United Nations Public Service Awards Case Studies

The Main Association of Austrian Social Insurance Institutions is the umbrella organisation for all Austrian social insurance institutions. Among other things, it is responsible for publishing the so-called “Code of Reimbursement”, a list of all medicinal products which have a marketing authorization in Austria or the EU, a guaranteed supply and which are reimbursable. In order to keep this list up to date as regards scientific findings and practical experience, there must be a permanent exchange of information between senior clerks and specialized departments of the Main Association, consultants and representatives of the pharmaceutical industry and members of an independent Drug Evaluation Committee.

New legal provisions introduced in 2004 made it necessary to amend procedures and communication processes for drawing up and monitoring the list. Communication which had previously been mainly analog was to take place as of day X solely via the Web portal of the Austrian Social Insurance (www.sozialversicherung.at). This means that internal and external cooperative procedures had to be realigned. The Main Association saw itself faced with challenges of the technical, communicative, strategic, organisational and social kind. It reacted unilaterally by setting up a team of experts from various disciplines to establish an electronic workflow system. The team had to work under immense time pressure and on the basis of legal texts which had still not been clearly formulated.

The integration of the interests of very heterogeneous partners and requirements and diverse technical systems for the purpose of an optimal interface management was an immense challenge facing both the workflow modelling experts and the communication experts as well as the scientific experts of the Main Association. However, this challenge was met by means of a proactive cooperation with all partners, accompanying informative communication work and extremely transparent measures. All these measures led to success being achieved in just one year.

All new procedures for adding medicinal products to or amending data in the Code of Reimbursement have been fully digital since September 2005. Members of the Drug Evaluation Committee have also had electronic access to the records since January 2006. In the past six months, the experts have succeeded in evaluating and further optimising all business processes as regards workflow, interfaces and communication channels.

What is the initiative about? (the solution)
Due to the introduction of the new legal provisions and the resulting workload as regards organisation and content, the project “Institution-overlapping digital workflow for procedures to amend the Code of Reimbursement” was created. In the course of this project, all basic organisational, content-related and technical conditions were created to facilitate the timely implementation of the digital workflow. The first most important step was to set up a project team with experts for modelling the business processes, members of the competence centre “digital social insurance“, staff of the competence centre "archiving and process control“, staff to implement all digital business processes at the Main Association and to implement all interfaces for the technical infrastructure for digital social insurance, staff of the specialized department “contract partners pharmaceuticals” in the Main Association of the Austrian Social Insurance Institutions to design business processes and quality assurance, programmers to implement the internet applications and the workflow system in the Main Association and communication experts of the Association. Pharmaceutical companies were invited in the course of the project to extensively test the system and to contribute proposals to optimise the system. These proposals were analysed together with representatives of the pharmaceutical industry, solutions specified and then used for the productive system. A large number of further communicative measures taken prior to the conversion, such as offensive informative work by giving lectures and training courses, intensive surveys, supporting measures during and after the implementation phase, made it possible to solve the complex challenges at all levels. On conclusion of Phase I, all new procedures for adding drugs to or amending data in the Code of Reimbursement were converted to a fully digital business process on 01.09.2005. Digital access to the records for members of the Drug Evaluation Committee was installed in January 2006. In Phase II (1st half of 2006) and Phase III (2nd half of 2006), the business processes as regards workflow, interfaces and communication channels were evaluated and optimised. It became possible to react quickly and flexibly to current legal amendments. An important part of the project work which is still ongoing are the services provided for all institutions involved, i.e. service pages on www.sozialversicherung.at are continuously updated, a support desk records all digital or telephone queries concerning procedures, any operating errors or inappropriate program responses and arranges that the problems be solved or that the queries be answered within 24 hours.

