# Presentation: 130988

## Administrative Uses of Patient Data Cards

- Dr David Markwell
- The Clinical Information Consultancy
- Reading, UK
- email dmarkwell@cix.compulink.co.uk

##  Eurocards - Background

- Part of the EU framework programme
- AIM preparatory phase
- Assessment of the needs and organisational impact of patient data cards
- AIM Development phase
- Preparation of a European Strategic Action for the use of data cards in the healthcare domain
- AIM Concerted action
- EUROCARDS

## Eurocards - Objectives

- Encourage use of Health Cards in Europe
- Framework for convergence
- Forum for consensus
- Catalyst to national initiatives
- Focus for awareness
- Additional input to standardisation activities

## Eurocards - Working Groups

- WG1 Cards in clinical specialties
- WG2 General studies
- Technology assessment
- Security aspects
- Health professional cards
- WG3 Administrative uses
- WG4 Emergency medical cards
- WG5 User acceptance
- WG6 Evaluation methodology

## Eurocards - Outcomes

- A book
- "Healthcare Card Systems" (published by IOS)
- Detailed material from WG1-WG4
- From Antonio Pernice DGXIII of EU
- G7 Health Cards
- An initiative extended to US, Canada and Japan

## Eurocards - Working Group 3

-  Primary focus
- Administrative uses of patient data cards
- Data required to support these uses
-  General considerations
- Healthcare card system architecture
- Organisational issues
- Business cases
- Prerequisites for success
- Interoperability and harmonisation

##  Administrative functions (1)

- Identification
- Confirm the identity of a patient
- Simplify entry of a unique identifier for a patient
- Generate an electronic signature
- Access to records
- Locate the patient’s clinical records
- Provide a key to enable network access

## Administrative functions (2)

- General administrative support
- Simplify the completion of forms
- Authenticate electronic communications
- Confirmation of entitlement to healthcare services
- Overlaps with the work of DGV  (E111 form)
- Foundation for other uses
- Clinical uses for emergencies, specialties, etc.

## Patient card administrative data

- Information about the card
- Patient details
- Security data
- General administrative data
- Entitlement to healthcare services
- Health organisations holding patient records

## PDC core administrative data (1)

- Information about the card
- Identification of the card issuer
- MII, country, issuer, check digit
- Dates of card validity
- Issue date and expiry date
- Identification of the patient
- Patient identifier
- Name
- Title, forenames, surname prefix, surname

## PDC core administrative data (2)

- Patient details
- Sex
- Date of Birth
- Address
- Postal country, Postcode, Address text
- Entitlement information
- Healthcare funding body identifier
- Insurance number / policy number

## Organisational issues

- Strategic alignment
- Card system objectives must align with ...
- Strategy of healthcare organisation
- Existing business processes
- Should be reviewed
- May need revision to maximise benefits
- Benefits and disadvantages for
- Patients
- Healthcare professionals
- Organisations and other users

## Management issues

- Overall coordination and project management
- Card Management
- Manufacture, personalisation and distribution
- Withdrawal and replacement
- Card access system management
- Development, installation and use
- Management of central systems
- Promotion and education
- Training users

## Business cases for health cards (1)

- Many potential benefits are hard to quantify
- Costs are difficult to estimate
- Costs vary according to technology / data capacity
- Cost variations apply both to cards and readers
- Estimates of the expected life of data cards vary
- Prices are likely to continue to fall
- Sensitivity to small changes in costs
- Cards ✖ Millions
- Card Readers ✖ Tens of thousands

## Networks PLUS Cards > Networks OR Cards 

- Growing role of networks
- Influences evaluation
- Competes for funding
- Networks and cards are synergistic
- Well-illustrated by the banking sector
- A solid business case requires a hybrid approach
- Networks PLUS Cards **>** Networks OR Cards

## Prerequisites for success (1)

- Identifying / resolving legal and ethical issues
- Security measures that meet requirements
- Rules for updating and maintaining integrity
- Selection of appropriate card technologies
- Deciding
- Who should have Patient Data Cards
- Who should access PDCs and where

## Prerequisites for success (2)

- Gaining the acceptance of patients and users
- Partnerships with other interested parties
- Interoperability where appropriate
- Planning appropriate timescales
- Defining potential benefits
- Analysing benefits realised

## Harmonisation, interoperability and standards

- Technical standards should
- Enable a card to be accessed by many systems
- Allow a system to access different cards
- Produce a vigorous open market for card systems
- Interoperability and harmonisation
- Non technical dimensions
- Legal and ethical
- Economic and political

## Conclusions

- Value of a card system increases with scale
- Pilot healthcare card projects are often small
- Widespread use is essential to realise benefits
- Healthcare administrative uses
- Account for all large scale health card projects
- Will shape card system infrastructure
- Will influence future clinical use