ITU-T Work on Standardizing e-Health

1. Joint ITU-WHO Workshop on e-Health Standards and Interoperability(Geneva, Switzerland, 26-27 April 2012) ITU-T Work on Standardizing e-Health Masahito Kawamori Rapporteur, ITU-T Q28/16 NTT masahito.kawamori@ties.itu.int

2. ITU-T • ITU-T is working on e-health standardization from the perspective of general ICT infrastructure, such as future networks, multimedia, and biometrics and security. • Requirements and network capabilities for E-health monitoring services (SG13) • Multimedia Framework for eHealth Applications (SG16) • Telebiometrics (SG17)

3. Main results to date • ITU-T has produced the following Recommendations and documents. • ITU-T Rec. X.108x series on telebiometrics, including security, authentication, interfaces, API and protocols. • Y.EHM-reqts (draft) “Requirements and network capabilities for E-health monitoring services” • HSTP.EHMSI (draft) “Multimedia Service and Interfaces for e-health ” • ITU-T TechWatch Report “E-health Standards and Interoperability”

4. Future activities • ITU-T is working on the following items • ITU-T Focus Group on M2M Service Layer - To study requirements and specifications for a common Machine-to-Machine (M2M) Service Layer with the initial priority on e-Health • IPTV and mobile application for e-health • Application Challenge on IPTV Apps for e-health • Requirements and network capabilities for E-health monitoring services

5. Contact details for further info • Masahito Kawamori, masahito.masahito@ties.itu.int • Links to general and/or specific web resources • http://www.itu.int/en/ITU-T/studygroups/com16/ehealth/Pages/default.aspx

6. [Optional]Additional slides

7. Relevant Links • www.itu.int/itu-t/recommendations/ • http://www.itu.int/ITU-T/studygroups/com17/sg17-q9.html • . 7

8. ITU-T Study Group 16 • Lead group on Multimedia issues • Received Emmy award for its H.264 codec Recommendation • Studies issues such as e-health, accessibility, IPTV, video-conferencing, wireless multimedia, etc. 8

9. ITU-T Q28/16 • focuses on standardization of multimedia systems to support e-health applications. • achieve interoperability among systems and to reduce the cost of devices through economies of scale. • provide the environment for harmonization and coordination of the development of a set of open global standards for e-health applications.

10. Q28/16 Study Items • Identification of users' requirements • Multimedia framework (including overall concept) for e-health applications (and telemedicine, in particular) • Roadmap for e-health (including telemedicine) standards • Generic architecture for e-health applications (and telemedicine, in particular) • Specific system characteristics for e-health applications (e.g. video and still picture coding, audio coding, security, directory architecture, etc) • Considerations on how to help measure and mitigate climate change

11. Q28/16 Study Items (cont.) • Creation of Glossary of e-health (telemedicine, in particular) • Methods for inputting, transmitting and processing data for e-health (telemedicine, in particular); • Databases and knowledge-bases of information and expertise on, and technologies for, e-health (telemedicine, in particular) as well as consultants and specialists, and potential customers of e-health (telemedicine, in particular). • Mechanism for querying, finding, identifying, and categorizing consultants and customers in the area of e-health (telemedicine, in particular) • Personal terminals for e-health (telemedicine, in particular)

12. New Work Items E-health on IPTV: e-health, among other e-services, is a good application of IPTV. Mobile e-health: There are actual products using mobile terminals in the market, but they use proprietary solutions. Unified interfaces for telemedicine/e-health are needed. Wearable and sensor networks Networked vehicle (e.g. in an accident) in an emergency response (e.g. by an ambulance) situation Accessibility and e-health, it was pointed out that accessibility should be closely tied to e-health

13. E-health Apps Server IPTV widget Consolidated reports Phone working as gateway Normal programme Blood pressure meter © I2R, NTT © I2R, NTT Pedometer Scale

14. eHealth Apps on IPTV © I2R, NTT • This prototype eHealth App on IPTV • Collects health data from healthe care devices such as pedometer and blood pressure moniter in standard format and displays its graph on TV • Allows the user to send the data to the doctor via e-mail on IPTV • Receives the reply from the doctor to show his professional advice on the TV screen