Who proposed the solution, who implemented it and who were the stakeholders?
On conclusion of Phase I, all new procedures for adding drugs to or amending data in the Code of Reimbursement were converted to a fully digital business process on 01.09.2005. Digital access to the records for members of the Drug Evaluation Committee was installed in January 2006. In Phase II (1st half of 2006) and Phase III (2nd half of 2006), the business processes as regards workflow, interfaces and communication channels were evaluated and optimised. It became possible to react quickly and flexibly to current legal amendments. An important part of the project work which is still ongoing are the services provided for all institutions involved, i.e. service pages on www.sozialversicherung.at are continuously updated, a support desk records all digital or telephone queries concerning procedures, any operating errors or inappropriate program responses and arranges that the problems be solved or that the queries be answered within 24 hours.

Describe how and when the initiative was implemented by answering these questions
a. What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
The Main Association of the Austrian Social Insurance Institutions safeguards general social insurance interests and represents the various social insurance institutions in general matters. It also represents the Austrian social security system at meetings with similar institutions abroad and acts as contact for the health, accident and pension insurance institutions in international social insurance matters. In its representative capacity, the Main Association is responsible for publishing the Code of Reimbursement. This publication is specified by legal provisions. These provisions regulate the tasks of the Main Association for the publication of the list, determine the main features of the procedure and provide for the establishment of a second authority, the Independent Drug Evaluation Committee, to review the decisions of the Main Association. The detailed procedure for publishing the Code of Reimbursement is defined in legally regulated rules of procedure. Proceedings can be started either on application by legitimised representatives of a pharmaceutical company or by the Main Association itself. In the course of each procedure, the respective drug is submitted to a comprehensive examination by the Main Association. The objective of this examination is the evaluation of the drug from a pharmacological, therapeutic and health economic aspect on the basis of current scientific findings.

b. What were the key development and implementation steps and the chronology? No more than 500 words
Pharmaceutical companies were invited in the course of the project to extensively test the system and to contribute proposals to optimise the system. These proposals were analysed together with representatives of the pharmaceutical industry, solutions specified and then used for the productive system. A large number of further communicative measures taken prior to the conversion, such as offensive informative work by giving lectures and training courses, intensive surveys, supporting measures during and after the implementation phase, made it possible to solve the complex challenges at all levels.

c. What were the main obstacles encountered? How were they overcome? No more than 500 words
Prerequisite for the successful implementation of digital business models is a comprehensive e-government legislation. This has been realised in Austria in the last few years by enacting the Delivery Law, the e-Government Act and further accompanying laws. These laws define the prerequisites, procedures and legal consequences of digital communication processes between public bodies and their partners. Based on this, the project team “Digital Social Insurance” developed basic services for digital signature and authentication as well as legally valid digital delivery and implemented these under www.sozialversicherung.at. These basic services are developed and maintained centrally and placed at the disposal of all e-government applications in the Austrian social insurance system if and when the need arises. The digital signature makes it possible to confirm the authenticity and integrity of digital information and guarantees the identity of the person signing. Authentication means the process of proving access authorisation with the aid of a digital signature. A delivery service is an infrastructure to provide documents in digital form. As defined by the Federal Law on the Delivery of Official Documents, documents are not sent directly (by e-mail) but are deposited in an infrastructure specially designed for that purpose. The Citizen Card is a personal digital pass which allows the safe communication with authorities. The basis of the Citizen Card function are character strings (signature keys) with which one can sign digitally and in encrypted form. The Citizen Card combines the functions “safe, personal, digital pass” and “safe, personal, digital signature” and is an essential e-government component. With the basic services implemented and the various information pages on the Code of Reimbursement, the Austrian Social Insurance portal www.sozialversicherung.at becomes the main entrance for all external users of the digital workflow.

d. What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
More than 800 applications were dealt with from the beginning of the digital workflow on 1.9.2005 up to 30.10.2006. On the whole, more than 16,000 documents with a data volume of 8 GB had been managed in the digital system up to 30.10.2006. The workload of the groups involved has been reduced immensely as a result of the new form of communication. In the past, applications - which can consist of several hundred pages - had to been submitted by pharmaceutical companies twentythreefold and were then distributed to the members of the Drug Evaluation Committee. This committee had an average number of 32 applications to examine at each meeting! Projects of the magnitude of that of the e-workflow for the Code of Reimbursement are ideal for making the advantages of the medium Internet usable and transparent for a large user group. They will in future lead to a lasting change in forms of cooperation not only between government institutions but also with enterprises in the private sector, private citizens and other bodies. Dialogue and transaction instead of information, paperless communication, efficient digital administration tools, the smooth processing of complex transactions and fitting in with people’s needs are all factors which in future will characterise this type of communication.

