Germany: Status Quo

Dr. Georg HeidenreichIHE 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, HL7, 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/zulassung/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 HL7, gematik corresponds with ANTILOPE

Regional / National Issues ?

• “national issues” or “national topics”: YES!!!– language issues, DRG/ICD10, 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.

• eFA – eFallakte e.CV. “The Case Record Association”– eFA association membership consists of several hospitals– IHE-Germany joins forces with German health IT vendor association bvitG– 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

Deployment of IHE in Projects

Projects (2)

• Standards for e-procurement in Healthcare– IHE-Profiles for broadening the scope of profiles in the PHARMACY

Domain– Catalogs as of GS1, 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 – eGA, EHR, pHR 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