Download - Patient Identification in Europe
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Patient Identification in
Europe –
From EHIC to eEHIC
Andreas Grode
Head of Technology & Innovation, gematik, Germany
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Overview
• EHIC: Current content and usage
• From EHIC to eEHIC: Who was/is involved...
• Some technical details...
• Current status and next steps
• Limitations of (e)EHIC as patient identifier
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EHIC: Principle layout
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EHIC: Current content and usage
The European Health Insurance Card
• replaced the paper forms E111, E110,
E128 and partly E 119
• is a eye-readable only plastic card
• provides a unique insurant number
• is in use: ~200 Mio cards active
According to regulation 1408/71, all persons insured under the
legislation of a member state are entitled to healthcare during a
temporary stay in another member state.
• The EHIC certifies this entitlement.
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From EHIC to eEHIC...
• Responsible European Body is „CA.SS.TM“ • „Administrative Commission on Social Security for Migrant
Workers”
• Since 2007 two groups have prepared the introduction of the eEHIC• AdHoc-Group eEHIC (Rapporteur Andreas Grode)
• examined the legal, functional and technical basics
• examined the added value
• Issued the Final Report 2009/06
• CEN Workshop eEHIC• created an eEHIC standardized profile: CEN CWA 15974:2009
• describes the technical feasibility of an eEHIC which takes into account the diversity in Europe
• includes the technical specifications for eEHIC
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Objectives of electronification
• From an administrative point of view:
• Providing citizens with an easier and better accepted way to
proof their entitlement to receive care when travelling abroad
• From a technology point of view:
• Providing an automated, more reliable data entry and
transmission system for insured person’s identification data
• From an innovation point of view
• Providing opportunities for new services, i.e. remote access to
other data (administrative or even health-related)
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Technical Basis: CEN CWA 15974
• In a nutshell the CWA:
• provides the definition of the EHIC dataset
• specifies the eEHIC interoperability interface between the smart
card and the Client Application of the HCP residing on the
Workstation or Card Accepting Device (CAD) itself
• specifies a logical format for exchange of eEHIC information
between Healthcare Providers and Competent Institutions
• provides the definition of the metadata schemas that ensure
interoperability
• provides a method to identify and to access to the (specific)
EHIC data set on the citizen’s smart card.
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Technical specifications
allow flexible implementations
• CWA objective: freedom in implementation decision
• 4 possible types of cards can be issued1.New card with EHIC data set on-card
2.A card with a “pointer” where the EHIC data is stored (outside the card)
3.An existing card being able to add the EHIC data set as defined for type 1
4.An existing card carrying all the information of the EHIC dataset but differently than as per type 1
• The card reading infrastructure can accept all types of cards
• MS can include additional services for eEHIC without impacting the infrastructure of the other MS
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CEN CWA eEHIC: 4 generic types
HCP
HCP
HCPHCP ?
= eEHIC data
= “Pointer” to eEHIC Data
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Current Status and next steps
• CA.SS.TM is discussing how to introduce the
eEHIC (next meeting 2010-03-17)
• Usage of CEN CWA 15974 as the technical basis
• Which types of card have to be supported ?
• Is the introduction of the eEHIC affected by other
(ongoing) projects (and vice versa) ?
• How to integrate with EESSI
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The Future... (about reimbursement)
Home Member State
EESSI Network
Host Member State
eEHIC
Social Security Institution
Health Care Professional
National (Social Security) Network
National (Social Security) Network
Social Security Institution
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Limitations of (e)EHIC as patient
identifier
• Patient and Insurant may differ
• eEHIC is currently only used to support
reimbursement between Member States
• eEHIC needs to be accepted as identifier to
access medical data
• not always permitted (national legislation)
• no common process to access data from abroad
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Thank you! Questions?