eHealth Projects in Germany- funded by eTEN –

eMAC Meeting

German Federal Ministry of Economics and Labour (BMWA)

2005-05-12, Berlin

Best-Practice for eTEN Projects

Reinhold A. MainzFederal Ministry of Health and Social Security (BMGS)

Project Group Telematics - Electronic Health CardCoordination for eEurope, EU action plans and programmes, international activities

eTEN Programme:

Supporting market validation and implementation (of IST RTD results)

Reinhold A. MainzFederal Ministry of Health and Social Security (BMGS)

Project Group Telematics - Electronic Health CardCoordination for eEurope, EU action plans and programmes, international activities

32005-04-28

Objective Validation & deployment of public interest e-

Services

Orientation eEurope 2005 and beyond (iEurope 2010)* eTEN supports

implementation (no R&D or infrastructure support)

Themes eGov, eHealth, eLearning, eInclusion, Trust &

Security, services for SME’s

Procedure Calls for proposals* selecting the highest quality

within the available budget

Requirement - Trans-European dimension

- practical service demonstrationsbridge the gap between RTD and the marketplace: pragmatic, business, practical

42005-04-28

Some examples of good-practice eHealth projects –

funded by eTEN - with German partners

• Mobilalarm

• Netc@rds

• I2-Health

52005-04-28

MobilAlarm– A location-independent emergency service for older and disabled people

Slides from: Dr. Karl & Dr. Veli Stroetmann

empirica Institute for Communications- and Technology Research

Oxfordstraße 2, 53111 Bonn, Tel.: +49 (228) 985 3044, email: Karl dot Stroetmann at empirica dot com

62005-04-28

Supported by eTEN March 2004 - August 2005 Testing an innovative alarm service for

older, chronically ill and disabled people and all those concerned about safety while outside

Objective: prepare market role-out in EU

A Good Practice Case: The MobilAlarm Project

Validating European Mobile Alarm Services

for Inclusion and Independent Living

72005-04-28

Participantsempirica Technologieforschung GmbH (Bonn, DE)

Coordinator, private research & project consultancy

Attendo Systems GmbH (Ismaning, DE)

delivering device & service centre software

Telehealth S.L. (Valencia, ES)

Consultancy on ICT solutions for social services

Fundación Andaluzia de Servicios Sociales (Seville, ES)

public tele-assistance service provider

Attendo Response Ltd. (Rotherham, UK) private response service provider

Recontrol (Karlsruhe, DE)

private response centre

plus User Groups: Patients, Hospitals, Welfare, NGO, Police, ...

82005-04-28

The service will enable users to initiate an alarm call with a

specifically designed device.

On pressing the alarm buttons, a voice connection to a professional

service centre is established. The device calculates location

data by using the Global Positioning System (GPS) satellites and

transmits the position to the service centre: the operator needs

only one click for locating and mapping the user’s position on the

screen.

Service centre staff immediately calls people who can help.

Description

92005-04-28

On pressing alarm buttons: GSM voice connection to service centre

Location data calculation through Global Positioning System (GPS)

User location shown on electronic map on operator‘s screen

People who can help alerted immediately (relatives, neighbours, doctors, rescue services)

Service

102005-04-28

Specifically designed Size: slightly smaller than common

mobile phone Weight: only 100 gram Easy to handle: only five buttons Two lateral alarm buttons for being

pressed at once (simple but prevents false alarm)

Battery life of up to six days

Device

112005-04-28

The overriding objective of MobilAlarm is to test and evaluate the

technical, organisational and economic characteristics of this

trans-European tele-assistance service and to prepare its

accelerated roll-out in Member States.

Objectives

122005-04-28

Verification of regional user requirements & localisation of technology

Three test phases:

- Internal tests with service centre employees

- Small-scale pilot tests with real clients

- Large-scale tests with about 40-100 clients in 3 markets

Further tests with real customers will be conducted in the core stage of the project in spring 2005, allowing to adjust the device and service to particular user

requirements.

Tests in Germany, UK, Spain

Development of Deployment Plan

Methodology

132005-04-28

A current technical challenge is that the locating function cannot

work when the device is shielded from a sufficient number of

GPS satellites. This may be the case, for example, inside

buildings, in urban “building canyons” and in dense forests.

