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Insiel

Overcoming data protection issues for the development of a regional

card service systemExperience of Friuli Venezia Giulia

Autonomous RegionItaly

Department of International and European Community Relations of the Presidency Regional Ministry ICTHealth, Welfare and ICT Area

Overcoming Legal Challengesto eHEalth-Clinical Data AccessAER eHe@lth Network Seminar

25 september 2008, Luzern

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InsielItalian Legal Contex

I° Legislative decree n.196 of 30-june-03

“code on personal data security” that orders on management of citizen/patient data

II°Legislative Decree n. 82 of 07-march-05 (and following modifications) “digital administration code” that orders to Public Administration on digital management of data mentioned in Legislative Decree n. 196 of 30-june-2003

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InsielItalian legal context

I°

Legislative Decree n. 196 of 30-june-2003: “code on personal data security”

Aims

– Guarantee for recognition of citizen right on own personal data

– To discipline the “treatment”– To avoid that the treatment takes place against

citizen’s will

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Health data:– are confidentiality data– treatmnet needs written consensus– the health providers can management

health data patient, if patient signs assent

Italian legal context I°

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“Digital Administration Code”

Aims

to order public administration processes through information technology between public administrations and public administration and citizens/user

Italian legal contextII°

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national service card: document on information device, thar allows to access on line to services of Public Administration

citizens and enterprises rights (section II)

Right of use Information Technology Citizens and enterprise have rights to ask and obtain of use

Information Technology to communicate with public administrations and provider of public service, within limits of code. The rule is applied to regional and local administrations within limits of technologies and organizational resourses and in according to their own legislative.

Italian legal contextII°

Codice dell’amministrazione digitale

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InsieleHealth–FVG pathway

Duties and life improvement

Duties

• to guarantee protection of health data citizen

• to allow citizen to consult on line own data

life improvement

Life improvement of citizen is the outcome of combination of law duties and Information technology

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Insiel

Friuli Venezia Giulia Region

Austria

Slovenia

Veneto

Adriatic -Croatia

• 7846 square kilometres

• 1.207.870 inhabitants

• GDP Euro 26,7 billions

• Approximately 25% over 64 years old

• More than 75% with at least one chronic disease

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InsieleHealth – FVG model

Italian Health Service is a “universalistic model”, with regional jurisdiction and in Friuli Venezia Giulia Autonomous Region there is financial autonomy

FVGAR INFORMATION SYSTEM is unique and totally integrated in the Public Administration (Regional Information System) included Regional Social Health Information System (RSHIS)

Territorial health structures involved for 1.200.000 citizens:• 6 Local health agencies(ASL: hospitals and local health centers)• 2 Univerity Clinical Centers• 1 General Hospital• 3 National Research institute (IRCCS)• Regional central structure with coordination role

• Regional Health Agency (RHA)• Common Service Centre (CSC)

Development and management SISSR are arranged, according to RHP, by a triennial information health plane and a yearly operative plane. The management planes are assigned to technological regional partner

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Insiel

Hospital Information System (SIO)

Admission (ADT), First Aid, AmbulatoriesServices (operative theatre, laboratori and radiology)Hospital division and stay in hospitalClinical and Nursing file

Territorial System GPs/Pediatricians, Pharmacy Consulting-room Mental Health division (DSM)Integrated Domiciliary Aid (ADI)Booking System, 118

Social System Social FilePai, PeiAid Domiciliary Services (SAD)Front-End

Administration System Human resoursesBids and purchases, OrdersWarehousesDistribution, Requests, Purchases Manager

Government system ETL , DatawarehouseData mining (BO), PharmacyAnalytics, Activities (DRG, Services, waiting time,…)

Support Systems Electronic SignatureElectronic documents back-upManagement documents SystemsNational Services Card CNSHealth Operator Card

eHealth – FVG model

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InsieleHealth–FVG experience

“life improvement”

“ Regional Service Card ” Project

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Insiel

The Regional Card Project is the outcome of an institutional agreement between Friuli Venezia Giulia Region and Internal Revenue Service:

• Health Cards are distributed by Internal Revenue Service (IRS) in accordance to Friuli Venezia Giulia Region;

• Health card is complying to National Service Card specification;

eHealth–FVG experience

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InsieleHealth–FVG experience

• Health Card• TEAM (Tessera Europea di Assicurazione Malattia) • Tax Code

the national validity is immediately available (HC, EHCI, FCN), citizens don’t have to do anything, just put the card in their wallet.

Aim A single card acts as a multipurpose tool to access on line public

services.

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Micro

Chip

Tax Code

Name, Surname, City and date of born

Regional Logo

National Health Card and multi service regional card

Validity

Name, Surname and date of born

Tax CodeHealth Insurance Code and validity

Europe insurance Health card

eHealth–FVG experience

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InsieleHealth – FVG experience

• Each citizen resident in Friuli Venezia Giulia Region has own Smart Card (Regional Service Card)

• In order to use Regional Card to access on line services, it is necessary to activate it. – The start up requires the following steps:

• Citizen goes to front-end and shows his regional card and identity card.

• Employee checks validity of citizen’s cards and gives him a document to be signed for:

– Start up card request – Authorization to use health data – GP Authorization to consult health personal data

• Citizen receives at home PIN and PUK• Citizen accesses on line services by internet portal

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Insiel

MARIO ROSSIVIA ITALIA, 534100 TRIESTE

MARIO ROSSI

MARIO ROSSI

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InsieleHealth – FVG experience

• all health data are contained in database of the regional health structures, hedged in and and not transferablenot transferable

• Internet Portal has been developed as point of access to health data:– Citizen is identified by Regional Service

Card– Citizen inserts PIN to access own data

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Authorization Management

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Examination list

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InsieleHealth–FVG experience

• Health services on line for citizens:

• Log in Internet Portale RSC (pin code)• Access to:

– Health personal data– Own exemptions– GP’s data– Vaccination list– Booking stored list– Booking list ongoing

• Self-declaration to obtain exemption for age or low income• Change GP• Print paper copy of own Health Card• Payment• Sending selfmonitoring data to GP• Regional pharmaceutical care• Authorization management• Hospitalization data• Homecare nursing stored list• Other health online services are in working:• Result on line• Booking

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Insiel

• Department of International and European Community Relations of the Presidency: President dr. Renzo Tondo

• Regional Ministry of ICT: Regional Minister dr. Elio De Anna• Health, Welfare and ICT Area: director dr. Roberto Panizzo• Regional Ministry of Health and Social Care: Regional Minister prof.Vladimir

Kosic• INSIEL S.p.A: General Director and CEO dr. Dino Cozzi

Contacts• Elio.deanna@regione.fvg.it• Roberto.panizzo@regione.fvg.it• Fabrizio.spadotto@regione.fvg.it• Fulvio.sbroiavacca@insiel.it• Gilda.demarco@insiel.itTel. 0039-040-3774342; 0039-040-3775906Web site: www.regione.fvg.it; www.insiel.it