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International patient data exchange through the patient

How hospitals in different countries can share a patient's record through the patient: a portable FHIR R4 record, an International Patient Summary, consent per clinic, and what it does not replace.

When a patient moves between countries, the clinic that needs their history usually cannot reach the system that holds it. On Anpheros the record is held by the patient, in standard HL7 FHIR R4 form, and a clinic anywhere can read the part the patient allows, for as long as they allow it. The patient is the bridge between systems that do not talk to each other.

The problem

Hospital systems in different countries use different products, different languages and different legal frameworks. A direct connection between two hospitals needs agreements, security reviews and integration work that rarely happen for a single patient. The patient, however, is present at both ends and has a legal right to their own data in most jurisdictions.

How it works on Anpheros

The record is portable. It is stored as FHIR R4 resources with codes from standard terminologies, such as LOINC for laboratory results, ICD-10 for conditions and ATC for medications, and it can be exported as an International Patient Summary (Patient/$summary), a document validated with the official HL7 validator. See International Patient Summary (IPS) in FHIR.
The patient allows a clinic. The clinic sends a request, and the patient approves it from their phone wherever they are, for 30, 90 or 365 days. See how a clinic requests access.
The clinic reads, in its own language and system. Terminology is standard, so a laboratory value or an allergy means the same thing in each country. Free text stays in the language it was written in.
The clinic adds its own results, with the patient's consent, labelled with who wrote them, and the patient keeps them.
The patient can withdraw access at any time and see every read in the access log.

What it covers, and what it does not

It works through the patient. It does not connect national health systems to each other, and it does not replace them. Where a national system exists, such as a country's patient summary service, the patient-held record is an additional route, not a substitute. See the European Health Data Space for developers for how the wider European framework relates.
It carries structured data well: conditions, medications, allergies, laboratory results, vaccinations, measurements. Documents, such as discharge letters, travel as files with their checksum.
Language is not translated automatically. Codes and structured values are interpreted the same way everywhere; narrative text is not.
Data location: the data stays in the EU region by default, whichever country the reading clinic is in. A US data region is available on request for US production customers under a business associate agreement; production for US patient data starts only after it is signed.

For a hospital that wants to receive patients from abroad

Accept a patient's International Patient Summary or a request through the platform instead of asking for paper copies.
Map your system's patient, condition, medication and observation records to FHIR once; the same mapping works for every patient who arrives through the platform. The integration guide shows the steps.
Use the sandbox first, with synthetic patients, to test the integration before any real record is involved.

Frequently asked questions

Can a hospital in one country read a patient's record from another country?

Yes, with the patient's approval. The clinic requests access, the patient allows it for a stated period, and the clinic reads the allowed scope as FHIR R4 data. Neither hospital needs to connect to the other's systems.

Is this the same as a national health data exchange?

No. National and European exchanges connect institutions. This route runs through the patient and complements them; it is useful when no institutional connection exists between two providers.

Which language is the record in?

Structured data uses international codes, so it can be read in any language. Text written by a clinician stays in its original language; it is not translated automatically.

Where is the data stored when a clinic abroad reads it?

In the European Union. A clinic outside the EU reads it through the API; the data is not copied to another region by default; a US region is available on request for US patients.

What does the patient control?

Who can read, which resource types, for how long, and whether to withdraw. The patient also sees every read of their record.