Case Study Tablet PC for Health Applications Ingolstadt Hospital

Securing the authenticity and integrity of its electronic documents using handwritten signatures captured on a Tablet PC
The recent reform in the health sector requires German hospitals to reduce the time that patients stay in the hospital to a minimum as hospitals receive a case-based lump sum (until December 2003 hospitals received payments according to the patient's length of stay). Thus, it is no longer economical for the hospitals to keep the patient longer than necessary, e.g. no more weekend occupations where patients wait for treatment or dismissal on the following Monday.

Ingolstadt Hospital replaces its paper-based forms with a solution based on Microsoft Office Professional Edition 2003 and deployed on Tablet PCs. This reduces the amount of time spent for tasks that are not billable under the new law. Ingolstadt Hospital averages 25,000 emergency patient admissions each year, with up to 20 people concurrently receiving care in the emergency ward. The so-called DENA project was realized in a partnership with the medical sector of Siemens ICN. An extensive case study on this project was already published by Microsoft in 2003 (>> view Microsoft's case study).

Patient's data is captured on a Tablet PC in the emergency ward at admission thus avoiding media break costs and delays. Most of the existing paper based forms of the hospital are already standardized at all stations and institutions and will be replaced during 2004 with electronic documents using Microsoft InfoPath 2003. Data is exchanged via XML to existing sub systems in the hospital. Clearly structured information is accessible whenever and wherever required so that there is more time for diagnosis and treatment. Medical personnel will enjoy an extensive reduction in administrative tasks and a sustainable increase in productivity.

Starting from CeBIT 2004 the DENA application includes the option to capture and verify handwritten signatures (including their biometric characteristics) with a Tablet PC. Handwritten signatures are now providing integrity and proof of authenticity for documents in patient files. Signature capturing and verification is integrated using SignDoc® from the world's vendor for verification of signatures - SOFTPRO.

The immediate digitizing of signatures throughout the writing process using a Tablet PC offers security on a higher level compared to signatures captured on paper. Throughout the capturing process more information of a signature is extracted than meets the eye. These additional characteristics are completing the data set of the static signature image with biometric characteristics of a signature such as writing pressure and writing speed.

Every signature is unique. The unique combination of verification of static and dynamic signature characteristics deals with the natural variations of a signer's signatures.

Thanks to Tablet PCs and the integration of SignDoc, Ingolstadt Hospital is no longer required to print forms for signing purposes. "This closes the last gap in a fully electronic process." Dipl.-Ing. Thomas Kleemann, CIO of Ingolstadt Hospital, sums up: "We clearly prefer the handwritten signature to ensure the authenticity and integrity of documents. Signing a document is a process doctors, hospital staff and patients are familiar with and which does not have to be explained".

According to the experience of Mr. Kleemann there exists a lack of acceptance for solutions that use either chip cards, passwords or physical biometric characteristics (such as the finger print) for authentication. In the sensitive environment of documentation in a hospital the handwritten signature is by far the most appropriate method of authentication.