In one of the largest European private electronic patient record (EPR) deals to date Siemens and German private hospital group Rhoen Klinikum AG have agreed to implement up to one million web-based EPRs per year for the customers of Rhoen’s medical facilities.

The whole project covers at least 46 Rhoen hospitals as well as a number of outpatient clinics and general practitioners. Under the deal Siemens will provide its Soarian Integrated Care system.

Rhoen Klinikum AG is one of the three largest private hospital chains in Germany. Its announcement of plans to develop web-based EPRs follows similar announcements by rival groups.

Asklepios hospitals announced plans to develop a nationwide electronic patient record system a year and a half ago with Intel and Microsoft. In addition, Sana hospitals has just recently teamed up with GMD for an integrated electronic patient record system.

“We have agreed not to talk about the project volume in public, but in the end it is a very attractive deal for Rhoen”, said Dietmar Pawlik, member of Rhoen’s board of directors.

Pawlik told E-Health Europe, however, that the running costs are expected to be less than one million Euros per year.

“Rhoen hospitals are currently in charge of about 550,000 in-house patients annually. If the integrated EPR attracts an additional one thousand patients a year, Rhoen will have an additional turnover of 2.7 million Euros. This makes up for a rather quick return of investment.” He made it clear that he was talking about years rather than a whole decade.

Pawlik also told EHE that five of Rhoen’s 46 hospitals will get access to the integrated record system this year. The other hospitals, and the group’s outpatient clinics, will follow.

The IT system to be implemented is Soarian Integrated Care (SIC), an integrated electronic patient record solution that is compatible with a number of hospital information systems and with the IT solutions of the two major IT providers for doctors in private practice in Germany, CompuGroup and Docexpert.

SIC is the same software that is used for the Scottish eye screening programme, not to be confused with Siemens’ workflow-driven hospital information system, Soarian.

In fact, what lies beneath the label SIC is the architecture of the “Elektronische Fallakte” (“eFA”, electronic case record). eFA is an EPR-specification developed by the Fraunhofer Institute for Software and Systems Engineering (ISST).

It includes a standardised architecture and security infrastructure which is also used for the integrated EPR-projects of most other German hospitals, including Asklepios.

The eFA specification implies that medical documents are not stored on a central server, but remain with the individual hospitals or doctors. Each individual institution continues to use its own documentation system. SIC simply makes the decentralised data accessible with the help of a Master Patient Index

The whole system will be web-based in the beginning, as is the solution for the Scottish screening programme. However, Pawlik made clear to EHE that in time he would prefer to migrate onto a virtual private network.

Independently of the Siemens project, Rhoen is currently piloting an integrated EPR with VPN-access at Gießen university. The Gießen-VPN is run by T-Systems, so a Rhoen-wide T-Systems-VPN for a Siemens integrated electronic patient record looks like a possible future scenario.

As a novelty in Germany, the Rhoen EPR will be open to hospitals of other hospital operators. This means that regional integrated care scenarios can be realised involving different care facilities from different operators. Pawlik announced that later this year, the first of these electronic cooperation-schemes would go live.

Links ( This is the website for the EPR specification of Fraunhofer ISST)