Table 5.

Summary of the identified barriers and facilitators to the implementation of the SurPass^a (version 2.0) throughout all 3 health care system scenarios.

Characteristics			Barriers		Facilitators
Scenario 1: national EHISsb
	Austriac	Uncertainty about data retention Lack of resources		Standardized and structured data exchange Straightforward GDPRd compliance using pseudonymization Data protection can be guaranteed Use of ATCe code system for medication Use of ICD-O-3f for histology
	Lithuania	Uncertainty about data retention		Standardized and structured data exchange Majority of the data systems is accessible Majority of patient data is available Use of HL7 FHIRg Data protection can be guaranteed Sufficiency of resources Use of ICD-O-3 for histology
Scenario 2: regional EHISs
	Italy	EHIS infrastructure discrepancies Uncertainty about data protection Uncertainty about data retention Uncertainty about the sufficiency of resources		Availability of personalized EHRh (Fascicolo Sanitario Elettronico) Majority of the data systems is accessible Majority of patient data is available Use of HL7 FHIR Use of ATC code system for medication
	Spain	EHIS infrastructure discrepancies Unavailability of HDEi standards Uncertainty about data retention Uncertainty about the sufficiency of resources		Availability of personalized EHR (Historia de Salud Electrónica) Majority of the data systems is accessible Majority of patient data is available Data protection can be guaranteed
Scenario 3 cancer registries and hospital-based EHISs
	Belgium	Data origination from different sources EHIS infrastructure discrepancies Uncertainty about data protection Uncertainty about data retention Uncertainty about the sufficiency of resources		Majority of the data systems is accessible Majority of patient data is available Use of HL7 FHIR Use of ATC code system for medication
	Germany	Data origination from different sources EHIS infrastructure discrepancies Majority of the data systems is accessible but not downloadable Uncertainty about data protection Uncertainty about data retention Lack of resources		Availability of structured centralized clinical trial databases Majority of patient data is available Use of HL7 FHIR Use of ICD-O-3 and ICCC-3j for cancer diagnosis and histology

^aSurPass: Survivorship Passport.

^bEHIS: electronic health information system.

^cAccessibility of data systems and patient data availability is unknown due to missing answers from the information technology specialist from Austria.

^dGDPR: General Data Protection Regulation.

^eATC: Anatomical Therapeutic Chemical.

^fICD-O-3: International Classification of Diseases for Oncology, 3rd Edition.

^gHL7 FHIR: Health Level 7 Fast Healthcare Interoperability Resources.

^hEHR: electronic health record.

ⁱHDE: health data exchange.

^jICCC-3: International Classification of Childhood Cancer, Third edition.