Down the Pike September/October 2007

By Frank P. Nieto

Editor’s Note: Have you ever felt clueless about some of the new medical technologies your clinicians saw at their most recent conference? In this issue, the Journal of Healthcare Contracting launches “Down the Pike,” designed to offer contracting professionals a heads-up on some of the new technologies that may be coming your way.

Patient Health Card

Healthcare is a field that demands immediate access to secure information. Yet, because of the sheer volume of work generated by providers and the expenses tied to converting older information systems to more modern ones, such information isn’t always available. Rather than create all-new technology to solve the problem, Siemens adapted “smart card” technology for healthcare. In collaboration with Mount Sinai Hospital in New York, the company introduced the Patient Health Card to help caregivers quickly identify patients and gain access to critical medical information.

Siemens had previously used the Smart Card – which is a plastic card with photo ID and a computer chip that holds user information – to enable access to secure areas of buildings and computer networks. The user slides his or her card into a reader and enters a PIN. In the new, healthcare-specific version, the Patient Health Card holds up to 27 pages of patient data, which was judged by Mount Sinai’s admissions and emergency department staff to be the most critical at the point of access – demographic information, insurance, current medications, list of allergies, and recent lab test results. It can also store recent EKG studies for patients with heart ailments.

In addition to storing data that will speed up the delivery of appropriate care and help cut down on medical errors, the card is also HIPAA-compliant. “By its use, it is HIPAA compliant, since the patient’s consent is given by entering a PIN,” says Joe Camaratta, Siemens vice president, global solutions. In an emergency, if a patient is unable to provide his PIN, a hospital staff member can use a special card – which also has a PIN – to gain access to any Patient Health Card. All such emergency overrides are logged by Siemens to ensure that the override was necessary. The card itself has other security features, including data that is encrypted by the operating system to help protect it from attacks performed with electron microscopes, and protection against DPA (differential power analysis) attacks, as there are no public-key-infrastructure operations on the card.

The card is designed to only be updated by any hospital that is part of the network that issued it. Although any hospital with a smart card reader can access the information, it cannot update the information unless it is part of the network or system. This is said to promote loyalty to a hospital and a system.

The Patient Health Card requires Siemens software, but not the company’s health information system. In fact, Mount Sinai uses a different vendor’s information system. In addition, the provider must have a Smart Card reader, camera, card printer, and connection to a health information system in order to download allergy, medication and demographic information.

While the chip in the Smart Card is generic, the Siemens software will help keep it as up-to-date as possible, says Camaratta. “The way that you store information on the chip isn’t a function of the chip, but of the software. As we upgrade the system and upgrade the software, we will be able to add functionality.” For smaller systems and hospitals, the cards can be bought for $25 each, but for large systems requiring more than 100,000 cards, they can be bought through a licensing agreement.

To find out more on the Siemens Patient Health Card, visit

Frank Nieto is editor of Repertoire’s Dail-E News and Major Account News. U.S. LifeLine Inc. is the Carlisle, Pa.-based Information Division of MDSI, publisher of the Journal of Healthcare Contracting.