D7.3 version 2: Pilot deployment report

Ref. Ares(2021)1515471 - 26/02/2021 This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Grant Agreement No. 875299 Project acronym: UNICOM Project full title: Up-scaling the global univocal identification of medicines in the context of Digital Single Market strategy Call identifier: H2020-SC1-DTH-2019 WP7 eHDSI cross-border / national eHealth services piloting D7.3 version 2: Pilot deployment report Version: 2 Status: Final Dissemination Level1: PU Due date of deliverable: 31/05/2024 Actual submission date: 31/05/2024 Work Package: WP7: eHDSI cross-border / national eHealth services piloting Lead partner for this deliverable: ARIA Partner(s) contributing: SPMS, SAS, IHE, HL7, INDRA, KELA, HZZO, INFARMED, REGLOMB, DWIZ, ELGA, IEDOH Deliverable type2: R Main author(s): Alberto Zanini, Marcello Melgara, Angela Ferrara, Luca Garbarino (ARIA SpA) Other author(s): Inês Antunes, Gonçalo Lourenço (SPMS) 1 Dissemination level: PU: Public; CO: Confidential, only for members of the consortium (including the Commission Services); EU-RES: Classified Information: RESTREINT UE (Commission Decision 2005/444/EC); EU-CON: Classified Information: CONFIDENTIEL UE (Commission Decision 2005/444/EC); EU-SEC Classified Information: SECRET UE (Commission Decision 2005/444/EC) 2 Type of the deliverable: R: Document, report; DEM: Demonstrator, pilot, prototype; DEC: Websites, patent fillings, videos, etc.; OTHER; ETHICS: Ethics requirement; ORDP: Open Research Data Pilot UNICOM – D7.3: Pilot Deployment Report Page 2 of 22 Revision history Version Date Changes made Author(s) V0.1 31/05/2023 Table of contents, structure Angela Ferrara, Luca Garbarino V0.2 30/06/2023 Introduction Marcello Melgara V0.3 15/07/2023 Chapters Angela Ferrara, Marcello Melgara, Luca Garbarino V0.4 31/07/2023 Contributions by many authors Inês Antunes, Gonçalo Lourenço (SPMS), Juha Soikkeli V0.5 01/08/2023 Full document revision Angela Ferrara, Marcello Melgara, Luca Garbarino V2.1 15/05/2024 Final version review Alberto Zanini, Luca Garbarino V2.0 29/05/2024 Final version submitted to the coordination team Statement of originality This deliverable contains original unpublished work except where clearly indicated otherwise. Acknowledgement of previously published material and of the work of others has been made through appropriate citation, quotation or both. UNICOM – D7.3: Pilot Deployment Report Page 3 of 22 Deliverable abstract Deliverable 7.3 (D7.3), stems from the D7.1 Piloting Strategy and the D7.2 Proof of concept demonstrator. It aims at highlighting the current state of deployment among participating partners. The Deliverable, following an overview of the different eHDSI environments and testing, aims at providing tools to foster the preparation of testing data and explaining how to practically start testing in the Pre-Production environment. The last sections of the Deliverable are devoted to the evaluation of the Wave 6 PreProduction tests participating countries results; it contains contributions from Italy, Finland and Portugal. This Deliverable D7.3 version 2 is a final, updated and enriched version substituting V1, previously submitted. Key words: ISO IDMP; EMA; eHealth, ePrescription, Patient Summary, UNICOM, CDA Implementation Guide, ValueSets. This document contains material, which is the copyright of the members of the UNICOM consortium listed above and may not be reproduced or copied without their permission. The commercial use of any information contained in this document may require a license from the owner of that information. This document reflects only the views of the authors, and the European Commission is not liable for any use that may be made of its contents. The information in this document is provided “as is”, without warranty of any kind, and accept no liability for loss or damage suffered by any person using this information. © 2019-2023. The participants of the UNICOM project. UNICOM – D7.3: Pilot Deployment Report Page 4 of 22 TABLE OF CONTENTS Contents Deliverable abstract .......................................................................................................................3 List of Figures ................................................................................................................................5 List of Tables .................................................................................................................................5 List of Abbreviations ......................................................................................................................5 1 Executive summary ................................................................................................................7 2 Introduction .............................................................................................................................8 2.1 Background .....................................................................................................................8 2.2 Introduction to D7.3 ........................................................................................................8 2.3 Scope of the document ...................................................................................................8 3 