TV magazine- ServiceZeit Gesundheit - topic week "surveillance society"
The electronic health card
The term electronic health card means the entire infrastructure, which connects the national health care (doctors, pharmacies, hospitals, rehabilitation as well as health insurance funds). In detail: The server to store the patient details, internet access in doctors practices and pharmacies and the health hard itself with its integrated chip.
Some obligatory functions of the electronic health card have already been implemented, like the storage of insurant details, coverage within the european foreign countries as well as the electronic prescription. In future, voluntary functions like the emergency data set , pharmaceutical documentation and the electronic patient records should be implemented.
potential of the technology
The electronic health card aims at different goals: The administrative communication within the health care system should be advanced and the supply of medical data should be improved. Another goal is to reduce the costs which are caused by the media break, for example when issuing a prescription, adverse effects of pharmaceuticals or when receiving a two-way treatment. But as we all know technical advancement also causes new threats and conflicts.
risks concerning the surveillance society
The problems regarding the electronic health card can be distinguished by two factors: factor human and factor technology.
All parties participating on the infrastructure, like doctor's practices or pharmacies, are connected with each other and therefore are always online. This involves the risk that others may get access to the computer system and manipulate, extract or compromise the user data.Indeed patient details are encrypted on storage and during transmission at a high level of security, but there are still some security risks. One possible attack would be to bypass the regular re-encryption of the data with stronger encryption methods.
That means an attacker who has access to encrypted patient records may store them locally and therefore is able to avoid the re-encryption. In our days computer systems are becoming more and more powerful. In thirty years this may enable us to decrypt most of the,in these days classified as secure, data with an reasonable and economic effort. The data of a todays twen are still interesting in thirty years.
Another issue when talking about the surveillance society is the aspect of informational self-determination. The agreement to use the electronic patient record is voluntary, but the patient doesn't exactly know the location of his sensitive patient details in the infrastructure. Data management is realized through private operators and therefore the patient has to rely on a unknown person. Another potential risk would be if the government has the possibility to access patient data, by the help of amendments. An example from the past is the banking secrecy.
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