist wants to go to a pharmacy to take
his medication
oPharmacist can access his prescriptions
and dispense.
oThe dispensation data will be transfered
back to Italy and be handled there

6. epSOS cross border services
●Patient Summary for EU Citizens
Occasional and Regular Visit, fetch a summary of person’s
vaccinations, allergies, adverse reactions, immunizations,
past illnesses, medical devices, medication summary, etc.
etc.
●eDispensation for EU Citizens
Medication ePrescription and eDispensation, fetch
electronic prescriptions, dispense them, send dispensation
information back to patient’s home country

7. epSOS cross border services
▪Patient Access
Give the patients access to their information in multi-language
▪Health-Care Encounter Report
Report information about an encounter,
▪Medication Related Overview
Provide relevant information for medication dispensation, fetch
history of medication use (subset of a patient summary)

8. epSOS Reference Implementations
1st implementation - epSOS induced
✓Based on Proprietary software
2nd implementation – country independent initiative
✓epSOS open common components
3rd implementation (OpenNCP) - epSOS induced
✓Full set of open source components ready to reuse
✓As a bundle or as components
✓With a supporting open community

9. OpenNCP Vision
...design and develop a set of Open Source
Components (OpenNCP) that can be adopted by
Participating Nation, to build their local
implementation of the NCP (National Contact
Point).

10. OpenNCP High Level Architecture

11. OpenNCP Architecture
●Data Discovery Exchange Services: allow patients to be identified
and clinical information to be retrieved
●Trust Services: ensures validation, verification, signing and mapping
of messages/information as well as the patient consent mechanism
●Transformation Services: enables the translation and mapping of
taxonomy of the involved clinical documents
●Audit Services: assures the system traceability and operation
auditing
●Support Services: ensures service availability, response time,
guaranteed delivery and session

12. OpenNCP Components

13. Security
The OpenNCP security components implement
the security/privacy foreseen by the Circle of
Trust legal agreement, including end-to-end
secure communications (IPSec + SSL) and PKI
infrastructure

14. IHE Profiles used
●Cross Community Patient Discovery, XCPD
(identifying patients in remote countries)
●Cross Community Access, XCA (supports the
means to query and retrieve patient relevant data
kept in remote countries)
●Cross-Enterprise Document Reliable
Interchange, XDR (supports document interchange
using reliable messaging system)

15. IHE Profiles Used
●Clinical Document Architecture, CDA (pecify the
encoding, structure and semantics of clinical documents)
●Cross Enterprise User Assertions, XUA+ (communicate
claims about the identity of an authenticated actor)
●Audit Trail and Node Authentication, ATNA (keep
audits of all the transactions)
●Basic Patient Privacy Consents, BPCC

16. Transformation Services
●One of the main goals of epSOS and OpenNCP is to
deliver content in the final user language
●Master Value Catalogue (MVC) and Master
Translation and Transcoding Catalogues (MTC)
ensure semantic interoperability
●Based on standards like ICD-10,ATC-5,SNOMED

17. Results
●Offers a high level API of services for Infrastructures to
be used by countries
●OpenNCP has an associated web graphical user
interface (OpenNCP Portal) that incorporates a specific
CDA display tools, enabling visualization of information
for the end users
●Provide the semantic and security services required
for the EU cross-border scenarios

18. OpenNCP adoption
Most of the european
epSOS countries have
adopted OpenNCP
Solution
Austria, Croatia, Italy,
Luxembourg, Malta,
Portugal, Slovenia, Spain,
Greece, Hungary, Estonia,
Switzerland, Sweden

19. OpenNCP Testing
The OpenNCP components have been tested
by several countries in the past 4 IHE
Connectathons in Europe (Bern, Vienna,
Istanbul and Luxembourg)

20. Trillium Bridge
OpenNCP connects through
Trillium Bridge Project to allow
exchange of patient summary
between Europe and USA
(http://www.trilliumbridge.eu)

21. OpenNCP meets Stork
Stork Authentication to
authenticate and authorize
HCP and patients using
Stork EID solution
(https://www.eid-stork.eu)

22. OpenNCP Community
Open group of people orchestrated by an agile
software development methodology conducting
effort on designing, coding, testing and delivering
OpenNCP technology

23. Who we are

24. Development Tools Used
●Atlassian Bitbucket, for code sharing
●Atlassian Jira, for planning and support
●Attlassian Confluence, for documentation
●CI Jenkins, for automated builds, testing and
release
●Joinup, as publishing framework
●IHE Gazelle Validators, for testing message
exchanged validity

25. OpenNCP Presentation
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