That a healthcare professional in another European country can quickly consult, in a structured way, a patient’s allergies, medication or medical history is already a reality. The Patient Summary is one of the services of MyHealth@EU, the European infrastructure for the cross-border exchange of health data. The European Health Data Space (EHDS) Regulation, in force since March 2025, makes this exchange an obligation for all Member States from March 2029, within the framework of the primary use of health data, that is, its use for the healthcare of citizens.

As we explained in our introduction to the EHDS and in our guide to ePrescription and eDispensation, the new regulation transforms the cross-border exchange of clinical information. For organisations that develop healthcare software or manage electronic health records, the challenge goes beyond exchanging data: it is necessary to ensure that the information is interpreted correctly, keeps its meaning and is useful for healthcare professionals, regardless of the country in which it is consulted.

What is the Patient Summary and what is it for?

The Patient Summary is a set of essential clinical information that gives healthcare professionals a quick and structured overview of the most relevant aspects of a patient’s health, especially when they need care in another European country.

In Spain, the Ministry of Health defines the EU Patient Summary (EUPS) as a document containing the most relevant clinical information to facilitate unscheduled healthcare for European citizens outside their country of origin. It is generated from the data available in the electronic health record of the relevant health system.

Its application will be gradual: the obligations relating to the Patient Summary, together with electronic prescription and dispensing, will apply from March 2029, and those for medical imaging, laboratory results and discharge reports from March 2031.

What information does it include?

The Regulation itself, in Annex I, sets out what information the Patient Summary must include:

• Personal and contact details, and information on health coverage.
• Allergies and medical alerts, essential for preventing risks during care.
• Vaccination or prophylaxis, including, where applicable, in the form of a vaccination card.
• Current, resolved or inactive health problems, coded in international classifications, and textual information on the medical history.
• Medical devices and implants that may be relevant to care.
• Medical or care procedures and the patient’s functional status.
• Current and relevant past medication.
• Social history related to health, pregnancy history and data provided directly by the patient.
• Results of clinical observations on the patient’s health status and care plan.
• Information on rare diseases, including their characteristics and clinical impact.

How does the Patient Summary work in practice?

The Patient Summary is part of the cross-border exchange services of MyHealth@EU, together with electronic prescription and electronic dispensing, and is one of the main use cases of this exchange. In simplified terms, the process follows four steps:

1. Origin: the summary is generated from the information available in the electronic health record of the health system of the country of origin.
2. Exchange: MyHealth@EU enables the secure and interoperable exchange of this data between participating countries.
3. Consultation: when the patient needs care in another Member State, the healthcare professional accesses the essential clinical information in a structured format.
4. Care: the professional uses this data as support to assess the clinical situation and make care decisions, especially in unscheduled situations.

The Patient Summary is not sent automatically, nor is it stored in a centralised European repository. The information remains in the health system of the country of origin and is shared only when a professional who is treating the patient requests it. At that point, the request travels through MyHealth@EU, from the national contact point of the country where care is being provided to that of the country of origin, which makes the summary available to the professional securely. So, if for example a Spanish patient needs care in France, the French doctor can consult their summary at the moment it is needed and read it in their own language. For this exchange to be possible, health systems must overcome several technical and organisational barriers. The diversity of standards, terminologies and national infrastructures poses challenges that go beyond the transmission of data and that are especially relevant in the context of the EHDS.

Interoperability challenges of the Patient Summary

Sharing this information between countries is not simple: each Member State has its own infrastructures, terminologies and ways of recording clinical data. If your organisation develops or manages health record systems, these are the three fronts that affect you:

• Common coding and value sets: for a diagnosis, an allergy or a medicine to be interpreted correctly in another country, it is not enough to transmit the data: its meaning must be shared by the different systems. Semantic interoperability is essential for clinical information to keep its meaning when it crosses borders.
• Alignment with other services and the EHDS: the Patient Summary does not work in isolation. It is related to services such as electronic prescription and dispensing, and this connection takes on particular importance with the EHDS, which establishes a common framework to facilitate access to and exchange of electronic health data. The Patient Summary is precisely among the first priority categories of the regulation. For developers, this means preparing their systems to meet the European interoperability specifications and to make them compatible with the common exchange environment.
• Technological transition: different technologies and standards for exchanging clinical information coexist in health systems today. The EHDS establishes the European Electronic Health Record Exchange Format (EEHRxF), which the European Commission will specify through implementing acts before March 2027 and which will determine which standards will be used for each priority category, including the Patient Summary. The aim is not to create new standards: the format will build on existing international interoperability standards that are widely used by the industry. The technical proposals developed at European level, such as those of the Xt-EHR Joint Action, are based on HL7 FHIR for information exchange and on clinical terminologies such as SNOMED CT. Current systems will have to adapt to the new format, both for information recorded from now on and for historical data that already exists in digital form.