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Card Technology in Healthcare in U.S.A.

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Select data fields (ID, Administration, Emergency, provider, treatment locations, ... The industry has 60 days in which to comment. ... – PowerPoint PPT presentation

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Title: Card Technology in Healthcare in U.S.A.


1
Card Technology in Healthcare in U.S.A.
  • Daniel L. Maloney
  • Director, Emerging Technologies
  • Department of Veterans Affairs, VHA
  • Silver Spring, MD., U.S.A.
  • daniel.maloney_at_med.va.gov
  • http//www.va.gov/
  • http//www.va.gov/card/

2
Overview
  • Overview of Healthcare Card Projects in the US
  • What is the VA doing?
  • Major Influencing Events
  • Future Vision

3
Western Governors Association Health Passport
Project
  • Objectives Improve Delivery of Benefits
  • Lower Administrative Barriers to Care, and
  • Improve Data sharing Between Programs
  • RFP for system with 25,000 cards awarded in June
    97
  • Phased launch began in May 1999
  • Locations - Nevada, North Dakota, Wyoming
  • Preventative Health Care Programs
  • Womens Infant and Children (WIC)
  • Medicaid Eligibility (EPSDT)
  • Immunizations
  • Head Start
  • Maternal and Child Health
  • URL http//www.westgov.org/hpp

4
Secure Collaborative Telemedicine Over Public
Networks
  • West Virginia University in Morgantown, West
    Virginia under NLM Grant
  • Secure and private Telemedicine involves policy,
    administration, regulation and technology systems
  • Building on standards including G-8 1996
  • Health professional cards are required for use of
    secure Telemedicine applications
  • Includes role-based information access to data on
    patient cards
  • Emergency room physicians will have web based
    access to their patients electronic medical
    records
  • Authentication based on Digital Certificates
    (PKI)
  • URL http//www.cerc.wvu.edu/nlm/telemedicine.html

5
Department of Defense
  • Navy deploying smart cards
  • DoD decision to convert ID card to smart card
    with PKI as a function (Nov 10 1999 memo)
  • MARC
  • Multifunction and Multitechnology card
  • Testing in Hawaii and used for deployment
  • 50,000 cards in use
  • Smart Card, bar code, magnetic stripe, picture,
    signature block and embossed characters
  • Non Medical Functions include manifesting and
    deployment, food services and security
  • Medical Information includes Identification,
    Emergency Data, Blood Type, Immunizations,
    Allergies and Registration
  • DoD defining applications and planning the next
    generation of MARC
  • Highly successful program

6
Department of Veterans Affairs - Patient Card
Upgrade
  • Rollout began in Dec 1996, finished in April
    1997, Planning began in Dec 1993
  • Upgrade cards from simple plastic embossed card
  • New cards have printed and embossed
    information, magnetic stripe, bar code, black and
    white picture
  • Function as identifier and carrier of small
    amount of information
  • Speeds patient look-up on medical information
    system, allows mini registration
  • Personalized at facility, 2.5 million cards first
    year
  • magnetic stripe - date of birth, period of
    service and service related disabilities
  • Enhancements are planned

7
The Veteran ID Card
  • Photo Image
  • SC Indicator
  • Barcode
  • Embossed Info
  • Name
  • SSN, DOB
  • MAG Stripe
  • 1-800 Number

8
Department of Veterans Affairs - Home Healthcare
Initiative- Design Stage
  • Store commonly needed data on card to improve
    communications between different home health care
    providers
  • Always available to home health care provider
  • Also to be used at Emergency rooms and health
    care providers offices
  • Use of portable devices to read and update
    patient card
  • Begin in late 1999

9
Department of Veterans Affairs - Pilot of Secure
Access from Internet
  • Strong Authentication with smart card to control
    access from Internet to selected VA networked
    Resources
  • Levels of Control by person, by target resource
    (system, directory, file or URL), and by protocol
  • Pilot began in May 1998
  • 60 users for telnet, web access, FTP, Exchange
    mail, pcAnywhere, Citrix
  • Some users from other government agencies and
    business partners
  • Plans to migrate to system that uses PKI

10
Department of Veterans Affairs - VA / DoD
Multi-application Initiative- Planning Stage
  • Lab prototype of G-8 /Netlink compatible card
  • Reviewing Technical Interoperability Standards
  • Reviewing Medical Emergency Data Standards
  • Building interoperability prototype
  • Campus style multi-application card
  • Healthcare Functions - Identification of patient,
    data sharing and possibly electronic cash
  • Site Selected is Hawaii
  • Select potential applications (registration,
    emergency, contract provider, access, finance)
  • Select data fields (ID, Administration,
    Emergency, provider, treatment locations, keys
    and cash)
  • Initiate Pilot in of 2000

11
VA PKI Pilot
  • Established VA wide project to investigate and
    implement VA PKI
  • Steering Committee to advise project
  • Participate on Federal PKI Steering Committee
  • Drafting Decision documents and policy
  • Initial Capabilities Demonstration
  • Issuing VA Branded public keys / certificate
  • testing secure electronic mail
  • demonstration of certificate based access control
  • demonstration of digitally signed forms and data
  • supporting pilots

12
Influencing Events
  • The Web
  • HIPAA Act
  • Microsoft support of smart cards
  • American Express Blue Card - the first nationally
    available credit card with a computer chip
  • Washington Metro rechargeable chip card

13
Influencing Events
  • Health Insurance Portability and Accountability
    Act of 1996 (PL 104-191) - HIPAA (URL
    http//aspe.os.dhhs.gov/admnsimp/)
  • HHS responsible for identifying or developing
    EDI, privacy and security standards
  • Standards Groups have accelerated activities
  • Privacy Guidelines - HHS published new Heath
    Information Privacy Regulation as mandated by
    HIPAA. The industry has 60 days in which to
    comment.
  • Health Care Financing Administration - HCFA
    Internet Policy (URL http//www.hcfa.gov/ )
  • National Research Council report For the Record
    Protecting Electronic Health Information - March
    5, 1997
  • password or PIN in conjunction with a token
  • U.S. General Services Administration (GSA)
    Government wide contract for cards and card
    Services from the GSA Smartcard technology
    program (URL http//smart.gov/ )

14
Influencing Events
  • Digital Signature
  • Government Paperwork Elimination Act (GPEA) (URL
    http//www.whitehouse.gov/OMB/fedreg/gpea.html )
  • electronic business transactions
  • electronic signature
  • State digital signature legislation

15
Influencing Events
  • PKI
  • Federal PKI Steering Committee (URL
    http//www.gits-sec.treas.gov/oofpkisteer.htm )
  • Tunitas Groups Healthcare PKI Project - (URL
    http//www.tunitas.com/pages/PKI/pki.htm )
  • Connecticut Hospital Association - CHA (URL
    http//www.chime.org/ )
  • American Society for Testing and Materials (ASTM)
    E31.20 Healthcare PKI (URL http//www.astm.org/)
  • E31.17 Privacy, Confidentiality and Access
  • E31.20 Data and System Security for Health
    Information
  • GSA ACES contract (URL http//www.gsa.gov/aces/ )

16
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17
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