ENGLISH INFORMATION

The Austrian e-card System Requirements to System and Cards Data on the e-card Replacement of Health Insurance Vouchers Medical Approval Service Preventive Medical Check-up Hospitals Medication Safety-Belt - Pilot Project Electronic Referral - Pilot Project Electronic Temporary Disability Report NETC@RDS Citizen Card Function Future Applications Components of the System MPU and LAN Card Reader Smart Cards e-card Server Centre Health Information Network (GIN) Value Added Services Call Centre: e-card Serviceline The e-card Project is a Multi-Organizational Enterprise

The Austrian e-card System

The Main Association of Austrian Social Security Institutions was entrusted by law with the introduction and operation of the “Electronic Administration System”. The aim of this is to support administrative processes between insured people, employers, doctors and hospitals as well as Social Security Institutions. The first step was the replacement of health insurance vouchers by a smart card – however the Austrian e-card is now much more than only a health insurance card. The e-card system provides a secure broadband connection within the health sector and the infrastructure for a number of future projects. In addition, the Austrian e-card contains signature applications and is ready to be used as a citizen card.

Requirements to System and Cards

The main characteristic of the Austrian e-card is its keycard principle. Consequently, the smart card does not contain software functions, it only holds identification data which are the access key for applications. Other design requirements of the system include:

Online system with high availability
Loadability of future applications
Heterogeneous platform to connect all partners independently of their software
Extendable interface to medical practice software
Citizen card functionality
Acceptance of other cards with citizen card functionality in the medical practices

Data on the e-card

Only the cardholder’s administrative data is stored on the e-card i.e. name, academic title, insurance number, card serial number, sex and user group identification.

On the reverse of the e-card is the European Health Insurance Card (EHIC). The EHIC replaces the international health insurance voucher (form E111) for the claim of medical treatment during temporary visits (e.g. holiday) in member states of the European Union, the European Economic Area and Switzerland.

Additionally, the e-card contains signature applications.

Replacement of Health Insurance Vouchers

Within the scope of the application “replacement of health insurance vouchers,” the e-card serves as the patient’s proof of claim with the physician (or dentist) and replaces all forms of the traditional health insurance vouchers. For the cardholder, medical treatment is now accessible without administrative barriers and without paper documents.

Patients have to show their e-cards whenever visiting their doctor. When reading a card, the doctor checks via the secure data network – the so called health information network – if a person is insured and which health insurance institution will pay for the medical treatment. This data is not stored on the card but is requested online from the e-card system.

Medical Approval Service

Within the Austrian social insurance system, some special medications have to be approved by „controlling doctors“ of the various social insurance institutions. This request and approval process is running via the e-card system since May 2005.

Since 2008 this service is also available for hospitals.

The electronic way of approval has a lot of advantages for patients:

Short response time
Short waiting time
Close and practicable medical care
Undisturbed therapy and continuous approval process
Best possible coordination between prescribing physician, controlling doctors of insurance institutions and patients

Preventive Medical Check-up

Since January 2006 the verification of a patient’s right to the so called preventive medical check-up is also carried out within the e-card infrastructure.

With the e-card the doctor is able to check if the patient is still entitled to have a preventive medical check-up or if the patient is already in a current preventive check-up programme.

Hospitals

The connection of hospitals to the e-card system is an important next step. Some hospitals already read the identification data from the public sector of the e-card and receive secure patients’ data for their computer systems. Since March 2007 hospitals can also use the so called VDAS (Insured Data Query Service), the first online service for hospitals. Using this service hospitals get online information from the e-card system about a patient’s insurance status which results in a high increase of quality for patients as well as for the hospital administration.

Medication Safety-Belt - Pilot Project

In February 2007, a pilot project for the so called "Medication Safety-Belt" - an e-medication programme using the e-card infrastructure - startet in about 70 pharmacies in Salzburg.

The medication safety-belt is a data-base designed for pharmacists which automatically checks interactions between medications including all products prescribed by physicians as well as over the counter products. The key for this service is the e-card of the insured person. The data are stored in a data-base with the "Pharmazeutische Gehaltskasse". This service can be used on a voluntary basis in all 70 pharmacies participating in the pilot project. The pharmacies are connected via the secure and closed Health Information Network.

Electronic Referral - Pilot Project

In May 2008 a pilot project for electronic referrals started in Reutte (Tyrol) and Gmunden (Upper Austria). Instead of paper based referrals which have to be delivered to the physician by the patient the electronic referral is provided by the e-card system. By this physicians – after approval of the patient by plugging the e-card - are able to exchange information like diagnosis, requested service, medical intolerances, acute therapies etc. Using the electronic referral means an improvement of communication quality between health service providers since daily updated data are provided by the e-card system. In Austria annually about 12 million referrals are handled from physician to physician or from physician to hospital.

Electronic Temporary Disability Report

Since May 2009 a new e-card service is available for all Austrian insured. With the so called electronic temporary disability report a standardized procedure was introduced for all insurance institutions. Instead of a paper based process the temporary disability report is transmitted directly from the physicians‘ software via the e-card infrastructure to insurance institutions. The patient gets an Austrian-wide standardized certification to be presented with the employer. The advantages of the new service are a fast and secure transmission without losing time, less administrative effort and a standardized certificate for all patients.

