RISKID

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RISKID
logo
legal form non-profit registered association
founding 2012
founder Ralf Kownatzki, Christoph Fangmann, Heinz Sprenger, Michael Reichelt, Sabine Schwarz, Claudia Jacoby, Cord Neubersch, Marco Geiling
Seat Duisburg-Hamborn, North Rhine-Westphalia , Germany
main emphasis Detection of doctor-hopping / child protection
Action space Germany (all federal states)
people Ralf Kownatzki, Heinz Sprenger
Website www.riskid.de

The association RISKID e. V. is an organization that has set itself the task of improving intercollegial communication between paediatricians and adolescents . Especially the intercollegial exchange if child abuse is suspected is in the foreground. The term stands for RISKID RIS IKO K inder- I nformationssystem- D erm, which stands as a technical support system in the form of a database application, the doctors involved in RISKID available, must be why a distinction between the club and RISKID the technical system. The association was founded in Duisburg in autumn 2012 and continues the work of the RISKID pilot project , which had been organized by Duisburg 's pediatricians .

Goals of the association

The association has set itself the goal of uncovering doctor-hopping in the field of pediatric care for the purpose of covering up child abuse . The purpose of the association is to promote public health and public health care; likewise the promotion of crime prevention by preventing and combating child abuse.

The founding members of the association are mainly paediatricians and police officers who are confronted with the problem of child abuse on a daily basis.

The RISKID project

The background

The background for the start of the RISKID project was an investigation by the Duisburg police in 2005 into the death of five children.

Two of these cases were particularly tragic:

  1. At the age of six months, an infant died after prolonged abuse and because the parents starved him and finally killed him.
  2. The second victim, a four-year-old girl, was tied to the bed at home for a long period of time, locked up and tortured until she finally died of starvation and thirst from his numerous injuries.

Both children died at an age at which the statutory preventive medical check-ups U5 and U8 , respectively , were planned, to which the children had not been brought. In the second case, the legal guardians also frequently changed doctors ( doctor hopping ). Most recently, the child with its numerous injuries was locked in the apartment and no longer presented to a doctor.

Because of these incidents met in Duisburg paediatricians with prosecutors, the Forensic Medicine and the Criminal Investigation Department, to work out solutions that are designed to prevent the such cases. Initially, a verifiable preventive medical check-up was required for children , which in Germany has now been established in most of the federal states.

As a further means for the prevention and detection of child abuse , an internal medical information system was considered necessary, which should help the doctor to diagnose child abuse more accurately and earlier than previously possible through the timely exchange of medical findings. This is especially important when legal guardians who abuse their children switch doctors more frequently to cover up their abuse, which is known as doctor hopping .

Due to the second requirement, the RISKID information system was established in 2007 as a pilot project for internal medical information exchange in Duisburg. On the status of the RISKID project at that time and the information system used, numerous articles have appeared in various newspapers over the years, as well as reports on German radio. Unfortunately, however, the start of the project with its innovative approach to information exchange was quickly criticized due to data protection requirements , which was due to the way in which information was passed on in suspected cases of child abuse and the dissemination of diagnoses among doctors.

In order to meet the emerging requirements of data protection , a new database system was started in 2010 as an information system for RISKID, which is supposed to meet these requirements and only allows doctors to access data from their own patients. However, it is still possible to query the general existence of a patient in the database, only that, in the event of a hit, the inquiring doctors are only provided with the contact details of the doctor (s) previously treating. Whether and to what extent the doctors concerned then exchange information is entirely at their discretion.

Legal situation

Under the given conditions, it is for paediatricians absolutely necessary to obtain a consent of the parents before the storage of patient data in the database RISKID that legitimized an inter-cooperative exchange. In case of doubt, this means that doctors have to get permission from the abusers (here = perpetrators) to allow them to talk to colleagues about their patients, which corresponds to a paradoxical situation.

Doctors currently have the problem that they have to weigh between § 203 StGB (confidentiality obligation) and § 34 StGB (justified emergency) .

Political activities

In spring 2013, on the initiative of RISKID e. V. on the part of the CDU parliamentary group in North Rhine-Westphalia introduced a motion to the state parliament of North Rhine-Westphalia , which aims to create a legal situation at the state level that allows pediatricians to raise suspicions within the framework of the then applicable law of child abuse in their patients.

Going it alone in the state of North Rhine-Westphalia became necessary because the latest amendment to the Child Protection Act at the federal level did not make intercollegial exchange of paediatricians possible, but at the same time only gives doctors the opportunity to seek competent advice from the competent authorities in the event of suspected child abuse To get youth welfare offices of the respective communities.

