Consolidation of the use of the PHR/e-PHR

 
The implementation of the Personal Health Record (PHR), and accompanying Handbook for Health Professionals, as well as the related electronic platform, is planned to be continued in the countries where it was initially piloted within the Re-Health project (i.e. Croatia, Greece, Italy and Slovenia) upon their commitment.
 
The second phase of implementation will consolidate the use of the PHR/e-PHR with the view to demonstrate the feasibility and limitations of such a system.
 
It will be supported by the employment of trained health mediators, fluent in the main languages spoken by migrants/refugees, by the IOM Euro Health Mediators Platform – a supporting capacity building tool that will also allow networking for Health Mediators – by the provision of essential supplies and portable workstations equipment when/where needed.
 
PROMOTION OF THE TOOL
 
In order to increase the uptake and understanding among stakeholders of the value and advantages of the PHR/e-PHR and similar system, a minimum of three National Consultation Committee meetings (NCCs) will be organized as well as when/where necessary bilateral meetings with key stakeholders involved in the provision of health care for migrants (national/local authorities, hospitals, civil society organizations, etc.) and other authorities indirectly involved.
 
In addition, liaison with the services of the European Commission responsible for the European Strategy for people-centred digital health and care and the European Health Electronic Health Record (EEHR) will be further maintained through the project duration to be apprised of any new development in the sector.
 
IMPLEMENTATION IN NEW SITES
 
The implementation of the PHR/e-PHR and related electronic platform on its second phase within the Re-Health2 action, will be extended in a minimum three new sites, chosen based on political interest and commitment, areas with high level of recently arrived migrant and presence of established health units/health professionals.
 
The implementation includes training for health professionals on the utilization of the PHR and related confidentiality information, as well as constant monitoring and liaison with them to ensure effective usage. It will be further supported by:
  • Needs assessments in each implementation site, summarized in a short report;
  • Recruitment of health mediators when/where needed: the daily tasks of the mediators will be to support the work of health professionals in communicating with patients and explain the process and individual benefits of having a health assessment and the PHR/e-PHR;
  • Training of health professionals and health mediators on the e-PHR; 
  • Provision of essential supplies, such as medical devices and hygiene or dignity kits; and
  • Portable equipment, when/where needed.       
DATA COLLECTION AND ANALYSIS
 
The use of the e-PHR is set to allow the collection of data on migrant population in specific sites within the EU Member States, and through the aggregated data collected, facilitate the identification of training needs and topics, in collaboration with National Authorities and project implementation partners.

The analysis of the anonymised health data collected through the relocation health assessments according to respective countries’ agreed upon protocols, will lead to better knowledge and understanding of migrants’/refugees’ health needs. Furthermore, linking the PHR and the relocation health checks for refugees by printing the health assessments undertaken within the relocation scheme in a PHR format will allow further dissemination of the concept. 
 
More specifically, the use of the PHR/e-PHR and related electronic platform will allow the collection of two types of data:
  • On the utilization of the e-PHR, data related to the use of the e-PHR, including number of e-PHR, number of follow ups of same individuals (traceability), general trends and demographics, will be aggregated in a respective Report. Anonymised health data and demographics collected through the e-PHR will be available to health authorities for further analysis.
  • Migrants' health status at the moment of relocation and the main health problems identified (upon agreement with DG HOME for the use of aggregated data): Currently IOM MHD is supporting Greece and Italy in relation to the provision of health assessments for migrant beneficiaries of the EU Relocation Scheme within a DG Home project. The established tool for health assessments recording in the relocation project is the IOM MiMoSA platform. Health Data generated according to pre agreed protocols will be complied in a summary report outlining main health problems identified. Within the action Re-Health, the MiMoSA platform was modified to allow for the printing of the PHR in place of the IOM form to include in the relocated migrant’s folder. Such printing set up will be further consolidated through operational support within this action in Greece and potentially initiated in Italy, where the use of MiMoSA for relocation health assessments was initiated in February 2017 and allow further dissemination and buy-in of the concept and action.