This problem of conventional GPS will be eased by a new

technology named Assisted GPS (A-GPS). By being assisted

through the mobile phone network, the device holders can be

located even inside buildings and other shielded locations with an

accuracy of five meters.

Technical Challenge

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Experienced project coordinator (proposal writing, contract negotiation, financial issues -> empirica)

Committed industry partner (-> Attendo) All elements of the value system included

(from device production to user groups) Intermediary for language translation and management,

if need be (-> Telehealth) One partner with experience in an eTEN project

Important issues for consortium composition

152005-04-28

Attendo had business idea but not enough resources for market testing

Representatives from empirica and Attendo knew each other from conferences (networking like EHTEL (http://www.ehtel.org))

Concrete project idea was developed, consortium formed (at least 2 independent partners in 2 Member States)

Proposal was written After acceptance: number of partners reduced, workplan

modified

History

162005-04-28

(1) Management

(2) Business and Deployment Plan

(3) Requirements extension

(4) Technical testing

(5) Trials

(6) Marketing

-> typical work packages of an eTEN project

Work packages

172005-04-28

Administrative workload has to be considered Deliverable writing takes much time and

requires trained people For most partners, an eTEN project is extra work =>

continuous professional project management indispensable

Important issues for day-to-day work

182005-04-28

Dissemination

MobilAlarm: eTEN project of the monthFebruary 2005

192005-04-28

Project website: http://www.mobilalarm-eu.org

Some project partners: http://www.empirica.com - http://www.attendo.de

e-mail: veli at empirica dot com

More information about MobilAlarm

202005-04-28

Netc@rds – Smart Card and Network Solutions for the

Electronification of the European Health Insurance Card

Slides from: Central Research Institute of Ambulatory Health Care in Germany (ZI), Herbert-Lewin-Platz 2,

10623 Berlin; email: rtavakolian@kbv.de; Tel.: +49-30-4005-2418

212005-04-28

FranceFrance

Austria

Denmark

Italy

Greece

Finland

Hungary

Czech

Slovakia

Slovenia

Declaration of Accession:

others welcome

A Good Practice Case: The N E T C @ R D SN E T C @ R D S Project Countries with participating

contract partners:

222005-04-28

Setting the field

• March 2002• Basic decision of the European Council in Barcelona for

a European Health Insurance Card (EHIC)• February 2003

• Proposal for gradual phasing of visual EHIC (2004) towards an electronic EHIC (2008)

• October 2003• Decisions No. 189, 190, 191, on introduction of the

visual EHIC• June 2004

• Start of roll-out of the visual EHIC

232005-04-28

Objectives of Netc@rds

• Online verification of insurance data to prevent fraud and misuse

• Fostering mobility of European citizens

• Simplification of procedures for involved institutions:

- Health insurance providers

- Healthcare providers

- Interstate clearance bodies

• Integration of electronic data sets for EHIC into national cards

• Contribution to interoperability of eHealth in Europe

242005-04-28

Work items of Netc@rds

1. Status survey and analysis on EHIC handling

2. Technical proposal based on the NETC@RDS-cases

• Proposal for electronic data storage on chip cards

• Suggestions on interoperable infrastructure components

• Demonstrator setup of a verification network

• Automated optical data capture of conventional EHIC

• Post-processing interface of EHIC data (XML Output file)

3. Strategic proposal for eEHIC introduction

252005-04-28

Private payment Fill-out form 80 or photocopy

EHIC and ID

Declare duration of intended stay by insured on form 81

Specify chosen insurance provider by insured on form 81

Treatment

Archiving form copies for 2 years

Certify identity by physician

Identity CheckPassport or ID-Card

Sending forms immediately to chosen health insurance

Patient arrives with EHIC

Not available

Prototype example of EHIC handling

262005-04-28

Case 4: datasetcaptured from eye-readable medium

(EHIC, paper)

Home CountryMember-State

Member State ofTemporary Stay

Case 2: dataset captured from chip card & server

Case 3: datasetcaptured from server

Case 1: dataset captured from chip

cardhealth

insurancedata server

Netc@rdsdataset

Netc@rdsdataet

Netc@rdsdataset

Netc@rdsdataset

Netc@rds-Cases1-4

272005-04-28

eEHIC in process model viewpoint

1. Access / Data capture – the individual data must be available on the health care site completely and correctly

2. Identification – the concordance of the ID-data with the patient are verified

3. Verification – the entitlements rights of the person are checked

Access

Data capture

Identification

Verification

Trustworthy dataset

An electronic European Health Insurance Card (eEHIC) is a process with the result of a trustworthy data set for

entitlement at the healthcare provider.

