Doc. MUDr. Jiří Kofránek, CSc. UK Praha

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 Necessary to ensure both requirements Protection of sensitive personal data

Interconnection of information systems 1. Citizen should have access to any records, that are kept on him In 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 access must ensure Two fundamental rights of citizens utilization of health insurance payment

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 oncologic register Central Health 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 oncologic register Central Health Registers Individual biomedical data !!!Very sensitive personal data!!!

Central Health Registers !!!Very sensitive personal data!!! Individual biomedical data Strong data security management Anonymous data in central registers! Individual data in central registers! For therapy and diagnosis Individual data For evaluation of effectiveness of various therapeutical and diagnostical approaches Statistical data

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Record in register Record in register

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Record in register Record in register

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Record in register Record in register

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Record in register Record in register

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Record in register Record in register

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Record in register Record in register Evidence based medicine Statistical evaluation

Strong data security management Anonymous data in central registers! Individual data in central registers! Danger of misuse of the sensitive data Requirement of tracking of individual cases Technological solution

Neutral data document identifier Patient name… (personal ID) document identifier Medical record content Sensitive personal data Medical record content Neutral data document identifier Patient name… (personal ID)

Neutral data document identifier Patient name… (personal ID) document identifier Medical record content Neutral data Cross connection table Medical record database Sensitive personal data Medical record content Patient name… (personal ID) Reconnection is permitted to authorised persons only

Neutral data document identifier Patient name… (personal ID) document identifiers Medical record content B Neutral data Cross connection tables Medical record database B Neutral data document identifier Medical record content A Medical record database A Medical record content B Patient name… (personal ID) Sensitive personal data Medical record content A Request for interconnection approved

Neutral data document identifier Medical record content A Medical record database A Neutral data document identifier Medical record content A Medical record database A Neutral data document identifier Medical record content A Medical record database A Patient name… (personal ID) document identifiers Neutral data Cross connection tables Medical record database B Neutral data document identifier Medical record content B Neutral data document identifier Medical record content A Medical record database A Neutral data 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 Information Change Information Change Information Change Information 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 Protection Data AData B Data C Kofránek 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 Protection Data AData 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 Protection Data AData B Data C ORG - Converter Kofránek Request for interconnection with 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

Don´t reinvent the wheel ! Czech Republic eGovernment Architecture Interconnection of the healthcare information systems without a big brother creation is possible!

Thank you for your attention