Jak propojit zdravotnické informačnísystémy a nevytvořit při tom „velkého
bratra“
Doc. MUDr. Jiří Kofránek, CSc.UK Praha
Ing. Ondřej Felix CSc.Hlavní architekt eGovernmentu, MV ČR
How to connect the healthcare information systems and also not
create a „big brother“
Jiří Kofránek,Charles University Prague
Ondřej FelixeGovernment chief architect,
Ministery of Interior
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
ssary
to e
nsu
re b
oth
re
quir
em
en
ts
Protection 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 sharing
Protection against unauthorized accessmust ensure
Two f
un
dam
enta
l ri
gh
ts o
f ci
tize
ns
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
Sen
siti
ve p
erso
nal
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
Sen
siti
ve p
erso
nal
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)
Sen
siti
ve p
erso
nal
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
Inhabitans
Estates 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
Inhabitans
Estates 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
Inhabitans
Estates 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
Inhabitans
Estates 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
Inhabitans
Estates 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
Inhabitans
Estates 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
Inhabitans
Estates 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
Není třeba znovu vynalézat kolo!
Architektrura eGovernmentu v ČR
Bezpečné propojení zdravotnických dat bez tvorby velkého bratra je možné!