prof. dr. arno elmer, managing director, gematik (society for telematics applications)
DESCRIPTION
German E-Health Card – the Next Step toward Integrated Social and Health Care?TRANSCRIPT
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gematik Gesellschaft für Telematikanwendungen der Gesundheitskarte mbH Friedrichstraße 136 10117 Berlin
German E-Health Card – the Next Step toward Integrated Social and Health Care? Prof. Dr. Arno Elmer Managing Director
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The Connected Healthcare System - Telematics Infrastructre
general practitioners
pharmacists
medical specialists
dentists
insured persons
other healthcare professionals
hospitals
medical rehabilitation
facilities
health insurance companies
eHealth Card (eHC)
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
132 statutory health insurance companies
90% (~70 Mio.) insured persons
2.100 hospitals
21.000 pharmacies
208.000 primary care phycisians, specialists, dentists (incl. psychological psychotherapists)
2.3 million other healthcare professionals
80.2 million citizens
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Figures of the German Healthcare System
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
1 Quellen: KVNo, Statistisches Bundesamt 2 Quelle: Quelle: Pharmazeutische Zeitung 3 Quelle: Barmer GEK-Arztreport 2010 4 Quelle: Ärzte Zeitung Nr. 185 Jg. 2012 S. 17 5 Quelle: Statistisches Bundesamt 2013; Zensus 2011
1,48 billion doctor-patient contacts / year1
4 million patient contacts in pharmacies /day2
Ø 45 patient contacts per doctor / day3
5 billion documents per year 4
80 million people5
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Demography Report 2010 / EU Commission
26,7
23,7
21,3
20,5
19,7
18,9
18,8
18,9
59,5
60,8
61,3
59,5
56,7
54,2
52,3
51,1
10,6
12,3
12,7
14,4
16,6
18
17,8
17,8
3,1
3,3
4,7
5,7
6,9
8,9
11
12,1
0% 20% 40% 60% 80% 100%
1990
2000
2010
2020
2030
2040
2050
2060
0-19 years 20-64 years 65-79 years 80+ years
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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gematik - Gesellschaft für Telematikanwendungen der Gesundheitskarte mbH
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
The German government adopted in 2004 the law to implement the eHealth Card. The purpose of this law is to modernize the statutory health insurance.
The self-governed entities of the German healthcare system, especially the statutory health insurance is responsible for establishing the telematics infrastructure and implementing the ehealth card.
gematik was founded in January 2005 It is the German central coordination and communication center for all
topcis related to telematics infrastructure and ehealth card
Currently there are around 200 IT experts, application specialists and project managers employed at gematik
Managing Director: Prof. Dr. Arno Elmer
Shareholders:
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gematik: Competence Center for eHC / TI
• Concepts: The gematik develops conceptual designs and specifications to define the standards of the components, services and processes
• Patient Safety: The gematik works closely with the Federal Office for Information Security (BSI) and the Federal Commissioner for Data Protection and Freedom of Information (BfDI) in order to assure security and the functionality of all project components.
• Testing: Methods to guarantee safety, functionality and quality of all project components.
• Authorization: The gematik grants the authorization for the health telematics, after approved and successful testing.procedures
• Tender Procedure: The organization conducts the tender procedure and awards contracts to the industry partners for the development, the testing processes and the rollout
• Corporate & Organization Responsibility: The gematik oversees the operation of the telematics infrastructure and additionally carries the responsibility for its proper functioning.
• Communication: The gematik supports its stakeholders and is the central point of contact in all questions related to the eHC and TI.
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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Project Status – eHC Rollout Successfully Completed
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2011: 10%
2013: almost completed
2014 eHC becomes the mandatory proof of
insurance
2012: 70%
2014: mandatory
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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Project Milestones 2013 / 2014
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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Contracted Industry Partners
© gematik I BMG Patientenveranstaltung I Prof. Dr. Arno Elmer
Program
ORS1
Los 1 and 2 (establishing and operation of end-
user service within the testing region)
Los 3 (establishing and operation of the central services
of the TI)
G2
Los 1 and 2 (development
and provision of COS, initialized
cards and testing cards)
Los 3 and 4 (personalization validation and issue of HBA
and SMC-B inkl. PKI)
Los 5 (establishing and operation of the
CVC-Root)
Scientific Evaluation
Evaluation, acceptance an suitability for
daily use
request for proposals
09.04.2014
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Telematics Infrastructure – Connects Everyone
The telematics infrastructure offers: • Security, because it restricts the use to only
certified and proven interoperable components. The roles of the components are clearly defined.
• Constant availibility due to the centrally organized operations
• Guaranteed highest performance through unified standards
• Nationwide, cross-sector plattform
Secured investments for the industry: • Use is restricted to defined standards
• Continous, coordinated and approved development of the entire plattform and its components
• Persistent adjustments to the current security and data protection standards in order to remain conform with the legal requirements
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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Telematics Infrastructure – Phase Model
Telematics infrastructure and first applications during the trial period (testing) (Phase I): • establishing the telematics infrastructure • online update of insurance data • qualified electronic signature • secure communication between service
providers (e.g. * general practitioners)
Planned Application (Phase II + et seq.): • emergency data management • migration of health and medical data services to
the TI, eg. electronic medical record • data management for medication safety
Other projects & applications: • organ donation, QS-markers, telemedicine,
eprescription, electronic patient file, epSOS (European Patient – Smart and Open Service)
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
*subject to resolution possed by the shareholders
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Exampe: Use Case Polypharmacy – Data Management for Medication Safety
Studies found that:
• 10% of all insured persons consult ten or more different physicians a year • Problem: It is unkown what physician prescribed what medication? • 20 to 25% of all hospital stays in the USA are the result of side effects of medication
and harmful interaction of different medications. • due to the absence of a communication, information plattform and missing
coordination polypharmacy and issues caused my medication sideeffects create additional costs in the billions.
Source: Arzneimittelreport 2013 Barmer GEK
The amount of different prescription medications that 1/3 of all 65 year old
persons take:
five or more
data provided to improve medication safety therapy helps to reduce physical
harm by patients
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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Qualitative Future Benefits of Care
Additional examples of applications:
• eCase file
• ePatient file
• eMedication plan
• supplemental pay tracking system
• nursing file / nursing and care
documentation
• eDocumentation
• Medical diary (e.g. diabetes, pain
management, asthma,…)
• reminder function e.g. for
recommended screenings and medical
examinations
• eVaccination record
• Link between In- and Outpatient Care
• Bridge between Health and
Social Care
• Empowement of the patient rights
• Supporting AAL Assisted Ambient
Living Concept
• The industry invests already today
massively in the field of E-Health
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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gematik EU Activities – Communication across Borders
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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Conclusion
Goal: is to achieve full accessibility of the eHC/TI -potentials for the users. Additionally the validation of past and future investments by expediating establishment and availibility of added-value applications.
The successful realiziation requires:
- constructive partnership and cooperation as well as clear committment to the project by all shareholders
- efficient committee and steering structures - clear legal frameworks and support by the federal ministry of
health (BMG) - agreement and committment to the financing of the nationwide
rollout - billing regulations for added-value applications - the activities by all parties involved should be patient-centered - coordinated information and communication about the project
© gematik I Smarter Care Initiatives in Europe 2014 I Prof. Dr. Arno Elmer 01.04.2014
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We connect the healthcare system. Safe.