HealthNet - National secure Healthcare ITC infrastructure

HealthNet Luxembourg is a secure telematic network for health care professionals in the Grand-Duchy of Luxembourg. Important efforts and investments, which can be capitalized in the HealthNet project, have been undertaken since 1988. Finally in September 1995, the pilot phase of HealthNet Luxembourg project was started. HealthNet was launched to develop and install a national, value added network offering telematic services to all professionals working in health care and/or social security. Since September 2005, HealthNet has been constituted in GIE (economic grouping of interest) by the government. A complete list of institutions that are involved in HealthNet are available at the web page: http://www.healthnet.lu/institutions/ . Today, all the hospitals of the Grand Duchy, some laboratories and around 200 physicians are connected to HealthNet, as well as the health insurance and the “Entente des Hôpitaux Luxembourgeoise” (EHL, the organization representing all the hospitals). Approximately 250 individual users (medical cabinets and small associations) also benefit from this service.

• Luxembourg Telecom (P&T, Luxembourg Telecom),
• Union de Caisse de Maladie (UCM, Union of Sickness Funds),
• Ministère de la Sécurité Sociale (The Ministry of Social Security),
• Ministère de la Santé (The Ministry of Health), and
• Several hospitals of Luxembourg.

HealthNet’s objectives are divided into two parts, namely clinical objectives and technical objectives.

The technical objectives are:

1. Telecommunication
   1. Local & wide area (national) networks
   2. Interconnection of all health professionals in Luxembourg even with their colleagues in France, Belgium, Germany and Switzerland
   3. Distributed client-server applications
   4. Archives & databases related to telemedicine
2. Data management
   1. Security
   2. Development of a security policy specific to HealthNet
   3. Computer & Network security
   4. Authentication & digital signatures
   5. Encryption
   6. Installation of Firewalls
   7. Physical Access
3. Ordered List Item
4. Quality and reliability
5. Sensitization and information of the healthcare professionals
6. Development
   1. Enabling the professionals working in HealthCare to integrate or to develop specialized applications in the areas of tele-radiology, laboratory results exchange, telepathology, etc.

The technical infrastructure, which has been built up together with the Luxembourg Telecom, relies as well upon an SDH (Synchronous Digital Hierarchy) Network running over single mode optical fibre as the “traditional” copper networks.

The clinical objectives are:

• Telemedicine, on national and international level
• Distributed Laboratories
• Resource Sharing
• National Patient File
• Education and continuous education
• Medical and biomedical research

• September 1995 – August 1996: Phase 1 (the pilot project) was defined,
• 31 May 1996: The contract was signed by the Minister of Health Johny LAHURE,
• October 1996: Complement to the phase 1 (phase 1bis) was defined,
• 18 December 1997: First draft of phase 2 was defined (phase 1, phase 1bis and phase 2 will be discussed in detail in the following sections),
• 1997 – 1999: Number of meetings between with the Ministers of Health Johny LAHURE and Georges WOHLFART are made,
• 16 November 1998: Complete version of phase 2 has been presented,
• September 1999: Contacts with the new Minister of Health Carlo WAGNER about the HealthNet project started,
• May 2000: Propositions to continue the phase 1bis until the end of 2000 are accepted. Then, phase 2 would be realized between January 2001 and december 2005,
• 2001: Phase 2, which will last five years, began with a view to consolidating the infrastructure as well as the services like; exchange of laboratory results between laboratories and physicians, electronic radiology index, etc.
• 21/22 May 2005: For the previous 8 years, the server room of Healthnet Luxembourg® was located in the former building of the CRP Henri Tudor. Since the University of Luxembourg needed the room, the whole equipment moved to its new location at the eBRC (Luxembourg Hollerich).
• 12 September 2005: The Minister for Health and the Social Security, Mars Di Bartolomeo, presented network GIE HealthNet .
• 23 December 2005: As HealthNet Luxembourg® will move to the GIE-HealthNet by mid 2006, a submission is prepared to seek a new provider, which will take over the technical support of the network, servers and applications. On 23 December 2005, a public European submission was started, where interested companies can submit their offers until 12 February 2006. The requirements specification is available at the CRP Henri Tudor.
• Future: Based on the current HealthNet infrastructure, many applications and services are thinkable to improve the usage of the network. By now, it is an optimal platform for extensive data exchange and services.

There are several clinical applications developed over the HealthNet for health care professionals. Some of them are still being developed and some of them are planned for the future. The existing applications are:

• LABO - Electronic Exchange of Laboratory Results: Application for the exchange of laboratory data
• CVC: Virtual Oncology Center
• CARA: Carnet Radiologique Electronique - Establishing a radiological record in electronic form
• ICD-10: ICD-10 viewer
• Mammo - Digitalisation of the National Breast Cancer Screening Program: Setting up an operational RIS-PACS system at the Ministry of Health
• Secure internet access
• E-mail (SMTP + Lotus Notes)
• On-line affiliation control (via Social Security)
• Transfers of accounting data (to Social Security)
• Hosting of a database to count infections that happen during hospitalization
• Network traffic statistics