15. Liaison Relations ITU-D SG2 ITU-T SG17 HL7, DICOM, Continua e-Health Standardization Coordination Group (eHSCG) W3C Medical Technology Task Force, ISO TC215 ISO, IEC, CEN, ETSI, IETF, IEEE and other relevant standardization bodies

16. Network support of E-health services • ITU-T SG13 “Future Networks including Mobile and NGN” • Q3 of SG13 “Requirements and implementation scenarios for emerging services and capabilities in an evolving NGN” • Y.EHM-reqts “Requirements and network capabilities for E-health monitoring services” is currently progressed in Q3/SG13 - work started in August 2011 • Main contributions from China (China Unicom, Nanjing University of Posts and Telecommunications, others)

17. Y.EHM-reqts scope • The current scope of Y.EHM-reqts includes: • Classification of scenarios for E-health monitoring (EHM) services; • Description of features of EHM services from network perspective; • Requirements for support of EHM services from network perspective; • Network capabilities for support of EHM services.

18. Types of EHM services • EHM Healthcare (EHMH) services (for healthy state) • EHM Rehabilitation (EHMR) services (for recovery/sub-healthy state) • EHM Treatment (EHMT) services (for illness state) NOTE: EHM services are part of the whole set of E-health services and applications; highly relevant for the actors of the telecommunication market • These 3 types of EHM services share some common features but have also distinguished features , e.g. from the perspective of service coverage, target user number, target user mobility, reliability and priority levels of service data transmission, end point – user relationship, special scenarios.

19. EHM service requirements • According to the 3 types of EHM services, service requirements have been identified including, but not limited, in the following areas: • Service offering • Security and privacy • Accounting • Logging and report • Policy based communication • Location tracking • Data aspects (format management, access management, storage, identification and routing based on content, interoperability etc.) • Device management • Gateway aspects • Based on the identified service requirements, network requirements and capabilities are currently under work

20. E-health capability model with support for interconnectivity, internetworking and interoperability within an e-health monitoring system [based on the e-health user service model interactions from ETSI-TR 102 764] EHM capability model – under discussion

21. EHM capability framework - under discussion EHMR application EHMT application EHMH application Application layer Format management Data storage Service authorization Service provisioning Device management Data interoperation Data access control Device time synchronization Service accounting Service Logging & report Service/Application support layer Management Security and Privacy Routing of data based on content Policy, Event or Schedule Based Communication Location tracking Network layer Device Configuration/management Communication proxy Data aggregation Gateway • The above picture is shown here only as an example of the current Q3/SG13 discussions around the capabilities required for support of EHM services, it is not an agreed piece of content of the Y.EHM-reqts document itself Data Sensing & processing Device identity Device communication Device Device layer

22. E-Health monitoring service scenarios(Appendixes of Y.EHM-reqts) • Individual / family (indoor and outdoor) • Hospital • Vehicle • Physical examination • Disaster rescue • Prehospital Emergency Medical Service • Smart Ward Service • Chronic disease care

23. ITU-T Focus Group on M2M Service Layer – 1 • Established in January 2012 • To study requirements and specifications for a common Machine-to-Machine (M2M) Service Layer • Cost-efficient platform • Across vertical markets • Multi-vendor environment • Initial focus of the Focus Group: E-health • FG M2M is expected to organize its work according to 1) use cases and service models, 2) service layer requirements (and service architecture), 3) APIs and protocols for support of e-health applications and services NOTE : Machine-to-Machine (M2M) communications are considered to be a key enabler of applications and services across a broad range of vertical markets (e.g., health-care, logistics, transport, utilities, etc.)

24. ITU-T Focus Group on M2M Service Layer – 2 FG M2M will coordinate its efforts with the ITU-T Internet of Things Global Standards Initiative (IoT-GSI) FG M2M aims at including vertical market stakeholders that are not part of the traditional ITU-T membership, such as Continua Health Alliance and the World Health Organization (WHO), and will collaborate with M2M communities worldwide (including research and academia), SDOs, forums and consortia First meeting: 17-18 April 2012, ITU, Geneva Chair: Mr. Xu Heyuan (China Academy of Telecommunjcation Research of MII) Input welcome: Focus Group is open to any individual from a country which is a member of ITU and who is willing to contribute to the work Terms of Reference and additional information at www.itu.int/en/ITU-T/focusgroups/m2m/