"The eFA optimizes the treatment process by supporting the networking of all health care service providers. In the process we intend to contribute applications which offer added value for other services such as the health card," explains Volker Wetekam, head of the Global Solutions Division of Siemens Medical Solutions. "The eFA initiative strengthens the position of the relevant service providers and reduces costs since the individual organizations are able to specialize more in their own areas of expertise if cooperation among themselves is facilitated. With this initiative we could become a trendsetter - not only in Germany but the world over."

RHÖN-KLINIKUM AG emphasized that it attaches particular importance to data protection and the consideration of existing systems and standards. "RHÖN-KLINIKUM AG was there right from the start, when the eFA came into existence and is one of the pioneers when it comes to deploying advanced information technology in the clinic area in Germany, which is also demonstrated by our teleportal clinic concept," explains Dietmar Pawlik, CFO, RHÖN-KLINIKUM AG, Bad Neustadt/Saale. "The fact that we will test the case file between two clinic operators as early as next month shows that we have designed our system as an open system right from the outset. We intend to network with other clinics working with various different systems, in order to provide services. In doing so we will achieve interoperability across sectors and institutions."

The Fraunhofer ISST presented the next steps for the eFA: The project is now to be realized across the board, as a joint initiative of the entire in-patient sector, with the implementation of the specifications being centrally coordinated. In this process the specifications will be enhanced continuously and - as has been done in the past - coordinated with other stakeholders such as gematik, VHitG and IHE. "The electronic case file specified by the Fraunhofer-Institut für Software- und Systemtechnik on behalf of the consortium is well on the way towards establishing itself as a solution for cross-facility and cross-sector communication in the German health care system. The fact that two clinic operators with various different technical systems will soon be able to exchange digital data demonstrates the potential of a manufacturer-independent specification," says Jan Neuhaus, Deputy Head of Business Communication Management of the Fraunhofer ISST.

When communication between physicians in private practices and the hospital is implemented electronically, this is done using portals developed by various manufacturers. In the future, patient treatment from the primary sector to admittance to and treatment in the hospital through to after-care is to be fully processed via the electronic case file. In contrast to the electronic patient file, the eFA only focuses on the relevant case of illness. This means that those involved in the treatment are only granted access to the data associated with the relevant treatment case and not to the lifelong file containing the patient's entire history. When giving their consent, patients are thus assured in very clear terms that the data is being used for one specified purpose.

The data itself can be viewed by all treating physicians, using a "FAT Client" or using a browser via SOAP (Simple Object Access Protocol) web services, while the data is generated and stored in the IT systems of the relevant service provider. There is no additional central data management; only references to the encapsulated data are generated. This data may only be viewed following authentication, for example by means of the Health Professional Card.

Electronic case file
The initiative for the development and establishment of electronic case files (eFA) enabling reliable and diagnostic-related data exchange between health care service providers, was launched by the private clinic chains Asklepios Kliniken, RHÖN-KLINIKUM AG and Sana Kliniken GmbH & Co. KGaA as well as by the Deutschen Krankenhausgesellschaft e.V. and the Fraunhofer ISST at the start of 2006. In the meantime this initiative was joined by further hospital operators such as the Universitätsklinikum Aachen, the Charité Berlin, the Klinikum Dortmund, the Helios Kliniken, the Städtisches Klinikum München, the Universitätsklinikum Tübingen and the Vivantes company. The initiative is actively supported by the IT industry which is currently testing the implementation and application of the eFA specifications in ten model projects. Furthermore, the providers of IT solutions for the health care system are actively involved in the enhancement of the specifications. Further information: http://www.fallakte.de http://www.isst.fraunhofer.de

eHealth at Siemens
The eHealth product range of Siemens Med comprises security components and the Soarian Integrated Care software in which a case-based concept has already been realized and implemented in the web-based electronic patient file (WebEPA) for RHÖNKLINIKUM AG. The upcoming eFA specification 1.2 has for the most part been developed in this software; the first peer-to-peer pilot with RHÖN-KLINIKUM AG and another partner is scheduled to take place in December 07.

About RHÖN-KLINIKUM AG
RHÖN-KLINIKUM AG is one of Germany's leading private hospital groups. It is committed to the highest standards of patient focus, combining superior quality and good value in its patient services. The company's objective is to build and operate hospitals, with attention clearly focused on acute hospitals at all care levels. When it went public in 1989, RHÖN-KLINIKUM AG became the first listed hospital group in the country. In fiscal 2006, the company achieved sales of almost Euro 2 billion as well as profits of Euro 180 million. RHÖN-KLINIKUM AG shares the values and goals of the German health system; its aim is to uphold the efficiency of this system on the basis of the maxim of "rationalization before rationing". RHÖNKLINIKUM AG currently comprises 46 hospitals (44 acute / 2 rehab) at 35 sites, with approximately 15,000 beds. The company employs more than 31,000 people at present. For more information, visit http://www.rhoen-klinikum-ag.com.

About The Fraunhofer-Institut für Software- und Systemtechnik ISST
The Fraunhofer-Institut für Software- und Systemtechnik ISST provides consultancy to companies and public organizations during the design, realization, introduction and operation of long-lasting information and communication infrastructures that are capable of evolving. In doing so the institute develops innovative concepts, technologies and procedures in software and system engineering. Its services range from the classical innovation consultancy and preparation of expert reports through to strategic cooperation ventures for the purpose of prototype development. The Fraunhofer ISST is currently actively involved, in particular, in the areas of health, building and living, public administration, automotive engineering and in industrial and logistics companies.

About Siemens Medical Solutions
Siemens Medical Solutions is one of the world's largest suppliers to the healthcare industry. The company is a renowned medical solutions provider with core competence and innovative strength in diagnostic and therapeutic technologies as well as in knowledge engineering, including information technology and system integration. With its laboratory diagnostics acquisitions, Siemens Medical Solutions will be the first fully integrated diagnostics company, bringing together imaging and lab diagnostics, therapy, and healthcare information technology solutions, supplemented by consulting and support services. The company is a single-source provider of solutions across the entire continuum of care - from prevention and early detection, to diagnosis, therapy and care. Siemens Medical Solutions employs more than 48,000 people worldwide and operates in 130 countries. According to U.S. GAAP, in the fiscal year 2007 (until Sept. 30th) Siemens Medical Solutions reported sales of 9,85 billion €, orders of 10,27 billion €, and group profit of 1,32 billion € (preliminary figures, unaudited). Further information can be found by visiting http://www.siemens.com/medical.