The initiative in North Rhine-Westphalia has been supported since August 2013 by a legal opinion, which was drawn up by Guido Schmidt and Damian Schmidt and which confirms the legitimacy of an inter-collegial exchange of information between doctors in North Rhine-Westphalia. The experts justify this with § 9 II of the professional code of the Medical Association of North Rhine-Westphalia . Although this is not a law, § 31 HeilBerGNW (Heilberufegesetzt NRW) regulates that the duties of doctors are regulated by their professional code. Section 9 II of the professional code of conduct for doctors in North Rhine-Westphalia regulates a doctor's disclosure, insofar as this is “necessary to protect a higher legal interest”.

In order to ensure final legal security for doctors in North Rhine-Westphalia , § 9 II of the professional code of doctors is to be explicitly included in the medical professions law and applied here as part of a legislative initiative . RISKID e. V. actively supports this legislative initiative, which, according to its own admission, is currently meeting with the goodwill of the SPD , CDU and the Pirate Party in North Rhine-Westphalia.

The information system RISKID

The information system RISKID for paediatricians is operated by RISKID e. V. operated and administered. The database solution included is offered to general practitioners as well as clinics that treat children and adolescents. The system is also available to all other doctors who want to join the RISKID project. So currently (11/2013) z. B. also children's dentists and a laboratory for coagulation disorders are connected to the system.

The RISKID database system is used by doctors to save suspected or confirmed cases of child abuse . So all doctors have the opportunity to B. when introducing new patients to search for them in the database in order to either consult the pretreator (s) in the event of a positive result, or to examine the patient more closely. A hit in the RISKID database is not proof of child abuse, but it can confirm or confirm your own suspicion.

RISKID inquiry and result

Contents of the database

The basic data of a patient can be saved in the RISKID database by an authorized doctor. The principle is always that as little patient data as possible should be stored in the database. In order to be found in a later query, the following data must be entered as a minimum:

  • First name
  • Surname
  • Date of birth

Further data is not required.

Reasons for inclusion in the database

A patient is only included in the database if one of the four following criteria according to ICD-10 is met, there is a suspicion, or if evidence is provided:

  1. neglect
  2. Physical abuse
  3. Sexual abuse
  4. Mental abuse

Under certain circumstances, children at risk can also be stored in the database, if e.g. For example, child abuse has already been diagnosed in siblings , which is classified as "R" in the following list. This extension of the storage supplements the extended ICD-10 in RISKID , which is used in Germany in the outpatient area.

  1. A = exclusion
  2. G = confirmed diagnosis
  3. V = suspected
  4. Z = state after
  5. R = risk for

The criteria can optionally be included in the RISKID database as a combination.

Access to the data

Only doctors can register with the database, whereby the target group of the project are paediatricians . All other doctors who treat children are also very welcome. Authorities such as the police or the youth welfare office have no access to the database, as the relationship of trust between the doctors, their patients and the legal guardians must not be damaged.

Registration for participation

You can only register for RISKID via the riskid.de website. After submitting the registration form, the registering doctor will be informed by RISKID e. V. and the necessary access information is sent to him.

Costs and requirements for participation

There are no costs for doctors to participate. All you need is an existing internet connection and a PC to participate in RISKID.

The financing

The association finances its activities and the operation of the database 100% through donations and personal commitment of the association members.

Awards

The RISKID project and the two initiators Ralf Kownatzki and Heinz Sprenger received the Bul le Mérite award from the BDK in 2009 .

Web links

Individual evidence

  1. ↑ landtag.nrw.de (PDF; 79 kB) Application from the CDU to the state parliament of North Rhine-Westphalia
  2. ↑ cdu-nrw-fraktion.de ( Memento of the original from December 11, 2013 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. , Press release of the NRW-CDU from October 8, 2013 @1@ 2Template: Webachiv / IABot / www.cdu-nrw-fraktion.de
  3. ↑ Federal Child Protection Act. bmfsfj.de
  4. ↑ riskid.de (PDF)  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. (PDF; 246 kB), legal opinion by Guido Schmidt and Damian Schmidt@1@ 2Template: Toter Link / www.riskid.de  
  5. ↑ a b c Professional Code of the Medical Association of North Rhine-Westphalia. aekno.de
  6. ↑ a b Health Care Professional Act NRW. aekno.de
  7. ↑ Award 2009. Bul le Mérite by the BDK