Can the International Patient Summary Capture the Complexity of a Person’s Health?

Since the Trillium Bridge Project first proposed a common International Patient Summary (IPS) for Europe and the US in 2015, the concept has evolved into an ISO-ratified global standard (ISO 27269:2021).

But the very universality that makes it powerful also raises a critical question:
Can a standardised summary ever convey the complexity of an individual’s health?

What is the International Patient Summary?

The IPS defines a minimal yet universal dataset, including allergies, problems, medications, immunisations, procedures, and results, that can travel securely across borders and care settings. Its purpose is ambitious yet noble: to make essential patient information “available anywhere, for any caregiver, at any time.”

The Promise of the International Patient Summary

Evidence gathered across healthcare literature demonstrates tangible benefits from the IPS. These include:

• Enhanced quality of care through improved medication management and fewer errors
• Shorter hospital stays and lower readmission rates
• Improved clinician communication through interoperable data sharing
• Reduced duplication of tests and overall cost efficiencies

Collectively, these studies demonstrate a link between information exchange and improved patient outcomes and system efficiency. The IPS’s structured, machine-readable design supports safer transitions of care, particularly in emergency and cross-border contexts.

The Double-Edged Nature of Standardisation

While standardisation enables seamless data exchange, it can also limit the richness of medical narratives.

The IPS dataset is intentionally minimal, designed for universal interpretability rather than exhaustive detail. It defines what data should be shared, but not how it should be summarised. This means the IPS doesn’t capture a clinician’s reasoning, diagnostic uncertainty, or nuanced case context.

This design prevents inconsistency but introduces risk by abstracting away narrative meaning. The IPS may under-represent multimorbidity, psychosocial factors, or longitudinal trends that influence clinical decision-making.

Furthermore, summarisation itself is inherently subjective. What one clinician omits as “inessential” may later prove vital. While brevity enhances clarity and speed, it can oversimplify complex, chronic conditions.

What are the barriers to the adoption of the IPS?

Despite its potential, the adoption of IPS faces human and systemic barriers. Privacy concerns, data security risks, interoperability challenges, and limited funding all contribute to these issues. Clinicians may also resist change, fearing usability issues or breaches of patient confidentiality.

Successful implementation, therefore, requires cultural change alongside technical progress, training, trust-building, and alignment with real-world clinical workflows.

Toward Context-Aware, Intelligent Data Exchange

In practice, summaries are not neutral; they reflect both the producer’s perspective and the consumer’s expectations. For the IPS to succeed, both parties must share a common semantic foundation, ensuring clarity and preventing misinterpretation.

While the IPS provides consistency, that very consistency can flatten nuance. A concise summary is only valuable when supplemented by access to full underlying records.

Emerging paradigms such as Digital Phenotyping aim to restore this depth. By integrating EHR data, wearable sensor outputs, and behavioural signals, these models can coexist with IPS frameworks, layering personalisation atop standardisation.

When combined with computable clinical guidelines, the IPS could serve as the anchor for intelligent, context-aware data exchange across the health ecosystem.

Ensuring Trust Through Provenance and Extensibility

A key challenge lies in data provenance, knowing where information originated and how reliable it is. Without traceable sources, the IPS cannot underpin safe clinical decisions.

Cross-border exchanges must therefore include mechanisms for verifying authorship, consent, and data integrity, principles that are also echoed by the European Commission’s X-eHealth Initiative.

Rather than replacing full Electronic Health Records (EHRs), the IPS should be viewed as a gateway layer, a clinically curated extract optimised for speed, safety, and interoperability.

Future iterations should also accommodate domain-specific modules (e.g., oncology, rare diseases) while maintaining universal standards. Narrative-rich systems such as clinician notes and patient-reported outcomes must remain accessible to preserve human context.

A Pragmatic Step Toward Global Health Interoperability

The International Patient Summary represents a pragmatic and essential step towards global health information exchange. It enhances safety, efficiency, and equity, particularly during emergencies and transitions to cross-border care.

Yet by design, it cannot and should not capture every nuance of a patient’s journey. Its strength lies in complementarity, providing a clear and interoperable foundation upon which richer, context-sensitive data can be built.

The future of digital health will depend on blending the precision of the IPS with the empathy and narrative understanding that define good medicine.

Learn More

Discover how Orion Health’s interoperability solutions support global standards like the IPS and empower connected, patient-centred care.

Authored by Tom Varghese, Global Product Marketing & Growth Manager at Orion Health.

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