Summary Introduction The protocols developed by ITU-T E-Health protocol Architecture of e-Health X.th1 X.th2 to X.th6 Common Alerting Protocol Conclusion

Introduction E-Health is an area rich and complex, so safety is an essential element in this type of technology because of the sensitivity of the data transmitted. Standard X.th offers this possibility of data transport including safety.

The protocols developed by ITU-T Two protocols for e-Health and protection: E-Health protocol X.th series (X.th1 to X.th6). Common Alerting Protocol X.1303.

E-Health protocol The series of Recommendations contain: o X.th1: generic recommendation. o X.th2 to X.th6: specific recommendations.

Architecture of e-Health Well endowed clinic in an urban area with expertise Consultant / Surgeon Video, surgical manipulator Voice Local medical team (probably in a mobile van) in another country or rural area Medical support team Surgical equipments Voice Mobile / satellite

X.th1 The framework The protocol is open and extensible : o it contains several categories of exchange o it provides security with encryption and integrity of data.

Definition of objects Defines information object classes to defined objects associated to: Patients Observers Laboratories Medical devices Medical insurances Medical staff Pharmaceutical staff Drug manufacturers Medical software Data records (dental, DNA)

Open protocol Each data contains two elements: An ASN.1 object identifier The data itself

Definition of messages Three types of messages: Setup message Send-and-ack Interactive

Setup message Type of communication Security mechanisms Usage of voice and video channels

Send-and-ack session The sender sends a message containing E- Health data. The receiver replies with either: an acknowledgment or an error.

Interactive session It defines a dialog containing multiple steps. This type of session has been designed for remote interventions.

The security It is based on CMS (Cryptographic Message Syntax) which is provides: Integrity Encryption

CMS : normal and signed data id-data (OID) Data id-signedData (OID) Id-data (OID) Data signature

CMS : encrypted data and encrypted and signed data id-envelopedData (OID) id-signedData (OID) id-envelopedData (OID) Encrypted symmetric key Encrypted-data Encrypted symmetric key Encrypted data signature

Encoding of messages BER: Basic Encoding Rules PER: Packed Encoding Rules for narrow bandwidth XER: XML Encoding Rules

X.th2 to X.th6 X.th2: physics X.th3: chemistry X.th4: biology X.th5: culturology X.th6 psychology

Elements defined in specific parts Each part defines: Table of quantities, units and symbols. ASN.1 information objects for quantities, units, and symbols. Messages to transport the data.

Common Alerting Protocol Initially developed by OASIS (Organization for the Advancement of Structured Information Standards) in April 2004 using XML (CAP 1.0). In 2007, this protocol has been completed with ASN.1 definitions and adopted as an ITU-T Recommendation for CAP 1.1 (X.1303).

Common Alerting Protocol CAP is a protocol for alerting people for various events. It is open and can be adapted by definition of profiles for local needs. It is compatible with emerging technology of data transmission. Compatible with encryption and signature. Support of images and audio data.

Main information of a CAP alert A CAP message may contain four categories for information: Identification parameters Information parameters Area parameters Resource parameters.

Identification and information parameters The identification parameters specify: identification of the message sender date time alert status (actual, exercise, test,etc) alert type (alert, acknowledgement, etc) The information parameters describe the event: category: fire, health, safety, etc. event: in human-readable text responseType: action needed (for example evacuate) urgency (expected, future, etc) severity (extreme, minor, moderate, etc) certainty (likely, possible, etc)

Area and resource parameters The area parameters specify the geographical area concerned by the alert which can be defined by: a polygon a circle an altitude A maximum altitude (ceiling). The information resources allow addition of more information: files URI.

Message encoding The ASN.1 module contains in ITU-T X.1303 can be used with any standard encoding rules. Two encoding rules are particularly used: XER (XML encoding rules): to be compatible with XML applications. PER (Packed encoding rules): useful for networks using narrow bandwidth.

Conclusion The protocols developed in ITU-T are appropriate for Radioactivity safety and security situations: CAP can be used to alert population of the situation and actions to be taken. E-Health allows remote tests and diagnostics and also remote prescriptions.