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eHealth Card

eHealth Card. Motivation Configuration Trays Universal ID Quantity structure Process of ePrescription Health Professional Card. eHealth Card. Motivation. Improvement of the quality of health care, among other things pharmaceutical drug safety Improvement of patient-oriented services

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eHealth Card

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  1. eHealth Card • Motivation • Configuration • Trays • Universal ID • Quantity structure • Process of ePrescription • Health Professional Card

  2. eHealth Card

  3. Motivation • Improvement of the quality of health care, among other things pharmaceutical drug safety • Improvement of patient-oriented services • Improvement of personal responsibility, cooperation and activity of patients • Improvement of cost effectiveness and transparency in health care • Improvement of operating processes • Supply of up to date statitical information concerning public health http://www.die-gesundheitskarte.de/ http://www.worldcongress.com/events/NW615/presentations/Harald%20Flex%20-%20EHR%20and%20IT%20Innovation%20Summit.pdf

  4. Administrative Applicationsobligatory • Specification of the state of insurance including extra payment • Warrantyto be treatedin the foreign countries of Europe • Paperless transmission of prescriptions

  5. Medical Applicationsvoluntarily • Documentation of taken drugs • Emergency information (for example blood type, chronic disease, allergy, heart disease, dialysis, asthma) • additional health information (for example current diagnoses, surgery, immunizations or X-ray examination )

  6. Medical Applicationsvoluntarily • Possibility to store electronic messages like discharge letter • Receipt about medical treatment and their costs (in Germany the statutory health insurance covers the costs and the patient normally doesn‘t know the fee) • Data provided from the patient (for example blood sugar level or Health Care Directive http://www.cmanet.org/publicdoc.cfm/7

  7. configuration

  8. configuration

  9. configuration back side

  10. ContentSegmentation in trays • Tray for drugs = all drugs of the patient including self-medication. Input by physician, pharmacist orclinician • Emergency information (European emergency document of identification) = Name, address, etc., medical data to the health status such as bloods type, allergies, chronic organ suffering, heart disease , asthma or diabetes

  11. Content Segmentation in trays Additional Healthcards = Additional information, special disease related information , for example OncoCard, DIABCARD, QuaSi-Niere, DENTcard, DEFICARD, immunisation card, x-ray card

  12. Content Segmentation in trays • Security tray (if desired, for example Viagra, Methadon, HIV-drugs) - only exceptional reading access - automatic test of interactions - in the case of yes, warning signal to the physician • ePrescription replaces the paper as transportation medium, supports medical prescription with drug documentation and drug information

  13. Content Segmentation in trays Electronical medical report = transport of discharge letter, referral and hospitalisation, other reports. Data can be used without media discontinuity Pointer - Pointer to reports on special examination like X-ray examination

  14. Content Segmentation in trays • introspection / additional information • tray for input by the patient, (card owner) • chronic disease • additional information for emergencies • Health Care Directive • organ donor • implants • Health insurance company • Membership • State of additional payment • Warranty to be treated in the foreign countries of Europe

  15. Universal Card The federal cabinet has decided that the eHealth card should be equipped with a digital signature. Then it can be used with e-Government applications like electronic tax computation, bank transfers or online-shopping http://www.heise.de/newsticker/meldung/57276

  16. http://www.telemed-berlin.de/telemed2005/programm.html

  17. Costs and Benefits • 1,7 Billion € costs for eHelth card • 500 – 700 Million € economy per year • 10.000 to 30.000 dead persons per year caused by interactions of drugs

  18. Medical datalegal constraints • Mapping between data and persons is only allowed to authorized users (The system administrator is no authorized user) • Tracing of data that allows conclusions concerning owner or content has to be avoided • A central directory that allows combinations with other databases has to be avoided

  19. ePrescriptionconstraints • The prescription is a secret that is only known to • Physician, Patient, Pharmacist • The Prescription is fraud-resistant • The Physician does not know the Pharmacist • The Pharmacist does not know the Patient

  20. Hybride ciphering • Data are ciphered first with a symmetric session key. • The session key is ciphered with the public key of the patient. • To decipher, the patient first has to get the symmetric session key with his private key

  21. Challenge - response • A challenged or a mystery is stored with the data and only the owner can solve it. • The challenge is a random number which is ciphered with the public key of the patient. Only he can solve it by deciphering it with his private key

  22. Encrypted Prescription HPC Pharmacist ePrecription Prescription Session key HPC Physician ~~~~ Signature Encrypted Prescription Ticket / PukPat\ DatenID Session key Secret S PukPat (S) Ticket eGK Patient Ticket ~~~~ Signature DatenID ~~~~ Signature Session key Prescription

  23. Virtual file system • How does an authorized person find his data? • How can it be assured that a public / private key belongs to that person? • How the data can be retrieved if the keys are changed?

  24. Virtual file system • Each object gets a unique object ID • Each object gets a non ciphered parent ID • Each object gets a ciphered child ID (ciphered with the public key of the patient)

  25. Losing and theft The data are stored in a file system, The Child ID is ciphered with the public key of the patient Additionally the data can be linked with the public key of an alternate eHealth card. When the card is lost, the alternate eHealth card can be used. When the card is stolen, the link of the root is deleted.

  26. Potential attacks against the data DataID is located on the eHealth Card DataID and random number are ciphered with the public key of the patient. Trial and error with all public keys of the 80 million insured persons: DataID and random number are ciphered with a second random number SeKT and stored as Hash value.

  27. HPCSynonyme • Health Professional Card • Arztausweis • elektronischer Heilberufsausweis • Heilberufsausweis • Heilberufskarte

  28. Health Professional Card

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