The Ability Passport is an information system developed by CSI-Piemonte aimed to create a central digital repository of disability certifications for the Regione Piemonte supporting the Regione Piemonte Legal Medicine Services activity. The Ability Passport will be integrated with the national pensions institute (INPS), the regional tax office, local authorities, regional schools and job placement offices to help disabled citizens having the services they need avoiding paper certifications.

Policy Context

In June 2003, the Piedmont Region asked CSI-Piemonte to develop a network I.T. system to simplify access to services for disabled citizens. System deployment needed to be gradual and started during the first months of 2004. The project aim to build a central regional repository of disability certification and to develop a network of on line services within 2006. The repository must be accessible by the 22 Legal Medicine Services but is important to protect the citizen privacy restricting the access to certification class and disability percentage, the diagnosis access is restricted to the Legal Medicine Service that issued the certificate. The first deployment of the Ability Passport involved all the 22 Legal Medicine Services. The developing of the integrations with other institutions offering services to disabled citizens is scheduled in 2007 and 2008 according to a program issued by a steering committee including representative of the stakeholders.

Description of target users and groups

According to a report of ISTAT (Italian National Institute of Statistics)[1] about the 2% of Italian teenagers have disability related problem at school, the percentage of disabled rise the 5% between the adults and the 19% between the elders (over 65 years). The 2% of the disabled are forced to bed, about 2% have significant problems in walking, about 3% cannot have a normal life without help, the 1% of disabled are blind or deaf-and-bumb.

Description of the way to implement the initiative

The key aspects addressed by the Ability Passport can be defined as follows: - the number of certifications issued per year: more than 100,000; - the number of Legal Medicine Services in Piedmont: 22 local offices, including more than 70 medical commissions across the whole regional area; - other institutions to be involved in network development are the following: INPS (Italian NHSS), local authorities, hospitals, pharmacies, local health support groups and organizations; - the need to guarantee disabled citizens’ privacy, ensuring that each institution involved in the network may have access exclusively to the information required, avoiding indiscriminate access to the databank, in line with the national privacy legislation. The problems of the volume of data, the number of subjects involved, and the protection of disabled citizens’privacy led to the developing of the project using RUPAR Piemonte Network , which offers full regional coverage and ensures high-level reliability and security. Citizen privacy is guaranteed as all communications that take place on the network between the services, the Legal Medicine commissions and the central database are encrypted. Furthermore, suitable policies and practices are employed with regard to access and tracking operator activity on the system.

Technology solution

Given the need for reliability, scalability and cost effectiveness, and considering the time allowed for design and development before the first deployment (about six months), the technological model adopted is a three-tier infrastructure based on an Oracle database system, Microsoft business logic and TCP-IP network based interface. The system’s remote access point only requires a standard personal computer, with a recent web browser connected to the RUPARPiemonte network and a local or network printer. All data interchange is encrypted. The infrastructure is made up of two separate servers: the server database, with s.o. Unix and the application server, with s.o. Microsoft Windows 2000 Server. The database server holds the archives, while the application server holders the business logic and the interface. Both servers are on a private sub-network named Server Farm Regione Piemonte, with private addresses and protected by a firewall. Access is through a hardware system with a bridge between the Server Farm Regione Piemonte and RUPAR Piemonte, which the Legal Medicine services use to access the system. Technology choice: Proprietary technology, Standards-based technology

Main results, benefits and impacts

The first Ability Passport deployment phase leads to the implementation of a regional disability certification repository. By 2007, the system covers the 100% of the about 80,000 disability certifications issued by the Piedmont Region's Legal Medicine Services per year. The deployment of the Ability Passport is having a significant impact on the Legal Medicine Offices, it implies a new work organization, a good IT infrastructure and formation programs for employees. All these changes are to be introduced without compromise a day-by-day activity that is extremely important for disabled citizens. The work in the Legal Medicine Services is changing radically because the front end activity became more important and most of the request for certificates copies can be processed immediately and make available on demand, the back office work for archives search should be limited to old certifications not yet present in the central repository. Certification data should be typed directly by the medical commissions as the patient visit is going on, some certificate could be issued just at the end of the visit. Every Legal Medicine Service must have a good network connection to the Regional Public Administration Network (RUPAR), since all the work must be done on-line and all the working places must be equipped by up to date personal computer and network connection. On citizens side repository data will be extremely useful for disabled people only if it success in make easier the access to services. Logically, once the repository has been developed, the main future project developments will be the integration with bodies providing services, assistance, and financial assistance, such as: - INPS (Italian NHSS), to reduce the amount of time taken to receive disability allowance; - employment offices, to simplify and speed up work placement for the disabled; - regional tax office, to allow disabled citizens to receive automobile tax reductions; - schools, to simplify the procedure for special assistance for disabled students; - home help, to access data required for home health care and assistance; - local authorities, to request parking permits. The Ability Passport will become a key data repository for resource and activity planning at a regional level. It will also result in the implementation of a data warehouse system for regional and local administrations and for regional health care service management.

Return on investment

Return on investment: Not applicable / Not available

Track record of sharing

The PABI project was invited for presentation to eChallenges Awards 2004. The project has been presented in some regional and national conferences and events (as FORUM PA, Legal Medicine Conferences etc.). A statistical overview about disabled citizens in Piedmont based on the PABI Data has been published in the Health Observatory 2006 edited by Universita Cattolica di Milano.

Lessons learnt

Lesson 1 - Carefully analyse European, national and local regulations regarding disabilities and pay particular attention to their actual application in terms of procedures and forms. Lesson 2 - Separate system deployment into phases and adopt a methodology for field testing and fine-tuning before proceeding with each phase. Lesson 3 - Carefully coordinate system deployment and diffusion, avoiding as much as possible setbacks and errors which could be frustrating for the operators and/or citizens. Lesson 4 - Allow for feedback from operators and periodical system revision and updating. Lesson 5 - Allow for the setting up of a permanent commission made up of technicians, legislative experts, legal doctors, local authorities and disabled citizen representatives. Their job would be to guarantee that the system follows regulations and to coordinate development and integration with other local public administration I.T. systems. Scope: Regional (sub-national)