1. The vita-X Health Record
CompuGROUP Holding AG
The vita-X Health Record
Sofia, 2008/02/13
Manfred Glanzer, Senior Consultant E-Health, SYSTEMA Human Information Systems / Austria
CompuGROUP Holding AG - Maria Trost Koblenz - Tel.: Fax: Internet: 1

2. CompuGROUP - Facts Founded in 1987, HQ in Koblenz / Germany
European wide customer base of approx GP‘s, dentists and other health care suppliers
Approx employees in Germany, France, Italy, Austria, Poland, Slovakia, Spain, Turkey and Czech Republic
Major line of business: communication solutions for international health care markets
GP software
Dental software
Hospital information systems
Medical Decision Support System to assist medical therapy and prescription
Web based electronic health record
Communication services, data analysis and Content-supply
Workflow-solutions and services for GP (networks), medical centers, hospitals, health insurances and pharmaceutical companies

3. Medical data sharing
Electronic Health Records

4. communication methods
directed
non directional
receiver/ time of usage is unknown
information is shared without a specific request
requires a central storage for medical data or a central registry
part of the usual medical treatment process
transfer of specific med. documents at a certain point in time
document-exchange between one sender and receiver ?

5. CompuGROUP approach patient centric data sharing  Patient empowerment
Patient has his/her own physical data repository
full governance (patient is data-owner)
doctor-guided (family physician)
Patient is an active player in the sharing -process

6. CompuGROUP approach server based EHR secure integrated patient centric
increases availability (vs. decentralized approach)
encrypted storage (unreadable for ‘data-hoster’)
RBAC (can be defined by the patient)
cost-effective central database vs. multiple registries/repositories (no add. hosting services,…)
Smart Card-based
integrated
patient centric
smart client adaptor handles client-side encryption/decryption (no special HW needed)
- communication with existing SW
directed communication with patient as active participant (empowerment)
data governance (patient is data-owner)
simplification
fewer components/resources (Hard- and Software, maintenance-personnel)
fewer dependencies
vs. decentralized  independent on availability of Health-Provider’s systems
security concept preserves confidentiality
usually addresses all legal requirements
increased acceptance (patients & doctors)

7. CompuGROUP’s Solution
Electronic Health Record

8. PRIMARY SYSTEM (GP-System,HIS,…)
vita-X - overview
logon server
handle authorization
provide session-keys
Health professional
PRIMARY SYSTEM (GP-System,HIS,…)
directory server
adaptor
stores pointers to data-packets
data server
encrypted & fragmented EHR-data

9. vita-X - security data protection has the highest priority!
- keys are stored on the smart-card only smart-card & pin-code are needed to access the EHR no encryption-key is ever sent to or stored on the central server(s)
encryption/decryption performed by client-adaptor only additional transport encryption is used
encrypted and fragmented Datastore cannot be associated with a physical person encrypted EHR-objects are spread amongst different data servers server-side decryption is virtually impossible
RBAC, Logging and Auditing restrict EHR-access (based on doctor’s medical field,…) documents access to EHR, provide access-history
confidence
Confidentiality is preserved
Risk of unauthorized access is minimized
Increased acceptance (patients & health professionals)

10. vita-X - content structured / unstructured
Each Medical Data Object (MDO) is structured (author, creation-date, type,…) and can have an unlimited number of unstructured attachments.
Supports the use of (international) classifications like ICD-10, OPS (Operations and Procedural Key), PZN (Central Pharmaceutical Number),…
machine readable data objects allow efficient integration of modern decision support systems (drug interaction check modules,…) and data-import into the HP’s primary system
stores any document type as MDO-attachment
digital signatures Each MDO is digitally signed by the author
content areas health-professional area (crypto+) patient-area (Org)

11. vita-X - accessibility
multiple authentication levels
dual/single Smart Card based
patient-access without HP-Smart Card (eg. vita-X Patient-Terminals in Hospitals)
extended Health Provider Access (allow a HP to access the EHR without the patient’s Smart Card for a specific period of time)
‘Integration instead of isolation’
vita-X client adaptor allows full integration into primary system
smart-client
secure client-interface to access the vita-X EHR.
browser based
using signed java-applet (browser-sandbox) to connect to card-reader and vita-X system

12. vita-X – front-end vita-X pro vita-X home for health-professionals
data is stored in HP-content-area (Patient’s can not manipulate the data, but configure RBAC)
HP-verified content
Information at a glance (prima vista)
risk factors, permanent medication,….
vita-X home
for patients
data is stored in patient-content-area
patient has full control
for self-monitoring purposes

13. vita-X – benefits
for sponsors & health providers
enables cross institutional communication
Support of disease management programs (cross institutional information management)
reduces double examinations
integrates into existing applications & workflow
provides consolidated view on (all) important facts of patient’s medical history
quick overview on patient’s health-status
allows better drug interaction checks
optimization of treatment-process (anamnesis,…)
quality improvement, process optimization, cost reduction
for patients
transparency of medical treatment
benefit of quality improvement
access to EHR from anywhere, anytime
increased self responsibility, better health

14. Electronic Health Record
Projects

15. started on November 29th,2004 by Malu Dreyer (Secretary of Health)
vita-X – projects
Pilot project „ePA Rheinland-Pfalz“
started on November 29th,2004 by Malu Dreyer (Secretary of Health)
Goals:
networking of 50 general practitioners and 2 hospitals
electronic data exchange between general practitioners and hospitals without media disruption

16. vita-X – projects ePA Junior sponsors:
initiative of government, physicians association and CompuGROUP Holding AG
free personal electronic health record for all newborns of the year 2008 in Rheinland-Pfalz (Germany)
first prevention model for infantile health in Germany
first area-wide adoption of a professional-guided personal electronic health record
continuous documentation up to the 6. birthday
sponsors:
state of Rheinland-Pfalz / Germany (ministry for work, social affairs, health,family and women)
CompuGROUP Holding AG

17. one step ahead Thank you for your attention.
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