Country Profile: Austria

Given that Austria is characterized by a strong federalist structure, the Austrian healthcare system features a strong distinction between regional (Länder) and federal competencies. While healthcare in general is mostly subject to federal policy, the Länder are responsible for the organization of the individual hospitals

ICT use and eHealth strategy

In an EU-27 comparison, the use of ICT by Austrian healthcare providers is about average: while most GP practices are equipped with ICT equipment, the amount of practices with broadband Internet connections remains somewhat sub-par compared with the EU-27 average. The use of electronic patient data and Decision Support Systems is quite common in Austria, as is the electronic transfer of lab results.

While individual Austrian hospitals are managed on a regional level, health policy and eHealth strategy are a matter of federal policy. The Austrian Health Reform Act 2005 prioritizes the promotion of ICT in healthcare, and the national eHealth strategy - formulated the same year - elaborates on the central aims of Austrian eHealth policy:

• EHR: “ELGA”: Elektronischer Gesundheitsakt (electronic health record)
• e-Card: a health insurance / social security card with eID functionality
• Health information networks for citizens, HCPs and social security agencies
• IT process support mechanisms
• Health telematics services
• Decision support systems
• Tools for the analysis of data for science and research, planning, steering and transparency of services in the health sector
• Technical and organizational measures for data protection and data security

The e-Card, as the first manifestation of Austrian eHealth policy in widespread use, provides all beneficiaries of the healthcare/social security system with identification services as well as a streamlined means to settle accounts, and thereby making healthcare provision in Austria a safer and more efficient process. These services are enabled by the GIS network (Gesundheits-Informations-Netz, health information network)

The e-Card infrastructure does not, however, involve the storage of actual healthcare information of any kind. This is where ELGA, the Austrian EHR solution, will step in: ELGA’s objective is to provide a secure exchange platform for electronic patient information as well as services for:

• ePrescription (e-medication)
• e-radiology finding
• e-laboraty finding
• e-discharge letter

ELGA will not involve the central storage of all patient data. Instead, the service will only maintain a centralized registry indicating the storage location of individual-related health data.

The work group responsible for the ELGA (ARGE ELGA) is currently (2009) in the process of developing pilot implementations.

Legal framework

While the legal framework of eHealth in Austria is quite complex, only a few laws address matters of electronic healthcare directly: the Health Telematics Act regulates the electronic exchange of health data and includes strict provisions on data security and user authentication. Austria also has specific laws on electronic signatures and a strict framework for data protection and patient data documentation.

One of the distinguishing characteristics of the Austrian legal framework regarding healthcare is the fact that telemedicine is illegal: medical practitioners must carry out their profession personally and directly (“persönlich und unmittelbar”), thereby making the physical presence of the practitioner indispensable.