In January 2004, the Federation of Austrian Social Insurance Institutions commissioned Siemens IT Solutions and Services with implementing the TP1 subproject of the e-card project (operations center and terminal equipment software). Siemens was in charge of developing the customer specific software and the 2 operation centers, which are configured as high-availability systems. Subcontractors include IBM for setting up the operations center, and Telekom Austria for presentation and training services. After the doctor's ordination pilot was launched on schedule in December 2004 and following successful pilot operations in three districts in Burgenland, roll-out for all of Austria commenced at the end of May 2005. Roll-out was completed by the end of 2005. After that Siemens provided, together with the SV-Chipkarten Betriebsund Errichtungsgesellschaft, fullscale operations for pproximately 12,000 contract partners (doctors, outpatient clinics, and health insurance funds). Every person insured under the Austrian social insurance system receives an e-card which, in a first step, replaces the paper health care vouchers used so far (a key and signature card compliant with ISO7816). The contract partners also get PIN-protected surgery cards, so called o-cards. The e-card system already furnishes the basis for applications needed by the Federation of Austrian Social Insurance Institutions in the future. The highperformance infrastructure has been designed to accommodate a broad range of follow-up projects, such as:

• Citizen card, e-government and e-Social Insurance
• Medication approval service
• Integration of hospitals
• Electronic Health Record (EHR), e-Health

The back of the e-card acts as a European public health insurance card.

The challenge

• Keeping to a very tight schedule
• Building up a high-availability operation center
• Top-level data and transaction security in line with BSI and ISO 7799
• Future-proof, scalable infrastructure for new applications in the social insurance sector
• Basic system for connecting doctors, outpatient clinics and health insurance funds
• Online and offline capabilities in doctor's surgeries, link-up to mobile clients

Benefits for patients, health insurance funds and contract partners

• No more issuing, distribution, archiving, and administration of about 42 million health care vouchers a year
• Prompt and secure verification of entitlement (configurable, rule-based) via a central, high-availability system
• Electronic handling of special approvals for medication
• Secured and signed data for downstream processes, such as billing and charging etc.
• Possible interfacing with existing solutions at hospitals, health funds, and doctors
• Infrastructure for further automation

Our contribution

• Project management
• Concept design, planning and set-up of operations center for a chip card based IT system
• Building and running the high-availability data center
• Concept design and development of server and client software for about 12,000 contract partners
• Interfacing of the server system to systems already existing at the Federation of Austrian Social Insurance Institutions and to other IT systems
• Interfacing of the client software to about 5,000 chip card enabled units (PDAs) to be used as inquiry terminals
• Maintenance for server systems and client software

Benefits for the organizations

• No more issuing and administration of about 42 million health care vouchers a year
• Prepared for future applications, e.g., sick leave reporting

Benefits for all stakeholders

• Public sector reference architecture
• Efficient and multi-functional use of IT
• Infrastructure for future e-health projects

The solution The e-card data center, which for availability and security reasons is distributed over two sites in Vienna, runs the central solution for the e-card as well as for other applications.

From a software point of view, the system consists of several components. The "Consultation system" handles the verification of entitlement through e-card insertion and inquiry from the central server. The "Chip Card Administration" component deals with everything having to do with e-card and o-card issuing and administration. The certificates needed for signing consultations are generated and made available by the chip card suppliers. An integrated client administration allows for centrally controlled software updates. Another component is in charge of handling applications for medication requiring special approval.