282005-04-28

Health insurance chip cards available in the Netc@rds pilots

France

Slovenia

Germany Austria

Italy (Lombardia)

292005-04-28

Summary

Online verification of entitlements rights

Replacement of paper forms

Contribution to interoperability

Interoperable dataset to foster electronic post-processing

Cost-effective extension to new card schemes

Simplified access to foreign healthcare systems

Fostering mobility of European citizens

302005-04-28

Project website located in France: please use a search machine

Co-ordinator of the German project partners: http://www.zi-berlin.de

email: rtavakolian@kbv.de

More information about Netc@rds

312005-04-28

I2-Health– A support action for an Interoperability

Initiative for a European eHealth Area

I2-HealthI2-Health

322005-04-28

Policy background

332005-04-28

eHealth services in Europe:

Dynamic development driven by

citizen demand Mobile citizens want to use eHealth services all other

Europe

Cross-border health care / European-wide services

Services used at home shall be available while staying in other Member States / countries

Use of specialiced centres in Europe

Systems (in Europe) must be interoperable

342005-04-28

Political targets

Mobility of citizens

Cross border e-Health services

European-wide e-Health services

Information about health and possible treatment and care, including

sufficient information to enable informed consent to treatment

European mechanisms to facilitate access to care in other Member States

and information about them

Patient empowerment

Patient-centred care

Efficiency and quality of health systems

352005-04-28

The challenge

The support of mobile citizens by european-wide or cross-border eHealth

services is only possible if similar local services are interoperable to each

other

aspects of interoperability are

legal and contractual framework, organizational agreements

technical connection of infrastructures like networks and middleware

services

standardized technical protocols for secure data transmission and

providing

agreements on structure, syntax, terminology, coding and

presentation of data

definition of the semantic of data and the given context and its

description by meta data

362005-04-28

Co-operation in Europe on eHealth

Transparency about national developments gives chances to learn from others

Finalized developments can be used by others to avoid reinventing the wheel example: framework architecture / specification of the German card

Co-operation backed by agreements on the policy level:European Interoperability Initiative, driven by the health ministries

372005-04-28

The EC eHealth Action Plan 2004Overview of actions with responsibility

by the Member States: 2005

Develop a national or regional roadmap for e-Health Deploying e-Health systems Setting targets for interoperability Setting targets for the use of electronic

health records Address issues such as reimbursement of e-

Health services

382005-04-28

The EC eHealth Action Plan 2004Overview of actions with responsibility

by the Member States: 2006

Common approach to patient identifiers Interoperability standards Health data messages Electronic health records Support and boost investment in e-Health

392005-04-28

Report of theHigh Level Group on Health

Services and Medical Care 2004to the Council of the European Union

Interoperability is the corner stone supporting citizens mobility and patient centred care

Appropriate structures for cooperation on information and e-health must be implemented

The needed resources must be secured

402005-04-28

eHealth Standardisation Focus GroupMain Recommendation

(2005)

Establish a platform with a mandate and the

necessary resources to facilitate co-

operation between European Member States

with support of the European Commission to

promote e-Health interoperability for the

mobile citizen

The Member States` Interoperability Initiativefor a European eHealth Area

Initiated byGermany, Austria, France, Norway, Slovakia,

The Netherlandssupported by

the EC

2004-06-01, Brussels

Member States`ministries of health

Interoperability Initiative

41

The Member States` Interoperability Initiativefor a European eHealth Area:

Supporting EC projects on the management level

InformalSteering Committee:

EHTEL Healthcare Authorities Governmental Group

I2-Health?