Piloting strategy ......................................................................................................................9 3.1 Overview .........................................................................................................................9 3.2 Cross border use case .................................................................................................10 4 eHDSI overview ....................................................................................................................12 4.1 National Environment ........................................................................................................12 4.2 Pre-Production Environment .............................................................................................12 4.2.1 Pre-Production Testing ................................................................................................12 4.3 Routine Operation Environment ........................................................................................13 4.3.1 Routine Operation Readiness Testing ........................................................................13 4.4 Preparation testing data ...............................................................................................13 4.5 How to practically start testing in the Pre-Production Environment? ..........................14 5 Wave 7 Pre-Production Test ................................................................................................16 5.1 Participating Deploying countries results ..........................................................................17 5.1.1 Italy ..............................................................................................................................17 5.1.2 Finland .........................................................................................................................18 5.1.3 Portugal........................................................................................................................20 6 Conclusions and recommendations .....................................................................................22 UNICOM – D7.3: Pilot Deployment Report Page 5 of 22 List of Figures Figure 1: Cross-border information workflow. ...............................................................................11 List of Tables Table 1: Wave for country PPT ......................................................................................................17 Table 2: Feedback Italy PPT .........................................................................................................18 Table 3: Feedback Finland PPT ....................................................................................................20 Table 4: Feedback Portugal PPT ..................................................................................................21 List of Abbreviations Abbreviation Complete form ADE Adverse Drug Event API Active Pharmaceutical Ingredients ATC Anatomical Therapeutic Chemical Code CEF Connecting Europe Facility CEN European Committee for Standardization eD eDispensation DSS Decision Support System EPF European Patients’ Forum eHDSI Health Digital Service Infrastructure EHR Electronic Health Record EMA European Medicines Agency eP ePrescription epSOS Smart Open Services for European Patients EU European Union FDA USA Federal Drug Agency GDPR General Data Protection Regulation GP General Practitioner GS1 Global Standards One HCPO Healthcare Provider Organisation HDR Hospital Discharge Report HL7 Health Level Seven HP Health Professional ICD-10 International Statistical Classification of Diseases and Related Health Problems, 10th revision IDMP Identification of Medicinal Products IHE Integrating the Healthcare Enterprise ISO International Organization for Standardization LTF Legal Task Force UNICOM – D7.3: Pilot Deployment Report Page 6 of 22 MPD Medicinal Product Dictionary MS Member State MVC Master Value Catalogue NCA National Competent Authority (for human medicines) NCP National Contact Point NCPeH National Contact Point eHealth NIA National Identification Authority Ophelia OPtimising HEalth LIterAcy OTC Over the Counter PhP Pharmaceutical Product PhPID Pharmaceutical Product identifier PS Patient Summary SDO Standards Developing Organisation SPOR Substance, Product, Organisation and Referential SubID Identification of the (active) substance TBD To be done UNICOM Up-scaling the global univocal identification of medicines WP Work Package WHO World Health Organisation UNICOM – D7.3: Pilot Deployment Report Page 7 of 22 1 Executive summary The main objective of the UNICOM project is to facilitate the implementation of various use cases, particularly focusing on the advancement of the Identification of Medicinal Products (IDMP). IDMP serves as a worldwide and unambiguous identification system for medicines, specifically designed for cross-border ePrescription and eDispensation. Comprising of five ISO standard specifications, IDMP establishes the necessary data elements and structures for the seamless identification and exchange of medicinal product information. By adopting this approach to medicine identification, enhanced patient safety is targeted, both within national