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The technical solutions adopted for HEALTH OPTIMUM – The Danish Health Data Network

The technical solutions adopted for HEALTH OPTIMUM – The Danish Health Data Network. MedCom EDIFACT messages - covering all major flows in primary care. Homecare Notify Care reports Doctors Letters. Hospital Discharge Outpatient Referral Booking Specialist. Pharmacy Prescription.

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The technical solutions adopted for HEALTH OPTIMUM – The Danish Health Data Network

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  1. The technical solutions adopted for HEALTH OPTIMUM – The Danish Health Data Network

  2. MedCom EDIFACT messages - covering all major flows in primary care Homecare Notify Care reports Doctors Letters Hospital Discharge Outpatient Referral Booking Specialist Pharmacy Prescription 3,2 mil. messages per month Radiology Request Report Laboratories Chemical, pathology and microbiology Results and request Insurance Reimbursements

  3. The Danish Health Data Network Referrals Referrals Referrals Referrals 64845 = 45 % Reimbursement 15637 = 66 % Prescriptions Prescriptions 1039105 = 73% 1139992 = 81% Disch Disch . Letters . Letters 826258 = 84 % 682923 = 85 % Lab. Lab. reports reports 543040 = 82 % 653974 = 97 %

  4. Background for the Danish Health Data Network • The internet is here to stay !! • The pilot project in MedCom III had shown the possibilities, but the security issue was not solved. • Agreement between GPs and counties – all GPs must have a fast secure Internet connection before the end of 2005. • Backbone for communication between hospitals • The national eHealth Portal www.sundhed.dk.

  5. The health sector The health sector is not like other sectors of modern society: • In most sectors (finance, transport), organizations exchange data via a few well-known applications • In the educational and research sectors, barriers are not as strict between parties • In public administration everyone keep to themselves, exchange messages and use a few common applications • But in the health sector there is a rising need for exchanging both data and a large number of applications (many of which are not pre-defined), • and at the same time, privacy and security has to be respected.

  6. Challenges in healthcare Challenges for communication in healthcare: • Everybody wants to exchange data (at least ideally!) • Every small part of the health system has its own firewall, security administration, access control mechanisms etc • The solution: The connection agreement system 

  7. Building the Danish healthcare network Pharmacy Laboratory Hospital County Pharmacy net Hospital Pharmacy Pharmacy Hospital Central node GP-system Municipality GP GP Autorites

  8. The technical infrastructure The principle behind the technical infrastructure: • Connecting exiting secure networks with Virtual Private Network (VPN) – to a central node. • Using existing internet connections • The “central node” adjusts to the exiting network – reuse of network structure and equipment • An new top-domain www.health.medcom (mail security) • The existing EDIFACT communication must not be disrupted

  9. VPN VPN Securty level: VPN connections: E.g. X-ray webserver DNS Cache + Server VPN koncentrator VPN VPN VPN PIX 515E Nokia Internet VPN VPN VPN VPN VPN Pharmacy GP Municipality DanNet Laboratoty County County GP system KMDnet Pharmacy Net Pharmacy GP Municipality GPs County Pharmacies

  10. 2. level of security • VPN-connections to a central “HUB” • Agreement system that controls access between IP-addresses

  11. VPN VPN IP agreement on data-pull from a GP DNS Cache + Server VPN koncentrator VPN VPN VPN PIX 515E Nokia Internet IP xxx www.X-ray.medcom VPN VPN VPN VPN VPN Pharmacy GP Municipality DanNet Laboratoty County County GP system KMDnet Pharmacy Net Pharmacy GP Municipality GPs County IP yyy Pharmacies

  12. The ”agreement” system

  13. The connection agreement system • Eliminates the need for administering a huge number of VPN tunnels • Establishes documentation of who ordered what connection and how long it is supposed to exist • Simplifies security administration • Is a simple and inexpensive solution to a problem that is common to all nation-wide health care systems

  14. 3. level of security • VPN-connections to the central node • Agreement system that controls access between IP-addresses • User-id and password (in the future PKI)

  15. VPN VPN Login and password / Digital signature DNS Cache + Server VPN koncentrator VPN VPN VPN PIX 515E Nokia LOGIN Internet VPN VPN VPN VPN VPN Pharmacy GP Municipality DanNet Laboratoty County County GP system KMDnet Pharmacy Net Pharmacy GP Municipality GPs County Pharmacies

  16. Thank you for your attention Danish Centre for Health Telematics www.cfst.dk Danish Health Data Network www.medcom.dk Claus Duedal Pedersen cdp@cfst.dk

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