1. Smart Cards Workshop – Budapest, 2002 Multifunctional Smart Card for Doctors in Hungary – a working smart card implementation Dr. László Békési Hungarian Medical Association E-mail: bekesi@mok.hu http://www.mok.hu/ Dr. Pál Simon Templar Partnership Co E-mail: templar.bt@chello.hu

2. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The situation - New tasks that had to be fulfilled by H.M.A. in 1999 The basic registration of the medical licenses (ordered by law) The administration of the medical licences (ordered by law) –Practice administration (practicing physicians) The administration of the continuous postgraduate medical education (compulsory by law) –50 credit points in 4 years (Identification as being a M.D.)

3. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The requirements of the whole project What was the motivation for the initiation of the project? The Hungarian Medical Chamber received an administrative task with legal background Requirements: Only HMA members can do medical practice Every physician has to be registered in the data base Every physician must have the valid official licence

4. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR Goals to be reached Implementation of the functions of an authentic medical licence for the members of the Hungarian Medical Association (also referred as Medical Chamber) Implementation of banking services of European standard, supporting the practice of the Chamber members and their way of life by introducing a multifunctional smart card. Implementation of the requirements of the international standards (EMV, CEN-TC224, TC251, ISO, Europay), and possible evolution towards Health Professional Cards.

5. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR Evaluating the concept of a multifunctional card - bank services would support the working and life conditions of physicians; - the official administartive function would be realised with modern means; - new, creative role for the bank. The concept of the project could be correct, because: - the two different services may have been inconsistent with each other; - the rigorous data protection requirements may have caused several problems. The concept of the project had the following risks :

6. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR Additional aspects taken into consideration Special task : very rigorous and accurate data protection HMA had no major financial resources for the project therefore the solution needed sponsors. This could add new services to the card (bank services - optional) The proof of the official medical licence has to be modern and it should prepare the way for the health professional card

7. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The solution Multifunctional Smart Doctor Card System (MSDC) implementation that satisfied the listed requirements and still left possibilities for further improvements

8. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The card technology behind the MSDC system Multifunctional chip with divided functions: - credit/debit bank function - special medical professional functions MSDC H UNGARIAN M EDICAL CH AMBER * CIB IT REALISATION FOLD-R Co: Application software, Personalisation, Photo digitalisation Reader/writer equipments (50) CIB Bank Co: Assembling and roll-out and distribution of the cards BULL-HUNGARY: Transporting of the smart cards (40.000), IT Support, EMV Standard knowledge, Know how (Sesam Vitale) PHOTO DIGITALISATION Type of card: EMV OTS hibrid smart card (Bull) Traditional magnetic stripe: Cirrus/Maestro (Europay) Standards: EMV OTS Europay, based EMV, Off-the-Shelf international standard Credit-Debit mask (Bull) ISO/IEC 7816 standards and the EMV 3.1.1. specification PROJECT MANAGEMENT: Templar Partnership Company, Budapest

9. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The functional model of the MSDC system CIB BANK MULTI- FUNCTIONAL TRANSACTIONS LOCAL CHAMBER HUNGARIAN MEDICAL CHAMBER FOLD-R MULTI- FUNCTIONAL TRANSACTIONS BULLHUNGARY CIB BANK FILIALS MEMBER Of CHAMBER MSDC H UNGARIAN M EDICAL CH AMBER * CIB HEALTH INSTITUTES HEALTH INSURRANCE F1. F2.

10. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The Medical Chamber functions (F1) Further informatics supporting services for the members and the administrative Chamber functions of the HMCh : MULTI- FUNCTIONAL TRANSACTIONS MSDC H UNGARIAN M EDICAL CH AMBER * CIB Issue of the authentic medical licence for the members: 38.000 cards are issued, 38.000 cards are issued, out of these 31.000 are out of these 31.000 are distributed. distributed. out of these approx out of these approx 40% are activated as a 40% are activated as a bank card, too. bank card, too. continuous supply of the authentic practice licence for the all HMCh members; continuous supply of the authentic practice licence for the all HMCh members; MSDC application for recording the education and qualification data; MSDC application for recording the education and qualification data; preparation of MSDC for the implementation of digital signature, preparation of MSDC for the implementation of digital signature, medical professional functions in health insurance and in health care. medical professional functions in health insurance and in health care. MEMBER OF CHAMBER HUNGARIAN MEDICAL CHAMBER LOCAL CHAMBER F1.

11. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The Banking functions (F2) MULTI- FUNCTIONAL TRANSACTIONS MSDC HUNGARIAN MEDICAL CHAMBER * CIB MEMBER OF CHAMBER EUROPAY hybrid EMV OTS Cirrus – Maestro standards provide Special bank services for the members of HMCh: Participation in establishment of private health insurance funds; Participation in establishment of private health insurance funds; Supporting the medical education; Supporting the medical education; Preferencial credit for young physicians starting out on a career; Preferencial credit for young physicians starting out on a career; Preferential credit for modernisation of medical consulting room; Preferential credit for modernisation of medical consulting room; CIB BANK CIB BANK FILIALS F2.

12. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR MOK Magyar Orvosi Kamara Technical possibilities: Implementing digital signature / fingerprintIndividual preparation of identifiers HDW BOX - authorization digitalization, digitalization,personalizationelectrooniccontrol Preparation for National or International Accreditation Individual Individualfunctioncontrol

13. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR Use of the card in the social security system IMPLEMENTATION - development, - implantation, - conversion, - care, MOK Regions - query, - modification NATIONAL HEALTH INSURANCE Local doctor-insurance fund transactions: - modification - query NATIONAL HEALTH INS. contract database, change management: - modifictaion - query EXTENDED MEDICAL LICENCE FUNCTIONS: access of stored medical databases - data processing, - modification, - cancellation, - query HDW BOX - authorization MOK Magyar Orvosi Kamara

14. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR Continuous postgraduate education ( E-learning ) HEALTH EDUCATION BOARD MOK Magyar Orvosi Kamara HDW BOX - authorization PREPARATION For International ACCREDITATION MOK terminals LEARNING TERMINALS UNIVERSITY

15. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The Present ~ 40,000 members of Hungarian Medical Chamber ~ 38,000 cards are issued (roll-out in June 2000) ~ 31,000 cards are delivered ~ 12,500 are used as a bank card (debit card) as well Possible other usage: –loyalty card –key card for SW-s –bank loan / credit card –other price reductions, loyalty Problems about protection of personal data (card delivery)

16. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR Maintaining the work of the system Educate the users Card issuing Card personalization Card delivery Renewal of the old cards –2 yrs as a bank card –5 yrs as a membreship card Change management Improvement in card services (new card generation?)

17. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR The Future? There is a future: Doctors need to get used to the special card Encourage the use of the card –Installing low function terminals Supporting healthcare SW vendors Acceptation of IST initiatives Support for other Hungarian Healthcare related card ideas Joining other projects Introducing E-Learning for Doctors

18. Smart Card Workshop, Budapest 2002HMA - CIB - FOLD-R - BULL - TEMPLAR THANK YOU FOR YOUR ATTENTION!