NETC@RDS

The NETC@RDS Project aims to improve the access of mobile European citizens to national health care systems using advanced smart card technology. It also aims to facilitate the use of existing national health insurance cards (e.g. the Austrian e-card) abroad and to replace the current visually readable proof of claim (the European Health Insurance Card and paper forms) by a European-wide electronic solution.

Citizen Card Function

The citizen card function of the e-card is part of an Austrian e-Government Strategy and will modernize Austria’s administration. Austria is the first country in the world which provides citizen cards for all citizens.

In addition to the Social Insurance Signature (used for applications within the field of social insurance) the e-card contains “sleeping” signature applications according to e-Government Law:

Secure electronic signature (for qualified signatures according to Signature Law
Advanced electronic signature (for advanced signatures and encryption)

The activation of the citizen card function can be carried out easily either by registering at one of the registration outlets provided by the social security institutions or via the social insurance website (www.sozialversicherung.at). After registration, the card holder is provided with the secure data for his citizen card. These data are stored on the e-card (certificate and identity link parameters). The electronic signature (the certificate) can be activated by the citizen himself. The activation code is provided by the registration outlets or via registered mail.

Austrian Social Security institutions already provide several e-services on their websites such as information on insurance data (data on insurance periods, insurance status, old age pension account). Further applications in the e-government sector include the annual tax declaration, child allowance and student allowance applications, criminal records and residence registration confirmation.

Future Applications

The basic structure for modern health telematics has been provided by the e-card infrastructure and the health information network. In the planning period, this infrastructure was constructed with regard to future applications which will be controlled via the system and will contain the following:

Austrian-wide electronic referrals and transfer of findings
ePrescription and eMedication
Emergency data
Electronic vaccination record
NETC@RDS (further steps of enlargement)
Disease management by using the e-card for authentication and identification

Components of the System

The e-card system is an IT-System which consists of the basic elements: smart cards, the medical practice unit and the LAN chip card readers for the medical practice, the central system, the health information network and the call centre.

MPU and LAN Card Reader

The medical practice unit (MPU) contains the application-software with the help of which business procedures during a physician’s consultation are handled. It is a securitIy, application and transaction monitor and the interface to the IT-Systems of health professionals. For the processing of the e-cards and the administrative professional cards a LAN chip card reader is connected to the MPU.

Hospitals use a server based MPU.

Smart Cards

The e-card is the central component of the compound system and the access key to system-based services and data. This is possible due to the design of the e-card as an electronic signature card. Identification data for reading access and the signature mechanism are stored on the card.

The administrative professional card (o-card) is also designed as a key card and is the physician’s authorization card. Only both “keys” together open the access to services and data.

e-card Server Centre

The central system consists of a consultation system and a card system. The consultation system handles the communication with the medical practice units in the medical practices. The card system handles all transactions between smart card production and the card service clients.The administration of e-cards and o-cards is executed in the component “card system”. The certificates for the signature of the consultations are generated and provided by the Trust Centre.

In the component “consultation system” the claim check is carried out. For security reasons the e-card server centre is set up at two locations in Vienna.

Health Information Network (GIN)

The Health Information Network (GIN) connects the e-card server centre via a Peering Point, with about 12 000 doctors and 70 pharmacies and uses ADSL-technology. For security reasons the GIN is a closed user group which means that only partners of the e-card system have the right to participate. The GIN is protected by effective firewalls. The application “replacement of health insurance vouchers” needs the capability of an ADSL-network (check of claim within 5 seconds) — however only a part of the entire broadband capacity is required. For this reason so called “value added services” are provided via the same network.

Value Added Services

Using the Peering Point as a central platform, the health information network provides value added services such as secure e-mail, secure access to internet and transmission of findings to the doctor. The appropriate secure data transmission with priority control for each application is carried out by the IT-equipment of the Peering Point Company which is owned jointly by the Austrian Camber of Physicians and the Main Association of Austrian Social Security Institutions.

Call Centre: e-card Serviceline

The e-card Serviceline is single point of contact for insured individuals and doctors. The agents of the e-card call centre answer general questions from the public and also handle technical problems of the doctors.

The e-card Project is a Multi-Organizational Enterprise

The e-card project was executed by the SVC within its function as system integrator. In order to make sure the e-card system was installed on time and effectively, the project was divided into 7 partial projects:

Partial project 1- Design and operation of the Operational Server Centre and Terminal Software - also called “Consultation System” is the heart of the e-card system
Partial project 2 - the Card System – represents the key to the system, i.e. the e-cards and the administrative professional cards as well as trust centre functions.
Partial project 3 - Communications Services – represents the data network for the connection of the medical practices to the e-card system
Partial project 4 - the Call Centre – is responsible for the effective communication with insured individuals and doctors.
Partial project 5 - Rollout and Training – deals with the training of doctors and their personnel as well as the rollout of the corresponding IT-components
Partial project 6 - the Administrative Client of Social Insurance Institutions - enables the efficient, and simple administration of the system, for instance the issue of cards.
Partial project 7 - cooperation with medical software producers.

Mehr im Internet

The Austrian Citizen Card

The NETC@RDS project

EHIC

SVC