eHealth Projects in Germany - funded by eTEN

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eHealth Projects in Germany- funded by eTEN
eMAC MeetingGerman Federal Ministry of
Economics and Labour (BMWA)2005-05-12, Berlin

• Best-Practice for eTEN Projects

Reinhold A. Mainz Federal Ministry of Health and
Social Security (BMGS) Project Group Telematics -
Electronic Health Card Coordination for eEurope,
EU action plans and programmes, international
activities
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eTEN Programme Supporting market validation
and implementation (of IST RTD results)
Reinhold A. Mainz Federal Ministry of Health and
Social Security (BMGS) Project Group Telematics -
Electronic Health Card Coordination for eEurope,
EU action plans and programmes, international
activities
3

• Objective Validation deployment of public
  interest e-Services
• Orientation eEurope 2005 and beyond (iEurope
  2010)
• eTEN supports implementation (no RD or
  infrastructure support)
• Themes eGov, eHealth, eLearning, eInclusion,
  Trust Security, services for SMEs
• Procedure Calls for proposals
• selecting the highest quality within the
  available budget
• Requirement - Trans-European dimension
• - practical service demonstrations

bridge the gap between RTD and the marketplace
pragmatic, business, practical
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Some examples of good-practice eHealth projects
funded by eTEN - with German partners

• Mobilalarm
• Netc_at_rds
• I2-Health

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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. [phone], email Karl dot
Stroetmann at empirica dot com
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A Good Practice Case The MobilAlarm Project
Validating European Mobile Alarm Services for
Inclusion and Independent Living

• 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

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Participants
empirica 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, ...
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Description

• 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 users position on the screen.
• Service centre staff immediately calls people who
  can help.

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Service

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

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Device

• 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

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Objectives

• 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.

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Methodology

• 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

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Technical Challenge

• 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.

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Important issues for consortium composition

• Experienced project coordinator (proposal
  writing, contract negotiation, financial issues
  -gt empirica)
• Committed industry partner (-gt Attendo)
• All elements of the value system included (from
  device production to user groups)
• Intermediary for language translation and
  management, if need be (-gt Telehealth)
• One partner with experience in an eTEN project

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History

• 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

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Work packages

• Management
• Business and Deployment Plan
• Requirements extension
• Technical testing
• Trials
• Marketing
• -gt typical work packages of an eTEN project

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Important issues for day-to-day work

• Administrative workload has to be considered
• Deliverable writing takes much time and requires
  trained people
• For most partners, an eTEN project is extra work
  gt continuous professional project management
  indispensable

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Dissemination

• MobilAlarm eTEN project of the monthFebruary
  2005

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More information about MobilAlarm

• 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

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Netc_at_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_at_kbv.de Tel. [phone]
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A Good Practice Case The N E T C _at_ R D S Project

Countries with participating contract partners
Finland
Declaration of Accession
Denmark
Slovenia
Austria
Slovakia
France
Czech
Italy
Hungary
others welcome
Greece
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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

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Objectives of Netc_at_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

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Work items of Netc_at_rds

• 1. Status survey and analysis on EHIC handling
• 2. Technical proposal based on the NETC_at_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

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Prototype example of EHIC handling
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Netc_at_rds-Cases1-4
Member State of Temporary Stay
Home Country Member-State
Case 1 dataset captured from chip card
health insurancedata server
Netc_at_rdsdataset
Netc_at_rdsdataset
Netc_at_rdsdataset
Case 4 dataset captured from eye-readable
medium (EHIC, paper)
Netc_at_rdsdataet
Case 2 dataset captured from chip card server
Case 3 dataset captured from server
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eEHIC in process model viewpoint
Access
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
Data capture
Identification
Verification
An electronic European Health Insurance Card
(eEHIC) is a process with the result of a
trustworthy data set for entitlement at the
healthcare provider.
Trustworthy dataset
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Health insurance chip cards available in the
Netc_at_rds pilots
France
Germany
Austria
Slovenia
Italy (Lombardia)
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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

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More information about Netc_at_rds

• Project website located in France please use a
  search machine
• Co-ordinator of the German project partners
  http//www.zi-berlin.de
• email rtavakolian_at_kbv.de

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I2-Health A support action for an
Interoperability Initiative for a European
eHealth Area
I2-Health
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• Policy background

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eHealth services in EuropeDynamic 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

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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

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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

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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
  levelEuropean Interoperability Initiative,
  driven by the health ministries

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The EC eHealth Action Plan 2004Overview of
actions with responsibilityby 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

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The EC eHealth Action Plan 2004Overview of
actions with responsibilityby the Member States
2006

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

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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

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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
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The Member States Interoperability
Initiativefor a European eHealth Area
Initiated byGermany, Austria, France, Norway,
Slovakia, The Netherlands supported bythe
EC2004-06-01, Brussels
Member Statesministries of health
Interoperability Initiative
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The Member States Interoperability
Initiativefor a European eHealth
AreaSupporting EC projects on the management
level
InformalSteering CommitteeEHTEL Healthcare
Authorities Governmental Group
Member Statesministries of health
Interoperability Initiative
I2-Health?
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The Member States Interoperability
Initiativefor a European eHealth AreaFirst
supporting or proposed projects
InformalSteering Committee
Member Statesministries of health
Interoperability Initiative
...
I2-Health
TMA-Bridge
Netc_at_rds
ERA eHealth CA
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A Good Practice Case The I2-Health project
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. [phone], email Karl dot
Stroetmann at empirica dot com
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Background

• 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

I2-Health
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• 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-Health
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Strategic goal

• 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.

I2-Health
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Objectives

• 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

I2-Health
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Workpackage overview and interrelationships
I2-Health
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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-Health
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More information about I2-Health

• Project website in preparation
• Project coordinator http//www.empirica.com
• e-mail veli at empirica dot com

I2-Health
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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?

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Many thanks for your attention!
Do you have questions?
Reinhold.A.Mainz_at_BMGS.Bund.DE Tel. [phone]
3199