Germany Status Quo Dr Georg Heidenreich IHE Deutschland

Germany: Status Quo Dr. Georg Heidenreich IHE Deutschland e. V.

Overview • • Many regional projects are underway, generally a high level of electronic communication in healthcare No nationally harmonised “center of gravity” for standards and certification SDOs (DIN, HL 7, IHE, . . . ) use www. interoperabilitaetsforum. de as the platform to develop and adapt specifications (4 meetings per year, free meals) National health insurance card has been rolled out (http: //www. gematik. de/) including a secure electronic patient ID and cryptographic functions, and a photo of the patient – No central services at the moment – Projects scheduled for field trial 2014/2015: online patient demographics, digital signature for healthcare providers, central services, card terminals, secure access components ("connector") – additional projects to follow: patient summary, secure point-to-point communication for providers, services for electronic case records (e. g. provider registry)

Status in Germany • GEMATIK (http: //www. gematik. de/) is authority for specification and approval of cards and “card terminals” – approval requirements are specified by gematik: testing and certification (by BSI and others) – approval and certification will further extend as the health card projects evolve, see above – for details see: http: //gematik. de/cms/de/zulassungstart. jsp • Many decision makers are involved in the German healthcare telematics infrastructure (TI) project – – – Shareholders of gematik: healthcare payor and provider organizations Federal Ministry of Health, legal framework Payors: Social security / insurance providers issue cards for insured persons Hospitals / resident doctors / other healthcare providers: card-based ID and demographics used in reimbursement • Through its membership in EHTEL/ELO and HL 7, gematik corresponds with ANTILOPE

Regional / National Issues ? • “national issues” or “national topics”: YES!!! – language issues, DRG/ICD 10, usability / process details, legal requirements, security methods, … • Documentation in the national language – The documentation of the approval requirements (testing and certification of cards and “card terminals”) at the moment is available in German language only • What kind of support do you need from the project partners? – GEMATIK has established detailed processes for approval of infrastructure components. – It would be interesting to check if the GEMATIK processes and methods fit into the ANTILOPE framework.

Deployment of IHE in Projects • e. FA – e. Fallakte e. CV. “The Case Record Association” – e. FA association membership consists of several hospitals – IHE-Germany joins forces with German health IT vendor association bvit. G – Introducing IHE XDS and IHE XUA into an updated EFA-interface specification • OR. NET - “Safe Medical Device networking in the OR” – – – • Reliable control Integration of earlier (diagnostic) documents Comprehensive OR-Reports ca. 40 partners from academia, medicine, manufacturers, SDOs Funded IHE-Position (employee, ½ FTE) with University Heidelberg Public funding from BMBF (Federal German Research Ministry) Steering Committee Tour de Table Vienna, 7 April 2014

Projects (2) • Standards for e-procurement in Healthcare – IHE-Profiles for broadening the scope of profiles in the PHARMACY Domain – Catalogs as of GS 1, GHX, … – Electronic integration with suppliers – Coordinated by Univ. of Applied Sciences Niederrhein – Funded IHE-Position (employee, ½ FTE) with University of Heidelberg – Public Funding by BMWI (Federal Ministry of Economics)

Projects (3) • Privacy Law-conformant Implementation of EHR – – – e. GA, EHR, p. HR on IHE XDS Use-Case-oriented approach IT-Security below OSI Level 7, Specification of XACML-Policies Examples for typical security-relevant scenarios Open commenting / resolution for Ballot three • Point-2 -Point DICOM – Using selected mechanisms of ITI – Dr. Marc Kämmerer (VISUS IT) prepared it – Open editing / commenting / resolution required

Organisation Board: Prof. Dr. Björn Bergh, Univ. Heidelberg (User Co-Chair) Dr. Georg Heidenreich, Siemens AG (Vendor Co-Chair) CEO: Andreas Kassner Caretakers: (by years of service) • Dr. Frank Oemig - ITI • Prof. Dr. Sylvia Thun, Christof Gessner - PHARMACY • Daniel Flemming - PCC • Stefan Müller-Mielitz - QRPH • Dr. Patrick Lehti - RAD • Katrin Berger - LAB • Dr. Stefan Schlichting - PCD • Prof. Dr. Gunter Haroske – PATHOLOGY • Michael Onken, Technical Manager