SummaryIntroductionThe protocols developed by ITU-TE-Health protocolArchitecture of e-HealthX.th1X.th2 to X.th6Common Alerting ProtocolConclusion

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-TTwo protocols for e-Health and protection:

E-Health protocol X.th series (X.th1 to X.th6).Common Alerting Protocol X.1303.

E-Health protocolThe series of Recommendations contain:

o X.th1: generic recommendation.o X.th2 to X.th6: specific recommendations.

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

exchangeo it provides security with encryption

and integrity of data.

Definition of objectsDefines 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 protocolEach data contains two elements:• An ASN.1 object identifier• The data itself

Definition of messagesThree 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 sessionIt defines a dialog containing multiple steps.

This type of session has been designed for remote interventions.

The securityIt is based on CMS (Cryptographic Message Syntax) which is provides:• Integrity• Encryption

id-data (OID)

Data

id-signedData (OID)

Id-data (OID)

Data

signature

id-envelopedData (OID)

id-signedData (OID)

id-envelopedData (OID)

Encrypted symmetric keyEncrypted-data

Encrypted symmetric keyEncrypted 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 partsEach part defines:• Table of quantities, units and symbols.• ASN.1 information objects for quantities, units, and symbols.• Messages to transport the data.

Common Alerting ProtocolInitially 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 ProtocolCAP 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 alertA 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 parametersThe 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 encodingThe 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.

ConclusionThe 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.