Jak propojit zdravotnické informačnísystémy a nevytvořit při tom „velkého

bratra“

Doc. MUDr. Jiří Kofránek, CSc.UK Praha

How to connect the healthcare information systems and also not

create a „big brother“

Associate Prof. MUDr. Jiří Kofránek, Ph.D.

Charles University Prague

Tools for making more efficient healthcare

Modern information technologies

Organizational changes

Protection of sensitive personal data

The necessary condition of healthcare information systems functionality

Healthcare information transfer (about patients, about medical services,

economic costs, etc.)

How not to build an Orwel's "big

brother"

How to safely interconnect healthcare

information systems?

Sharing

Protection

Nece

ssar

y to

ens

ure

both

re

quire

men

tsProtection of sensitive personal data

Interconnection of information systems

1. Citizen should have access to any records, that are kept on himIn the case of health care information systems –

citizen should have access to his medical records, to his the financial report on the utilization of its payment of health insurance etc.

2. A citizen should be able to itself (via Internet) to initiate updating the changed data (eg. change of address of residence).

Data sharingProtection against unauthorized access

must ensureTw

o fu

ndam

enta

l rig

hts o

f cit

izens

utilization of health insurance payment

Acute respiratory infections register

ophthalmology register

Intensive healthcare

registerArthral

implant register

Vascular surgery register

Agioplastic registerCardiosurgery register

Tuberculosis register

Veneral diseases register

National transplantation register

National oncologic register

CentralHealth

Registers

Acute respiratory infections register

ophthalmology register

Intensive healthcare register

Arthral implant register

Vascular surgery register

Agioplastic register

Cardiosurgery register

Tuberculosis register

Veneral diseases register

National transplantation register

National oncologi

c register

CentralHealth

Registers

Individual biomedical data

!!!Very sensitive personal data!!!

CentralHealth

Registers

!!!Very sensitive personal data!!!

Individual biomedical data

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

For therapy and diagnosis

Individual data

For evaluation of effectiveness of various therapeutical and diagnostical approaches

Statistical data

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Record in

register

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Record in

register

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Record in

register

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Record in

register

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Record in

register

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Record in

register

Evidence based medicine

Statistical evaluation

Strong data security management

Anonymousdata incentralregisters!

Individualdata incentralregisters!

Danger of misuse of the sensitive data

Requirement of tracking of individual cases

Technological solution

Neu

tral

dat

a

document identifier

Patient name… (personal ID)

document identifier

Medical record content

Sens

itive

per

sona

l dat

a

Medical record content

Neu

tral

dat

a

document identifierPatient name…

(personal ID)

Neu

tral

dat

a

document identifier

Patient name… (personal ID)

document identifier

Medical record content

Neu

tral

dat

a

Cross connection table

Medical record database

Sens

itive

per

sona

l dat

a

Medical record content

Patient name… (personal ID)

Reconnection is permitted to authorised

persons only

Neu

tral

dat

a

document identifier

Patient name… (personal ID)

document identifiers

Medical record content B

Neu

tral

dat

a

Cross connection tables

Medical record database B

Neu

tral

dat

a

document identifier

Medical record content A

Medical record database A

Medical record content B

Patient name… (personal ID)

Sens

itive

per

sona

l dat

a

Medical record content ARequest for

interconnection

approved

document identifier

Medical record content A

Medical record database A

document identifier

Medical record content A

Medical record database A

document identifier

Medical record content A

Medical record database A

Patient name… (personal ID)

document identifiers

Neu

tral

dat

a

Cross connection tables

Medical record database B

Neu

tral

dat

a

document identifier

Medical record content B

document identifier

Medical record content A

Medical record database A

Neu

tral

dat

a

document identifier

Medical record content A

Medical record database A

Information system of basic registers

Czech Republic eGovernment Architecture

Inhabitans

ID Legal persons, legal entities, public power

authorities etc.

Estates and addresses

(access rights etc.)

Rights and

Obligations

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Information Sharing

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Change Informatio

n

Change Informatio

n

Change Informatio

n

Change Informatio

n

Information Sharing

Basic Identifier of Natural Person (BINP)

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Data ProtectionData A Data B Data C

Kofránek

Agenda Identifieres of Natural Person (AINP)

Agenda Identifieres of Natural Person (AINP)

ORG - Converter

Basic Identifier of Natural Person (BINP)

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Data ProtectionData A Data B Data C

ORG - Converter

Kofránek

Request for data

Agenda Identifieres of Natural Person (AINP)

Basic Identifier of Natural Person (BINP)

Data B

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Data ProtectionData A Data B

Data C

ORG - Converter

Kofránek

Request for interconnectio

nwith Data B

Agenda Identifieres of Natural Person (AINP)

Information system of basic registers

InhabitansEstates and addresses

ID Legal persons, legal entities, public power

authorities etc.

(access rights etc.)

Rights and

Obligations

ID

Registry of Rights and Obligations

Registry of Inhabitans

Registry of Territorial

Identification, Addresses

and Real Estates

Registr y of Persons

Czech Republic eGovernment Architecture

Data Protection

ORG - Converter

Information Sharing

Distributed Information Health Care Systems

Don´t reinvent the wheel !

Czech Republic eGovernment Architecture

Interconnection of the healthcare information systems without a big brother creation is

possible!

kofranek@gmail.com

Thank you for your attention