Germany: Status Quo
Dr. Georg Heidenreich
IHE Deutschland e.V.
Many regional projects are underway, generally a high level of electronic
communication in healthcare
No nationally harmonised “center of gravity” for standards and certification
SDOs (DIN, HL7, IHE, ...) use as the platform to
develop and adapt specifications (4 meetings per year, free meals)
National health insurance card has been rolled out (
including a secure electronic patient ID and cryptographic functions, and a photo
of the patient
No central services at the moment
Projects scheduled for field trial 2014/2015: online patient demographics, digital signature for
healthcare providers, central services, card terminals, secure access components ("connector")
additional projects to follow: patient summary, secure point-to-point communication for providers,
services for electronic case records (e.g. provider registry)
Status in Germany
• GEMATIK ( is authority for specification and
approval of cards and “card terminals”
approval requirements are specified by gematik: testing and certification (by BSI and others)
approval and certification will further extend as the health card projects evolve, see above
for details see:
• Many decision makers are involved in the German healthcare telematics
infrastructure (TI) project
Shareholders of gematik: healthcare payor and provider organizations
Federal Ministry of Health, legal framework
Payors: Social security / insurance providers issue cards for insured persons
Hospitals / resident doctors / other healthcare providers: card-based ID and demographics used in
• Through its membership in EHTEL/ELO and HL7, gematik corresponds
Regional / National Issues ?
• “national issues” or “national topics”: YES!!!
language issues, DRG/ICD10, usability / process details, legal requirements, security methods, …
• Documentation in the national language
The documentation of the approval requirements (testing and certification of cards and “card
terminals”) at the moment is available in German language only
• What kind of support do you need from the project partners?
GEMATIK has established detailed processes for approval of infrastructure components.
It would be interesting to check if the GEMATIK processes and methods fit into the ANTILOPE
Deployment of IHE in Projects
• eFA – eFallakte e.CV. “The Case Record Association”
– eFA association membership consists of several hospitals
– IHE-Germany joins forces with German health IT vendor association bvitG
– Introducing IHE XDS and IHE XUA into an updated EFA-interface specification
• OR.NET - “Safe Medical Device networking in the OR”
Reliable control
Integration of earlier (diagnostic) documents
Comprehensive OR-Reports
ca. 40 partners from academia, medicine, manufacturers, SDOs
Funded IHE-Position (employee, ½ FTE) with University Heidelberg
Public funding from BMBF (Federal German Research Ministry)
•Steering Committee
Tour de Table
Vienna, 7 April 2014
Projects (2)
• Standards for e-procurement in Healthcare
– IHE-Profiles for broadening the scope of profiles in the PHARMACY
– Catalogs as of GS1, GHX, …
– Electronic integration with suppliers
– Coordinated by Univ. of Applied Sciences Niederrhein
– Funded IHE-Position (employee, ½ FTE) with University of Heidelberg
– Public Funding by BMWI (Federal Ministry of Economics)
Projects (3)
• Privacy Law-conformant Implementation of EHR
Use-Case-oriented approach
IT-Security below OSI Level 7, Specification of XACML-Policies
Examples for typical security-relevant scenarios
Open commenting / resolution for Ballot three
• Point-2-Point DICOM
– Using selected mechanisms of ITI
– Dr. Marc Kämmerer (VISUS IT) prepared it
– Open editing / commenting / resolution required
Prof. Dr. Björn Bergh, Univ. Heidelberg (User Co-Chair)
Dr. Georg Heidenreich, Siemens AG (Vendor Co-Chair)
Andreas Kassner
Caretakers: (by years of service)
• Dr. Frank Oemig - ITI
• Prof. Dr. Sylvia Thun, Christof Gessner - PHARMACY
• Daniel Flemming - PCC
• Stefan Müller-Mielitz - QRPH
• Dr. Patrick Lehti - RAD
• Katrin Berger - LAB
• Dr. Stefan Schlichting - PCD
• Prof. Dr. Gunter Haroske – PATHOLOGY
• Michael Onken, Technical Manager

State of the Art in Germany