Is the initiative sustainable and transferable?
The experience gained in the digital workflow project for the Code of Reimbursement can be transferred perfectly to projects also concerning communication via the Internet between different groups with heterogeneous interests. This applies not only to communication between government institutions and bodies themselves but also to communication with business enterprises and private citizens. The experience gained can also be transferred to the B2B sector; it was the maxims of this sector which also inspired the project team. The alignment of the project “Code of Reimbursement” to the policies of successful enterprises in the private sector makes it adaptable. The motto: Away from conventional hierarchic communication forms to communication at the same level on a partnership basis. Away from the confrontation with facts to service orientation, to alignment to the needs of all partners involved in the process. After all, the Austrian Social Insurance, as initiator of the project, has profited from this alignment. All opposition could be used constructively and the know-how and ideas of all parties can be taken into account. The “new“ alignment has proved to be so constructive that it is generally applicable to all projects in the e-government sector, no matter how large or small they may be. The experts of the Austrian Social Insurance hope that the know-how gained in the course of the project can also be utilised by other government institutions and they would be happy to advise other project managers. The project can provide valuable information wherever it is a question of modelling complex process steps and integrating heterogeneous digital and technical systems. The way the project team managed the changeover with operations still ongoing and the way they accompanied the whole project with manifold supporting measures, thus making the whole project possible, is certainly worthy of imitation and transferable to other projects both in the e-government sector and in the classic sector of e-business models.

What are the impact of your initiative and the lessons learned?
The new forms of communication between the Main Association of the Austrian Social Insurance Institutions and their partners have not only simplified previous workflows but also improved the cooperation between the partners. Today, processes are more efficient, more transparent and less problematic than in the pre-digital past. The intensive cooperation when modelling the individual process steps has led to optimised results. The digital workflow for the Code of Reimbursement enjoys a high degree of acceptance and trust both as far as the technology and the process steps as such are concerned. Moreover, the digital workflow has a positive influence on the fundamental way the pharmaceutical companies work. Data uploading, the uploading of electronic documents and the application of legally valid signatures mean that new organisational structures have to be set up. This results in tighter, quicker workflows. The organisational structures within the Main Association have also been adjusted to the digital models. Various work processes such as the receipt of documents, passing them on and processing them further, and the release of communicative measures are all possible today in optimised form. The efforts on the part of Social Insurance to solve the specific challenges of this project in an exemplary manner for all concerned and the orientation to classic B2B applications has led to a greater acceptance and implementation of new forms of technology in Austria - also beyond the social insurance sector. The project can by all means be described as being a key project as it shows the way from e-information to e-government. As pioneer, the project has indeed done quite a bit of educational work for further e-government activities and digital business models in Austria.


Institution Name:		Main Association of the Austrian Social Insurance Institution
Institution Type:		Public Organization
Contact Person:		Christian Schuller
Title:		eSV-CC Chief of Executive
Telephone/ Fax:		++43-1-711 32-1115
Institution's / Project's Website:
E-mail:		esv.cc@hvb.sozvers.at
Address:		Kundmanngasse 21
Postal Code:		1030
City:		Vienna
State/Province:		Vienna
Country:		Austria

The Problem

Solution and Key Benefits

Actors and Stakeholders

(a) Strategies

(b) Implementation

(c) Overcoming Obstacles

(d) Use of Resources

Sustainability and Transferability

Lessons Learned

Contact Information