If you are looking for a large market for smart cards, the healthcare sector offers huge potential.. Offering a combination of user friendliness, flexibility and information security, the technology is a natural choice for this area.

Europe leads the way in the introduction of the technology in health care, as it has with many other smart card initiatives. Three of the world's largest healthcare trials are underway in the region.

Also around the globe the Malaysian and Chinese Governments also are studying the potential of smart cards in their national health systems. The Electronic Patient Record The primary driver for using smart cards in health care is the electronic patient record (EPR), according to Dr. Francesco Sicurello, director of medical information at the research institute Consiglio Nazionale Ricerche in Italy.

Widespread implementation of electronic patient records has the potential to streamline processes and significantly reduce the overall costs associated with health care, according to Sicurello who spoke at the recent Cartes '97 smart card show in Paris. "Smart cards will become an important element in health care systems of the future," he says.

Once patient records are stored electronically rather than in traditional paper-based systems, their contents can be accessed more easily. Sicurello said time and resources were wasted when paper- based records had to be stored, accessed and transported between health care providers.

EPRs removed this inefficiency and smart cards played an important role in the process.

The concept of a patient data card (PDC) based created with smart card technology already is being implemented in Europe. Storing personal details and a limited amount of medical information, the PDC enables secure access to EPRs held on central databases, Sicurello says.

"The advantages are significant," he adds. "The PDC gives immediate access to centrally held medical records, streamlines administration and improves the speed of the insurance process.

Doctors end up being able to spend more time with their patients." European Projects Three major health care projects in Europe give an indication of the benefits and flexibility that smart cards offer the industry.

The Spanish government began the first phase of its Social Security smart card program in 1996. The objective is to reduce benefit fraud, such as false unemployment and disability claims.

"The use of smart cards represents a fundamental advance in making our service more accessible to citizens," says a spokesman for the Spanish Social Security Ministry. "Smart cards will enable multiple transactions with the Social Security to be carried out in a more secure manner, and their use can easily be extended to other services."

At health care centers, doctors can use the smart cards to access patient records via the country's new health care management computer network. This improves efficiency and allows automatic issue of prescriptions and reports related to sickness and maternity leave. Once implemented, the healthcare management network will comprise 3,300 local area networks connecting more than 21,000 personal computers. Eventually, Spain's entire population 32 million people - will be issued smart cards.

The first phase of the program is under way in the region of Andalusia where 7 million cards are being distributed and 633 kiosk terminals installed. The total cost of the first phase is $60 million. Biometrics Used In Spain The

project is one of the first to use biometric technology. The user's fingerprint is scanned and information stored on the card's chip when issued.

When users insert their smart cards into the kiosks, they are prompted to place a finger on a fingerprint reader. A comparison is made between the information stored on the card and the live fingerprint data. If verification is positive, the user is granted access to information on the smart card and the appropriate government services via the kiosk.

FNMT (Fabrica Nationale Moneta Timbres) is manufacturing the smart cards using Motorola {MOT} chips. The kiosk terminals were bought from AT&T GIS {T} and the biometric software element is made by Unisys {UIS} in Spain.

Phase two of the project is set to begin in early 1998 with 25 million smart cards. It is slated to be complete by the end of 1999. The French Project The second major European health care smart card project is taking place in France. The system offers two types of smart cards one for healthcare recipients and another for providers.

The new system is expected to streamline the provision of health care throughout France, says GIP CPS spokesman Jean-Franois Laporte.

French residents will receive an insurance smart card from GIE SESAM-VITALE, an organization of French health insurance companies.

Patients will present their smart card to the doctor at each visit and the doctor then will be able to access that patient's electronic records and check their insurance cover provisions, says Laporte. "There will be no more paper forms to fill in and the whole insurance process will be much faster."

The patient cards will contain identification information, such as family and beneficiary names, Social Security numbers, medical insurance details and the benefits to which they are entitled.

The first phase of residential program issuing one card to every family in France is slated to being in January and be completed by the end of the 1998. It will involve about 20 million cards, Laporte says.

In phase two GIP CPS will issue cards to doctors and other health care providers. A start date has not been set.

Cards for health care professionals will be issued by GIP CPS, an organization of government representatives, professional societies and user organizations, such as the French Federation of General Practitioners.

The cards will allow secure access to private medical information stored on centralized databases, to an E-mail system linking all health care providers and to secure facilities, such as hospitals, says Laporte. Additionally, it can generate electronic signatures for forms, he says.

Each professional card would contain the person's name, area of practice, identification number and electronic signature. Cards would be used in conjunction with personal computers installed in hospitals and in examination rooms. The Czech Card The Czech Republic perhaps has the greatest need to streamline its system with smart cards.. Under the country's health care insurance program, insurers issue their own identification card that residents present when obtaining treatment. The system generates high administrative costs and personal information often is incorrect.

So, the government is replacing the multiple cards with a single smart card issued to each citizen. The project began with a pilot using 10,000 smart cards, manufactured by German card producer ORGA Kartensysteme GmbH and containing chips manufactured by Motorola and SGS Thompson of France

"The pilot was successful and we expect that the project will be rolled out during 1988," says Karen Robertson, Motorola SPS marketing manager for transport and public service.

The cards used in the trial carried selected health insurance and identity details. This enabled faster delivery of health care services and provided instant access to key medical information, says Robertson. The project is expected to reduce administration costs and incidents of fraud.

Medical data, such as allergies, risk factors, vaccinations received, blood group, and organ donation preferences will be stored on the card at the user's request, Robertson says.

A section in the smart card's memory will be reserved for pharmaceutical information, including past treatment and previously prescribed medicines. Doctors will be able record details of treatments directly on to the smart cards. The system also has the capacity to include information. It is expected to involve more than 10 million cards. (Karen Robertson, Motorola, +44/135/556- 5000; Francesco Sicurello, Consiglio Nazionale Ricerche, +39 2/285-0001; Jean- Francois Laporte, GIP CPS, +33 144/533-655.) --IGAmEx Licenses Smart Cards To Others.