By Alexander Farnsworth

The current information society offers new possibilities for improving almost every aspect of healthcare, from making medical systems more powerful to providing better health information to everyone. Enter e-Health, a blend of IT and good old-fashioned medicine.

But e-Health isn’t just an empty buzzword and advanced e-Health initiatives by governments, policy makers, health care providers and others are already underway in the US, Europe and Taiwan.

One way or another, all of the initiatives aim to cut the administrative costs of distributing medical information on paper and replace the communication with electronic information instead.

In the US, 38 state legislatures have introduced 121 bills during 2005 and 2006 that specifically call for the use of health information technology to improve patient care. Thirty-six of these bills were signed into law in 2006. President Bush even signed an Executive Order in August 2006 to adopt health information technology standards by January 2007.

In Europe, EU health commissioners are also calling on governments and the private sector to make better use of IT in Europe’s health care systems. And in Taiwan, the Bureau of National Health Insurance implemented a 1.1 billion euro Health Smart Card program in 2004 for its 23 million citizens and 345,000 doctors.

Beyond a smart card
Currently used only as a personal health identification card containing personal data, insurance details and medication taken, the system has the potential of storing even more medical information to facilitate data exchange between health care providers and patients. Such information would include a patient’s last six doctor visits, prescription and vaccination records, history of allergies, pregnancy records and organ donor wishes.

“The card has already achieved savings of three times the initial investment,” said Hong-Jen Chang, CEO of the Taiwanese Bureau of National Health Insurance, to the OECD in Paris during a presentation on e-Health and the Informed Patient.

But smart card-enabled e-health networks are and will be taken further in terms of their functionalities. 

For Kurt Schmid, CEO of Omnikey, an Assa Abloy company that makes smart card readers also for use in e-health systems, smart card technology will be the focal point of all future e-health initiatives.

“I see it like a credit/banking card where every insured individual has one,” he says.

According to Schmid, smart cards for patients and doctors can help to reduce fraud, streamline administrative processes, and ease the communication between different health care providers. Taken together all of these features greatly enhance the quality of the medical service provided to a patient.

In Germany, for example, it is estimated that between 30,000 and 60,000 people die per year because of undesired medical drug interactions. In other words, there is no system in place to check which different prescription drugs patients are taking. A smart card containing this information would solve this problem.

Solutions vary
Germany, France, the UK, Austria and Spain, and the EU in general, are currently looking into ways to develop smart card technology to include patient’s health problems, journals, immunity or allergy to certain drugs, blood group, name and emergency data and so on, on these cards.

At the same time, such cards could offer protected access to other relevant documents about the patient that are located on hospital servers, for example.

And for a doctor, a smart card would offer full traceability and accountability of his or her actions towards patients. A doctor’s smart card could also contain an electronic signature for filling out prescriptions for patients.

Evidently, there isn’t one single solution for all countries. Instead, the approaches are very different and adapted to the local requirements. In Austria, for example, the cards will only contain medical data. In Germany, the medical data will be both on the card and in the background system.

Either way, these smart cards also have the possibility of evolving even further into a kind digital identity authentication for use on the Internet, for example.

“When all countries roll out smart cards for e-Health, the system will be in place to start talking about real e-Government,” says Schmid.