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 (manfred.glanzer@systema.info) CompuGROUP Holding AG - Maria Trost 21 - 56070 Koblenz - Tel.: 0261 8000-0 - Fax: 0261 8000-1166 - E-Mail: holding@compugroup.com - Internet: www.compugroup.com 1

CompuGROUP - Facts Founded in 1987, HQ in Koblenz / Germany European wide customer base of approx. 290.000 GP‘s, dentists and other health care suppliers Approx. 1.700 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

Medical data sharing Electronic Health Records

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 ?

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

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)

CompuGROUP’s Solution Electronic Health Record

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

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)

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)

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

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

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

Electronic Health Record Projects

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

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

one step ahead Thank you for your attention. If you have any questions or need more information on CompuGROUP’s software-solutions, do not hesitate to contact us. Visit our Web-page at www.compugroup.com to request product-specific information