CEO News #3
The Electronic Health Record – Part 2
The current discussion about potential computer chip vulnerabilities demonstrates how important a secure communications environment in healthcare is - a field which is about our most sensitive data.
Most recently, this was exactly what I discussed in my first CEO News.
Taking our responsibility seriously, we have examined the possible effects of potential vulnerabilities that have now become known on the Telematics Infrastructure (TI), just as gematik and the Federal Office for Information Security have done. With little surprise, everyone has come to the same conclusion: this danger is successfully warded off by the special architecture components of the TI.
To support the worldwide security level of the TI, I would like to inform you about the following:
The (still) little known but enormous impacts of the electronic health card (eGK)
1. The EHR as an infrastructure element
2. CGM LIFE security architecture (construction and USP)
3. CGM data model
4. Strategic line-up
5. List of applications in which CGM LIFE is integrated.
It depends on three things
In order for the electronic health records (EHR) to have their full effect on the insured as well as for healthcare as a whole, three prerequisites need to be created:
The data must be available in a confidential, integer, authentic, and natural way. Unauthorized persons may not read, modify or understand the data at any time.
The different authorized systems must be able to read, add, and process content further.
The data must be saved in a standardized form so that automated procedures can recognize or deduct medical facts securely and reliably.
What does that mean in detail?
The protection of sensitive health data is of paramount importance and our responsibility. It needs to be secure at all times, regardless of whether the doctor and the patient use, send, or store the data - and, of great importance from unauthorized third parties. We are aware of our responsibility. This is also demonstrated by the security architecture of our EHR, the CGM LIFE file.
In online banking, for example, the information between the bank and the customer is secure on the digital "route." That does not apply to the server of the bank. Employees of the bank can see them there. A manipulation by insiders, but also by third parties penetrating the systems is thus basically possible.
This is not the case with CGM LIFE: All health data is encrypted and digitally signed on site in the doctor's office or on the insured person's terminal (e. g. a smartphone). At no time will data be decrypted on the server of CGM LIFE. This is also not possible because we do not save any keys on our servers. This ensures that no unauthorized person can access unencrypted data. But we also make sure that no one can slip into the role of another and circulates data counterfeits.
Additionally: Due to our special, patented procedures, neither we nor other unauthorized third parties know the keys. Nobody, not even a state authority, will receive the keys and thus the plain text data via our CGM LIFE server. That is why we speak of a technical appropriation protection. Our patented procedures are so far unique in the German healthcare system. Again, to clarify: Neither CGM as the operator of the EHR, nor any third party can view the data or change it unnoticed. Even our administrators do not know the keys. Only persons who are authorized by the record owner can read the data. However, in this case, as well, only on a terminal running a CGM LIFE based application.
When other healthcare providers of health records promote their systems being secured in a state-of-the-art technique and end-to-end, it only applies to their weak point of key usage for rights management - because except for us - the owner or a representative is in possession of a less strongly encrypted key material. CGM LIFE is thus the only health record that gives the customer complete technical control over his data worldwide.
The electronic health record can only be effective if it is interoperable, thus ensuring barrier-free, cross-sectoral data provision. This requires a fundamental, common framework by the legislature, to which all record providers, but also all manufacturers of ambulatory information systems commit. Already today, there are standards such as IHE, which appear basically suitable. But they are far from sufficient. Especially when it comes to maintaining the highest standards of data protection. We are committed to meaningful and feasible solutions that do not compromise data security. In addition, we provide a technical solution that fundamentally and in advance enables this interoperability: the CGM LIFE partner-ready interface.
Only if the health data from an EHR can be used meaningfully, it can help to improve the patient's care.
CGM LIFE uses the CGM data model, which begins its "work" in the doctor's G3-based primary system. It gives the data a clear and uniform meaning. In addition to medication, vital signs and findings are also included. For example, when it is clear that entries are on various uniquely identified drugs, can an automated check for intolerance be applied. This is not precisely possible when based on algorithms and rules if the data is only loaded into the EHR as free text in PDF form. Detecting and communicating complex data structures will work without translation loss between CGM LIFE and our G3-based software systems in the future.
In order for non-CGM systems to be able to pass on their data to CGM LIFE in a structured manner, a common agreement of all parties involved, a syntactic and semantic standardization that applies to everyone, is required. However, to avoid having to wait, we provide an intelligent solution: The CGM LIFE partner-ready interface, with which we publish our data structures and interfaces and make them accessible to partners.
CGM LIFE is an important, if not the central building block, when it comes to the digitization of healthcare: It is the most important infrastructure component for the content-related networking of everyone involved in the treatment process, also in the context of the telematics infrastructure. AXA, Debeka, and VKB already offer their insured customers CGM LIFE today. Together with our CGM LIFE eSERVICES for the outpatient sector, more than one million patients in Germany already use a wide range of areas of our EHR to communicate with their doctor. Health insurance providers use our CGM LIFE eSERVICES to digitize processes such as appointment booking or prescription orders. As integration with primary systems progresses, so does a simple and automated exchange of structured medical data and documents with patients and between health insurance providers.
Where in Germany is CGM LIFE already integrated?
- The CLICKDOC doctor search, as a generally available portal based on CGM LIFE.
- CGM LIFE eSERVICES on the CGM LIFE platform, which allows patients the direct communication with their doctors and the common usage of applications with them.
- Direct connection of our primary systems for health insurance providers:
- AIS: CGM ALBIS, CGM M1, CGM MEDISTAR, CGM TURBOMED, CGM DATAVITAL
ZIS: CGM Z1, CGM CHREMASOFT
Pharmacies: CGM LAUER FISCHER
- AIS: CGM ALBIS, CGM M1, CGM MEDISTAR, CGM TURBOMED, CGM DATAVITAL
- Connection of hospital systems via CGM JESAJA.NET
- The "My health" portal for privately insured people uses CGM LIFE and is being used by insured people of AXA, Debeka, and VKB.
- CGM LIFE is also the basis for publicly funded projects such as the drug account NRW, TIME for emergency data management, and the health record for asylum seekers.
- CGM LIFE becomes an integral part of CGM CLINICAL.
- In addition to our own applications, CGM LIFE is open to third parties which focus on their own applications, such as mediteo with their medication app, which is part of our partner-ready program.
With CGM LIFE, we are not only very well positioned with respect to the competition, but we have the big picture in view: We synchronize healthcare!