borders and across different countries. The final version of Deliverable D7.3 builds upon D7.1, which defined the Piloting Strategy and D7.2, which demonstrated how ePrescriptions, enhanced with IDMP data, can be used in the country of treatment to identify the Medicinal Products, and provide suggestions to Member States implementing pilot services, as well as through the work done in Task 7.3, which aims at the pilot set up and integration. The following chapters therefore contain the up-to-date evaluation of the efforts towards the incremental implementation of the specifications developed in WP5, 6 and 7. The close collaboration with National Contact Points of those Countries participating in the cross-border piloting was an essential contribution to the writing of this Deliverable. The initiation of the UNICOM eHealth Pilot was marked by the Wave 6 Preparatory PreProduction Testing, which served as the formal beginning of the project. During this phase, ePrescriptions, eDispensations, and Patient Summaries were exchanged between Italy, Cyprus, Greece, and Ireland. UNICOM – D7.3: Pilot Deployment Report Page 8 of 22 2 Introduction 2.1 Background The healthcare industry deals with a vast amount of complex information that needs to be collected and shared across various healthcare settings to ensure patient-centred care. However, insufficient identification of medicines can impede the safe provision of cross-border healthcare services. To tackle this issue, the eHealth Digital Service Infrastructure (eHDSI) was established under the Connecting Europe Facility (CEF) to oversee the implementation and operation of services for exchanging health data across borders. Through eHDSI, core and generic services like Patient Summary (PS) and ePrescription (eP) are set up and deployed to facilitate data exchange at both national and European Union (EU) levels. This enables the provision of CrossBorder eHealth Information Services (CBeHIS). Furthermore, the UNICOM project has been initiated by the EU to establish guidelines and criteria for piloting and assessing the readiness of Member States to participate in cross-border health information exchange. For more detailed information about the background and specifics of the UNICOM project, refer to deliverable 7.1 - Define the piloting strategy. 2.2 Introduction to D7.3 The evaluation of pilots, which are set up and implemented in T7.2, will be conducted based on the readiness criteria outlined in T7.1. Specifically, for cross-border pilots and relevant national/regional pilots, specifications and test tools developed by WP5 and WP6 will be utilised to ensure the syntactical accuracy of exchanged information. Pharmacists and physicians will provide support in performing cross-document validation and end-to-end Functional Testing. Depending on the pilot's scope, it may be necessary to connect the work done in this task to the corresponding activities of eHDSI, such as testing and audits. For pilots that are independent of operational eHDSI services, a self-assessment and partial peer-to-peer assessment will be carried out in accordance with the defined readiness criteria. The final decision for a pilot to go live will be formally made by the MyHealth@EU steering boards, based on the assessment results. If the pilot is part of the operational eHDSI services, the relevant decisions will follow the standard eHDSI processes. 2.3 Scope of the document The objective of this document is that of providing an up to date first report tackling the state of art of pilot development and testing by countries participating to the implementation of UNICOM pilot services, evaluating the test conducted in compliance with the overall rules of testing and describing the pre - production test, defined in D7.1 and D7.2. To pursue this goal, the present deliverable is structured in the following chapters: • Chapter 1, Executive Summary • Chapter 2, Background and Introduction • Chapter 3, Summary of the Piloting Strategy • Chapter 4, Overview of the eHDSI environments • Chapter 5, Pilot Product Test • Chapter 6, On Participating Deploying Countries • Chapter 7, Wave 6 Pre-Production Test • Chapter 8, Conclusions and further actions UNICOM – D7.3: Pilot Deployment Report Page 9 of 22 3 Piloting strategy 3.1 Overview The goal of the overall piloting strategy is to enable, facilitate and stimulate the adoption of IDMP enriched eHealth services, both at cross-border and at national level. The following list of actions is derived from UNICOM Deliverable D7.1. • Understand: o The ISO IDMP specifications and EMA SPOR Implementation Guides. o The NCAs plans to adhere to the EMA SPOR / RMS. o The HL7 ePharmacy Profile and eHDSI specifications. o The specific needs for eHealth services, starting with ePrescriptions and Patient Summary. • Define: o The data model for Medicinal Product based on ISO IDMP & eHDSI Specifications. o The Minimum set of IDMP attributes to describe the Medicinal Products. o With NCAs, the UNICOM Pilot Product List, as a starting point. • Co-operate: o With eHN Sub-Group of Semantics to include IDMP attributes and Identifiers into the eHN Guidelines (being the input to MyHealth@EU specifications). o With eHMSEG Communities (i.e., the ePrescription Cluster, the Semantic Task