1. Health Telematics Strategy of the German Bundeswehr
HL7 Working Group Meeting
1-6 May 2005, Noordwijkerhout, The Netherlands
Health Telematics Strategy of the German Bundeswehr
Bernd Blobel
Chair HL7 Germany, Co-Chair Security TC
Reinhard Bauske
German Military Medical Service

2. 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 cards by 2006
Introduction of electronic health records by 2008 (to be finished by 2011)

3. 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

4. eHealth Standardization Focus Group

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

6. 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.

7. 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

9. The German Health Telematics Platform – bIT4Health architectural framenwork and security infrastructure

10. bIT4health - 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 bIT4health 2003

11. Transformation of Architectural Framework to Solution
New Services
and Programs
Requirements
Architecture
Legislation
Architectural
Framework
Solution
Architecture
Transformation
Actual
Standards
Requirements
Partners
IT-System
Generic
Component
Specific
Component
Generic
Component
Specific
Component
Generic
Component
Specific
Component
Generic
Component
Specific
Component
© Copyright bIT4health 2003

12. bIT4Health Component Model
© Copyright bIT4health 2003

13. bIT4Health
ePrescription
Data Model
© Copyright bIT4health 2003

14. bIT4Health Component Model
© Copyright bIT4health 2003

15. bIT4Health Component Diagram
© Copyright bIT4health 2003

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

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

18. Room for Signature and further national elements
Pflichtelemente seitens der EHIC
Room for Signature and further national elements

19. Unterschriftenfeld
EU Decision
(2003/753/EG)

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

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

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

24. 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

25. EHR References
HL7 V3 / CDA
EN EHR communication
GEHR/openEHR

26. Contact: Chair: Office:
Bernd Blobel Ph.D.
Associate Professor
Head of the Health Telematics Group
Fraunhofer Institut Integrierte Schaltungen
Am Wolfsmantel 33
91058 Erlangen
Tel.:
Fax (Department Office):
Office:
Institut für Medizinische Statistik, Informatik
und Epidemiologie (IMSIE) Universität zu Köln Joseph-Stelzmann-Str. 9
50931 Köln
Telefon (0700)
Fax (0700)
Internet