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, HL7, IHE,...) use as the platform to develop and adapt specifications (4 meetings per year, free meals) National health insurance card has been rolled out ( 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 ( 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: 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 CommitteeTour de TableVienna, 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