RUM II Project as an enabler to digital signature and eid in healthcare
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1 RUM II Project as an enabler to digital signature and eid in healthcare Marek Ujejski Deputy Director IT Department National Health Fund, POLAND Member of eidas Expert Group DG CONNECT Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
2 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
3 Landscape of Poland 1 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
4 Landscape of Poland 2 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
5 Landscape 3 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
6 POLAND some facts Area Quantity of citizen Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
7 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
8 Status of NFZ Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
9 POLAND some facts Quantity of medical units Refund cost of medical treatments 2014 Year
10 Insurance expenditure as overall versus GBP per capita Wydatki KCh/NFZ (mln zł) PKB na jednego mieszkańca (mln zł) Differential % Differential % Source: GUS 2011, NFZ 2014 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
11 How polish healthcare is percived? Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
12 What about patient access to own data? Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
13 Main obstacles in getting access to the medical data Lack of ehr Lack of enough secure tools (eid means) Diversity of legal regulation in MS EU Diversity of sensitive data treatment in MS Diversity of technical solution Data formats crossborder issues Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
14 Author: Jerome Boehm DG SANCO, Workshop on ehealth 24th September 2013 Brussels Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
15 EPSOS European Patients Smart Open Services epsos II countries 20 UE MS 3 non UE MS Active Passive
16 Recital (10) eidas Regulation Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients rights in cross-border healthcare1 sets up a network of national authorities responsible for ehealth. To enhance safety and the continuity of cross-border healthcare, the network is required to produce guidelines on crossborder access to electronic health data and services, including by supporting common identification and authentication measures to facilitate transferability of data in cross-border healthcare. Mutual recognition and acceptance of electronic identification and authentication is key to make cross border healthcare for European citizens a reality. When people travel for treatment, their medical data needs to be accessible in the country of treatment. This requires a solid, safe and trusted electronic identification framework.
17 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
18 Backbone of system 1. Public Key Infrastructure 2. Card Management Systems (CAMS) 3. Primary Registers 4. Database of Healthcare Unit 5. Database of National Health Fund Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
19 How we approach to problem Cards as a tools in administrative and medical part of healthcare Electronic Health Insurance Card (ehic) Health Professionals Card (HPC) Administrative Professional Cards (APC) Card as a data carrier old approach Card as a key new approach Mixed role newest aproach
20 Lokal components of system 1. Cards (plus software) 2. Reader 3. Workstation (plus software) 4. Patient 4 5. Professional
21 How system RUM II works basic flow XML Serwer lokalny XML XAdES KUZ 1. Terminal verification (TA) due to EN Chip verification (CA) due to EN Card to Card Authentication 4. Patient insurance status (e-wuś) 5. Create document (medical description) 6. Electronic signature ( KUZ) 7. Professional signature (KSM) PKI 8. XML document (signed) stored locally 9. Reimbursement raport send to NFZ INTERNET E-WUŚ CWU XML XAdES KUZ XAdES KSM Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
22 How to use eid function? Country B Country A I N T E R N E T Authentication modul OK X Failed Data base contain ehr Patient Authorisation module for system
23 How to improve? Country B HUB B I N T E R N E T Country A HUB A Data base contain ehr Patient OK Authentication Services Level H Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015 Authorisation module for system
24 HIC (EKUZ) key function Electronic signature (1st key pair, no PIN) Electronic identification (2nd key pair, PIN required) Electronic signature (3rd key pair, PIN required) Carrier for: Administrative data Emergency data (on demand) Graphical layer Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
25 HPC (KSM) main function Electronic signature (PIN, PIN required) Electronic identification (2nd key pair, PIN required) Access to emergency data on patient card based on CVC (not for all staff) Carrier for: Administrative data Qualification status (not for all proffesionals)
26 Project schedule
27 Source: European Commission
28 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
29 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
30 Conclusion Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
31 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
32 Information Society and e-government in Digital Era The Danish and the Polish experience, Warsaw 2nd June 2015
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