Force and the Requirements WG) to co-create the specific change proposals to include in the normal eHDSI assets the IDMP enriched eP/eD and PS. o With the eHMSEG Semantic Task Force, the Requirement Workgroup and the Technical Workgroup to develop the Wave 6 assets, as implementation of the change proposals adopted by the MyHealth@EU governance bodies. o With the NCAs and Medicinal Product database providers to populate the Pilot Product List. • Suggest: o To Member States how to (gradually) implement IDMP enriched eHealth Services: ▪ starting with the enhancement of the NCPeH National Connector, by including the appropriate Medicinal Product Database, able to contain both medicinal product data currently in use in the Member State, and IDMP enriched ones. ▪ populating it with selected medicinal products from the UNICOM Pilot Product List (PPL) ▪ adopting, as far as possible, the Wave 6 Master Value Catalogue (MVC) ▪ creating the Reference Test Data for Pre-Production ▪ and by adopting the IDMP enhanced CDA Display Tool (released by the eHDSI Solution Provider as Wave 6 asset. • Enforce: o The co-operation, within each Member State, between the NCA and the eHealth Institution to study how to provide the coded data for the Minimum Attribute List o The co-operation among the NCAs and EMA to adopt equivalent coding approaches. • Stimulate: o The sharing of coded data among NCAs and eHealth authority for comparison and double-checking, to speed up the coding process and increase the reciprocal trust. o The participation to the Pre-Production Testing, to verify the implementation of IDMP enriched eP/eD and PS. o The exploitation of the Continuous Pre-Production Testing, to refine the UNICOM – D7.3: Pilot Deployment Report Page 16 of 22 5 Wave 7 Pre-Production Test The table below presents an in-depth overview of the services currently conducted by each Member State, along with the Member States anticipated to undertake Wave 6 Formal PreProduction Testing in Q1/2023 and subsequently commence Routine Operation in Q4/2023. The final columns highlight additional countries planning to initiate Pre-Production Testing in subsequent waves. It is worth noting that a total of 26 Member States, as well as Norway and Iceland, will initially undergo Pre-Production Testing before transitioning into Routine Operation. In particular, with respect to version 1 of this Deliverable, the table below has been updated integrating the latest data provided by Member States, regarding the services which have entered into operations and the ones which have been planned in next waves. In yellow, the services for which some Countries have not yet disclosed the planned Wave of entering in operations. Wave 5 Routine Operation Planned Wave 6 (2023-24) Next Waves Country PS(A) PS(B) eP(A) eP(B) PS(A) PS(B) eP(A) eP(B) PS(A) PS(B) eP(A) eP(B) CY     CZ     EE     GR     ES     FI     FR     HR     HU       LU     MT      NL   PL     PT     BG     IE         IT           LT       LV         SE      SI     CY       AT    DE   DK     IS     NO   UNICOM – D7.3: Pilot Deployment Report Page 17 of 22 RO       SK     Table 1: Wave for country PPT It must be remembered that, even before Wave 6, the medicinal product specifications already included all the ValueSets of Wave 6 except the SMS ValueSet for Substances and the Quantity Units (based on EDQM). The Member States that were already in the position of providing coded data for medicinal products already in Wave 5 or previous waves, in Pre-Production and Routine Operation can be considered as IDMP compliant. It would be relevant to determine which MSs and for which medicinal products these coded data were already in use in the cross-border services, to include them in the count of the required 10.000 ePs / eDs and 1.000 PSs. 5.1 Participating Deploying countries results 5.1.1 Italy The preparations of the piloting started with the definition of the piloting strategy together with Sogei and with the representative of the Italian pharmaceutical database. The first objectives were to understand what Unicom related actions could be taken in short term for supporting the piloting and on the other hand, to identify the current limitations. Some medicinal products were selected for piloting due to their presence in the Critical Test Data of Italian in the cross-border setting. The actual piloting was conducted with Ireland (Italy as country A role) and Cyprus (Italy as country A) and Greece (Italy as country A). After the transfer of the ep documents the CDA structures and the messages were analysed. Below the medical products exchange: Ireland: EP: eP-C4 (C10BX11/atorvastatin, amlodipine and perindopril) eP-C8 (N02AA01 Morphine) eP-C2 (A10AE04/Insulin glargine) eP-C5 (A12AX Calcium) Cyprus: EP: eP-C8 (narcotic) eP-C2 LANTUS INJ.SOL 100 IU/ML BTx10 PF PEN eP-C5 IDEOS* 60 CPR MAST eP-C12 EnaHexal Comp 20 mg/12.5 mg tablets 100 units Greece: EP: eP-C4 TRIVERAM 20/10/5 MG/TAB eP-C8 ORAMORPH 20MG/ML eP-C2 LANTUS OPTISET 100 eP-C5 IDEOS CHW.TAB (500MG+400IU)/TAB eP-C12 RENITEC 20MG/TAB For the PS it was used the EUTIROX*100MCG 50CPR for all countries. First the Gazelle CDA validator was used to validate the eP documents with Unicom attribute data and with this step it was ensured that the documents were well-formed. The Unicom UNICOM – D7.3: Pilot Deployment Report Page 18 of 22 prescriptions were obtained and examined by country B. In both cases the ePs were successfully sent to the Country of Treatment and the tester in the Country of Treatment could also make the dispensation after the eP retrieval. 