HL 7 Working Group Meeting 1 6 May

HL 7 Working Group Meeting 1 -6 May 2005, Noordwijkerhout, The Netherlands Health Telematics Strategy of the German Bundeswehr Bernd Blobel Chair HL 7 Germany, Co-Chair Security TC Reinhard Bauske German Military Medical Service

Basic Principles for the Military Health Telematics Strategy • The German military health telematics strategy follows completely the corresponding strategies in the civil sector • Introduction of health professional cards by 2006 • Introduction of electronic health records by 2008 (to be finished by 2011)

• Civil legislation and policies will be adequately applied to the military services • The military service EHR will be centralised contrary to rather regionalised or even local EHR in the civil sector

e. Health Standardization Focus Group

e. Health Europe Strategic Objectives Critical Applications • Improving access to clinical • EHR/EPR incl. EHR records architecture • Enabling patient mobility as • Electronic exchange of well as cross boundary health data incl. electronic access to health services transfer of prescriptions (e. Prescriptions) • Reducing clinical errors as • e. Prescribing with decision well as improving patient support safety • Digital imaging and related services requests and • Improving access to high result reporting quality information for both patients and health • Core Data Sets e. g. for professionals health surveillances • Improving efficiency of health services

Infrastructures to underpin applications • management of any principal’s identification, in the patient’s context including: – EU Health Insurance Card (enhanced by carrying medical data and providing cross-border access control facilities); – A common approach to patient identifiers; – Access control and authentication; • protecting personal information (based on PKI and data cards (tokens) for professionals and citizens/patients); • terminological systems for clinical records and medicines; • EU Health Data Cards.

Architectural Paradigms for Future-Proof Health Information Systems • Distribution • Component-orientation (flexibility, scalability) • Separation of platform-independent and platform-specific modelling • Separation of logical and technological views (portability) • Specification of reference and domain models at meta-level • Interoperability at service level (concepts, contexts, knowledge) • Enterprise view driven design (user acceptance) • Multi-tier architecture (user acceptance, performance, etc. ) • Appropriate multi-media GUI (illiteracy) • Common terminology and ontology (semantic interoperability) • Appropriate security and privacy services

The German Health Telematics Platform – b. IT 4 Health architectural framenwork and security infrastructure

b. IT 4 health - Project Objectives • Flexible extensible framework architecture for telematics applications in the healthcare sector with special emphasis to security and privacy • Emphasis on introduction of mandatory applications plus prioritised voluntary applications until 2006 © Copyright b. IT 4 health 2003

Transformation of Architectural Framework to Solution New Services and Programs Requirements Architecture Legislation Actual Standards Architectural Framework Transformation Solution Architecture Requirements Partners IT-System Generic Component Specific Component © Copyright b. IT 4 health 2003

b. IT 4 Health Component Model © Copyright b. IT 4 health 2003

b. IT 4 Health e. Prescription Data Model © Copyright b. IT 4 health 2003

b. IT 4 Health Component Model © Copyright b. IT 4 health 2003

b. IT 4 Health Component Diagram © Copyright b. IT 4 health 2003

Electronic Health Card Courtesy: Bruno Struif (Fraunhofer-SIT Darmstadt) Dr. Christoph Goetz (Kassenärztliche Vereinigung Bayerns) Dr. Stephan H. Schug (EHTEL Association)

Compulsory Elements of the e. HC Owner picture Card designation Standardized background design Card owner Insurance logo Braille card ID

Pflichtelemente seitens der EHIC Room for Signature and further national elements

(2 EU 00 De 3/ cis 75 io 3/ n EG ) Unterschriftenfeld

Endorsement Passport HP Data (Passport Data) Key Pair (Login) Card to Card PIN 1 Key Pair (Encryption) Key Pair (Electronic Signature) Attribute Certificates TTT (2003) PIN 2

Endorsement Passport Institutional Data (Passport Data) Key Pair (Login) Key Pair (Transport) Key Pair (Electronic Signature) Attribute Certificates TTT (2003) Card to Card PIN Form-Factor ID 000 (Plug. In)

German Healthcard • Compulsory – Insurance data – e. Prescription – EU Insurance Card • Optional – – – TTT (2003) Medication file Doctor‘s report Receipt Emergency data Electronic Patient Record

EN 13606 “EHR Communication” • This new standard has five parts: • Part 1: Reference Model • Part 2: Archetype Interchange Specification • Part 3: Reference Archetypes and Term Lists • Part 4: Security Features • Part 5: Exchange Models

EHR References • HL 7 V 3 / CDA • EN 13606 EHR communication • GEHR/open. EHR

Contact: Chair: Office: Bernd Blobel Ph. D. Associate Professor Head of the Health Telematics Group Fraunhofer Institut Integrierte Schaltungen Am Wolfsmantel 33 91058 Erlangen Email: bbl@iis. fraunhofer. de Tel. : +49 -9131 -776 -5830 Fax (Department Office): +49 -9131 -776 -588 Institut für Medizinische Statistik, Informatik und Epidemiologie (IMSIE) Universität zu Köln Joseph-Stelzmann-Str. 9 50931 Köln Telefon (0700) 7777 6767 Fax (0700) 7777 6761 Email info@hl 7. de Internet www. hl 7. de