The 56th revision of the ASVG (Allgemeines Sozialversicherungsgesetz, Law on General Health Insurance) assigned the task to the Association of Austrian Social Insurance Institutions to create an e-card as a foundation for an electronic administration system (ELSY). Originally produced as a substitute for the health insurance voucher nowadays the e-card system does much more. Step-by-step paper-based processes were replaced by electronic solutions, cutting out unnecessary steps for patients and bringing administrative facilitation to healthcare providers. The Austrian e-card also contains signature applications and can be used as a citizen card. The main characteristic of the Austrian e-card is its keycard principle. The e-card does not contain software functions, it only holds identification data which are the access key for applications.