5.1.2 Finland Preparation for piloting and objectives The preparations of the piloting started with the definition of the piloting strategy together with the Finnish NCA (Fimea) and with the representative of the Finnish pharmaceutical database. To address this issue, a joint workshop was held with these key stakeholders. The first objectives were to achieve a common understanding of Unicom related actions that could be taken in short term for supporting the piloting and on the other hand, to identify the current limitations. Specifically, in terms of the limitations, the key was to clarify the fundamental changes that needed more long-term planning and to define what tasks should be left out of the scope of the current piloting. Eventually it was agreed that the aim of the pilot and its supportive actions were to: • plan a high-level roadmap with the Finnish NCA and representative of pharmaceutical database for deploying Unicom attribute data in national use • enhance the National connector to support IDMP attribute data both in country A (Country Table 2: Feedback Italy PPT Country: Italy Preparatory PPT Status Formal PPT Status Routine Operation Status (Country A/B) Country A - - eHDSI Service PS-A eP/eD-A [services available in the country] - - Patient Identifiers CF: NCPNPH80A01H501K Last 5 digits of EHIC : 15972 [specific to each country] - - Data Exchange information PS: CF eP: [eP numbers] eP ID (NRE) e1900A4005159604 1900A4005159605 1900A4005159606 1900A4005159607 1900A4005159608 1900A4005159609 1900A4005159610 1900A4005159611 - - Status Completed Not started Not started Feedback / Issues / - - UNICOM – D7.3: Pilot Deployment Report Page 19 of 22 of Affiliation) and country B (Country of Treatment) roles • prepare, analyse and evaluate the piloting data • enrich the content of eP CDA L3 document with IDMP attribute data • co-operate with other Members states to transfer enriched ePs through NCPs (the actual testing phase) • validate the extended CDAs with wave6 Gazelle validators • analyse the need of structural changes in Finnish national ePrescription CDA so that national eP could carry IDMP attribute data • evaluate how IDMP attribute data is shown in the CDA Display tool in the Country of Treatment Furthermore, these actions were decided to be excluded from the piloting: • extension of the Finnish pharmaceutical database schema to support new IDMP attributes. The pharmaceutical database has its own pre-defined development cycles, and it was agreed that the Unicom related planning will be started in the autumn of 2023, • similarly, the planning of national active ingredient code system will be started later in the year of 2023. The idea is to introduce a new coding system for active ingredients where the link between national active ingredient codes and EMA Substance codes can be established. The definition of the piloting data was performed in an iterative manner together with the Finnish NCA. Eventually three medicinal products were selected for the Unicom piloting: Amorion (ATC code J01CA04), Klexane (ATC code B01AB05) and Yasminelle (ATC code G03AA12). These products were selected due to their presence in the Critical Test Data of Finland in the crossborder setting. For these products there were three additional IDMP attributes that were decided to be included to the eP CDA L3 for piloting purposes: • active ingredients represented as EMA SMS Substance codes. In the current Finnish eP active ingredients are presented either as uncoded or as ATC codes. In the piloting the approach was to replace the current presentation of active ingredients with EMA Substance codes. • route of administration represented as EDQM code • new identifiers MPID, PICD, PHPID. Even though at the time of the piloting the actual codes of these three identifiers provided by the Finnish NCA were temporarily national codes, the respective structures of these identifiers in the CDA document could be still tested. In the country B role (Country of Treatment), the main challenge was to identify what national CDA structures could be used for carrying IDMP attribute data so that this data could be also transferred to Finnish pharmacy systems and ultimately shown in CDA Display tool. To foster this, at the beginning of the piloting, the goal was to investigate if new CDA structures could be introduced nationally. However, it became quickly apparent that it was not possible in this piloting schedule and thus the decision was made for proceeding with the current and available structures. This means that the extension of the national ePrescription CDA for supporting IDMP attributes more flexibly was left for future development. This development needs to be done in a close collaboration with the Finnish Prescription Centre and with other relevant national stake holders. Formal PPT results After the preparatory phases the actual pilot tests could be performed. The tests were carried out with Ireland (Finland as country A) and Portugal (Finland both as country A and country B). These tests were performed after the formal PPT so that the Unicom piloting could be distinguished from the formal Wave6 testing of EHDSI. The test procedure followed the same steps that are part of the normal workflow tests of EHDSI: Country B requested the list of prescriptions, retrieved one of them and finally made the UNICOM – D7.3: Pilot Deployment Report Page 20 of 22 dispensation. Once the workflows were completed, the eP documents, the CDA structures and the messages were analysed from technical and pharmaceutical point of views. With both countries the tests were successful as the documents could be sent to the requested country. When it was applicable, the visibility of the new IDMP data in the CDA Display tool was also confirmed. For example, it was proven that the new IDMP data in a Finnish ePrescription could be shown in the CDA Display Tool in Ireland. In addition, as a part of the piloting as country A, Gazelle CDA validators were used to validate the eP documents. With this step it was ensured that the documents were wellformed. As a conclusion the Unicom tests could be performed as it was planned. However, it is evident that more elaborate testing with higher ePrescription volumes is needed in the upcoming test sessions. Gradually the focus in the testing should move towards specific use cases and how the health professional in the Country of Treatment can use IDMP data in order to provide more quality service and care. For Finland it is important to increase the awareness of IDMP data nationally to ensure that it will be considered in the national development of ePrescriptions and pharmaceutical database. 5.1.3 Portugal Table 3: Feedback Finland PPT Country: Finland Preparatory PPT Status Formal PPT Status Routine Operation Status (Country A/B) Country A Country A/B (eP/eD) Country A (PS) In routine operation eHDSI Service PS PS eP/eD eP/eD Patient Identifiers 1 Patient ID 7 Patient IDs Dedicated Patient ID for Unicom testing N/A Data Exchange information N/A 10+ ePs Dedicated ePs for Unicom testing EMA SMS Substance and temporary IDMP Identifiers only used for Unicom testing N/A Status Completed Completed Operational Feedback / Issues - - - UNICOM – D7.3: Pilot Deployment Report Page 21 of 22 The actual piloting was performed successfully with Finland (both as country A and country B), with the retrieval of evidence. Informally, we also tested with Italy (as country A) and Spain (as Country A). Table 4 Country: Portugal Preparatory PPT Status Formal PPT Status Routine Operation Status (Country A/B) N/A Country A Country B Country A Country B eHDSI Service N/A PS eP/eD PS eP/eD Patient Identifiers N/A For PS: 898765392 898765405 810813305 For eP: 294584908 N/A Data Exchange information N/A eP IDs: 2011000006856690403 2011000000030422800 2011000006958689307 N/A Status N/A Completed Operational Feedback / Issues N/A - IDMP identifiers will only be available in production environment when upgrading to W6 (October 2023) Table 4: Feedback Portugal PPT UNICOM – D7.3: Pilot Deployment Report Page 22 of 22 6 Conclusions and recommendations This deliverable D7.3 summarises the contents of D7.1 and D7.2 as for the UNICOM piloting strategy, fully integrated with the MyHealth@EU policies, strategies and procedures. As recalled several times, since MyHealth@EU Wave 6 specifications and assets, released on June 2022 with the support of UNICOM project, both ePrescription/eDispensations and patient Summary are fully IDMP compliant, as for the provision of structured and coded ISO IDMP attributes of the medicinal products. The specifications are also already ready for the adoption of the ISO IDMP Identifiers (PhPID, MPID, PCID), however the European readiness situation is still not mature to exploit these identifiers and deploy them in Operation. As also mentioned, even before Wave 6, the MyHealth@EU specifications already included the IDMP Attributes based on EDQM, UCUM and ISO ATC: only the EMA SMS substances code system was not included: Member States who exchanged fully coded medicinal products attributes were already IDMP compliant, in the spirit of the UNICOM pilot. Being D7.3 a pilot deployment report, it provides a partial description of the state of play of Member States Deployment: only few MSs provide the data of the exchanged ePrescriptions and Patient Summaries exchanged in Preparatory and Formal Pre-Production Testing. All the Member States, both the UNICOM partners and the others active in MyHealth@EU should be stimulated to provide data on the exchanged IDMP enriched documents during the PreProduction Testing. UNICOM WP7, in cooperation with the other UNICOM WPs, and MyHealth@EU Member States and Work Group, is stimulating a wider use of the Continuous Pre-Production Testing approach to further test IDMP enriched documents and prepare the deployment in Routine Operation of fully coded Medicinal Products in eP/eD and PS. Furthermore, we are attempting to collect information of an estimate of the number of fully coded ePrescription/eDispensation exchanged since July 2022 out of the total 15.900 exchanged both in Pre-Production and Operation; the outcome of this analysis may be assessed in the following WP7 Deliverables, and in particular D7.5 and D7.6.