In January 2004, the Federation of Austrian Social Insurance Institutions commissioned Siemens IT Solutions and Services with implementing the TP1 subproject of the e-card project (operations center and terminal equipment software). Siemens was in charge of developing the customer specific software and the 2 operation centers, which are configured as high-availability systems. Subcontractors include IBM for setting up the operations center, and Telekom Austria for presentation and training services. After the doctor’s ordination pilot was launched on schedule in December 2004 and following successful pilot operations in three districts in Burgenland, roll-out for all of Austria commenced at the end of May 2005. Roll-out was completed by the end of 2005. After that Siemens provided, together with the SV-Chipkarten Betriebsund Errichtungsgesellschaft, fullscale operations for pproximately 12,000 contract partners (doctors, outpatient clinics, and health insurance funds). Every person insured under the Austrian social insurance system receives an e-card which, in a first step, replaces the paper health care vouchers used so far (a key and signature card compliant with ISO7816). The contract partners also get PIN-protected surgery cards, so called o-cards. The e-card system already furnishes the basis for applications needed by the Federation of Austrian Social Insurance Institutions in the future. The highperformance infrastructure has been designed to accommodate a broad range of follow-up projects, such as: Citizen card, e-government and e-Social Insurance Medication approval service Integration of hospitals Electronic Health Record (EHR), e-Health The back of the e-card acts as a European public health insurance card. The challenge Keeping to a very tight schedule Building up a high-availability operation center Top-level data and transaction security in line with BSI and ISO 7799 Future-proof, scalable infrastructure for new applications in the social insuran...