Member States`ministries of health

Interoperability Initiative

42

The Member States` Interoperability Initiativefor a European eHealth Area:

First supporting or proposed projects

InformalSteering Committee

Member States`ministries of health

Interoperability Initiative

I2-HealthTMA-Bridge Netc@rds ++ERA eHealth CA

...

BilateralProjectD – F

cross borderhealth cards

BilateralProject

ePrescription /medication

management

BilateralProjectA – D

connector ...

BilateralProjectD – NL

document WebSite

43

442005-04-28

Interoperability Initiative for a European e-Health Area – Support Action

I2-Health Support Action for the eTEN Programme

Slides from: Dr. Karl & Dr. Veli Stroetmann

empirica Institute for Communications- and Technology Research

Oxfordstraße 2, 53111 Bonn, Tel.: +49 (228) 985 3044, email Karl dot Stroetmann at empirica dot com

A Good Practice Case: The I2-HealthI2-Health project

452005-04-28

Interoperability of health information systems:

• “Member States have expressed the need to support actions that cover the development of standards addressing the interoperability of diverse systems and services and

• to explore in particular the possibilities of open source applications to achieve this objective. ...

• The exchange of experience in the use of open standards and open source solutions among health administrations in Member States should be promoted.”

Communication from the European Commission (COM(2004)356) 30.4.2004 “e-Health – making healthcare better for European citizens:

An action plan for a European e-Health Area”

Background

I2-HealthI2-Health

462005-04-28

Project start: 1 February 2005

Project duration: 24 month

Consortium: • empirica Institute for Communications- und Technology Research,

Bonn, Germany (Coordinator)Members to empirica:• Work Research Centre Ltd. (WRC), Dublin, Ireland• Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany (ZI), Berlin, Germany• Technical University of Košice (TUK), Slovakia

• European Health Telematics Association (EHTEL), Brussels, Belgium

Reports are given to:(Informal) Steering Committee of Member State Healthcare Authorities

I2-HealthI2-Health

472005-04-28

• Initiate a coordination process for accelerating the deployment of e-health infrastructures and functional applications which are interoperable for trans-European use

thereby

• Enabling cross-country, interoperable e-health applications

while

• Safeguarding appropriate data security and privacy requirements.

Strategic goal

I2-HealthI2-Health

482005-04-28

• Identify interoperability and connectivity issues and priorities, barriers and gaps, and solution approaches

• Focus on fundamental interoperability issues (identification of actors, organisations, adequate measures to achieve interoperability, integration tests and certification)

• Analyse similarly key topics relating to e-prescription and messaging

• Develop a roadmap and concrete projects involving all relevant actors - guided by an open discussion process amongst Member State Healthcare Authorities and stakeholder groups

Objectives

I2-HealthI2-Health

492005-04-28

Workpackage overview and interrelationships

WP

1 C

on

cep

tual

Fra

mew

ork

WP2 Analysis of infrastructure concepts and building blocks, services and applications

WP6 Management

WP4 Workflow interoperability, prescribing and messaging

WP3 Identification management of actors, organisations and system components;

fundamental interoperability issues,

WP5 Dissemination

I2-HealthI2-Health

502005-04-28

Expected results

• Report on European-level key e-health interoperability issues and activities needed to overcome barriers

• Identification management e-health interoperability issues: gaps and needs analysis, and solution proposals

• E-prescribing and messaging: gaps and needs analysis, and solution proposals to achieve interoperability of existing implementations

• European e-health interoperability plan and roadmap: enabling the Interoperability Initiative

• Policy level

• Management level

• Implemenation level

I2-HealthI2-Health

512005-04-28

Project website in preparation

Project coordinator: http://www.empirica.com

e-mail: veli at empirica dot com

More information about I2-Health

I2-HealthI2-Health

522005-04-28

What can we learn from good practices?

idea with a real market chance? idea supporting urgent political needs? idea has support from the political scene? idea pragmatic / practical? consortium partners from different EU countries? consortium partners with experience in EC funded

projects? consortium leader is well accepted by EC staff? industry and relevant stakeholders involved?

532005-04-28

Do you have questions?

Reinhold.A.Mainz@BMGS.Bund.DE

Tel. +49 228 941 3199

Many thanks for your attention!