1、 ETSI TR 102 764 V1.1.1 (2009-02)Technical Report eHEALTH;Architecture;Analysis of user service models, technologies andapplications supporting eHealthETSI ETSI TR 102 764 V1.1.1 (2009-02) 2 Reference DTR/eHEALTH-0002 Keywords interoperability, safety, security ETSI 650 Route des Lucioles F-06921 So
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8、102 764 V1.1.1 (2009-02) 3 Contents Intellectual Property Rights6 Foreword.6 Introduction 6 1 Scope 8 2 References 8 2.1 Normative references .8 2.2 Informative references9 3 Definitions and abbreviations.10 3.1 Definitions10 3.2 Abbreviations .11 4 Architecture12 4.1 Overview 12 4.2 eHealth technic
9、al architecture 13 4.2.1 eHealth service abstraction layer 13 4.2.2 eHealth middleware abstraction layer.13 4.2.3 eHealth connectivity abstraction layer14 4.3 Interoperability and eHealth.15 4.3.1 Device and system considerations 15 4.4 Security in eHealth .15 4.4.1 Privacy16 4.4.2 Electronic signat
10、ure in eHealth.16 4.4.3 Non-repudiation in eHealth.16 4.5 Further work to be undertaken in SDOs (architecture).16 5 Specific eHealth support network architectures.16 5.1 Body Area Network architectures (BAN) 16 5.2 Personal Area Networks (PAN) .16 5.3 Personal Networks (PN) and PN-Federation17 5.3.1
11、 Personal Networks (PN) .17 5.3.2 Federation of Personal Networks (PN) .17 5.4 Infrastructure related network architectures for PN and PN-F .17 5.4.1 Home network infrastructure and architecture17 5.4.2 Vehicle network infrastructure and architecture.18 5.5 Further work to be undertaken in SDOs (spe
12、cific eHealth support network architectures) .18 6 Abstract communication services from telecommunications services.18 6.1 Parameterization of telecommunications services18 6.1.1 Ubiquity18 6.1.2 Mobility 18 6.1.3 Security.18 6.1.4 Connection capability .18 6.1.5 Connection (address) topology .19 6.
13、1.6 Content type19 6.1.7 Quality of Service (QoS) and Grade of Service (GoS) .19 6.1.7.1 QoS configurability.19 6.2 Existing Standards and standardization efforts application in eHealth ICT platform 19 6.2.1 Radio technologies20 6.2.1.1 RFID .20 6.2.1.2 TErrestrial Trunked RAdio (TETRA).20 6.2.1.3 W
14、iFi (IEEE 802.11a/b/g/n) .21 6.2.1.4 WiMAX 21 6.2.1.5 Ultra-WideBand (UWB) .22 6.2.1.6 The Global System for Mobile Communications, GSM (original acronym: Groupe Spcial Mobile)22 ETSI ETSI TR 102 764 V1.1.1 (2009-02) 4 6.2.1.7 Universal Mobile Telecommunications System (UMTS).22 6.2.1.8 Satellite .2
15、3 6.2.1.9 The PN and PN-F23 6.2.2 Fixed network technologies 23 6.2.2.1 Internet Protocol version 6 (IPv6) / version 4 (Ipv4) 23 6.2.2.2 NGN and IMS .24 6.2.3 Application service technologies 25 6.2.3.1 eSignature25 6.2.3.2 Naming numbering and addressing.25 6.2.3.3 Smart cards26 6.2.3.4 Messaging s
16、ervices26 6.2.3.4.1 Short Messaging Service (SMS)26 6.2.3.4.2 e-mail based messaging service.26 6.2.3.5 Telephony services26 6.2.3.6 Location based services.26 6.2.3.7 Application programming and development interfaces.27 6.2.4 Summary of communications technologies 27 6.3 Further work to be underta
17、ken in SDOs (development of existing standards to support eHealth).27 7 Abstract User Service Model .27 7.1 Overview 27 7.2 eHealth Info Acquisition 28 7.3 eHealth Info transfer.28 7.4 eHealth Info processing28 7.5 eHealth Info collation.28 7.6 eHealth security services 28 7.7 Imprinting/personaliza
18、tion .29 7.8 Synchronizing eHealth Info29 7.9 Further work to be undertaken in SDOs in support of the abstract user service model29 8 Use cases 29 8.1 Introduction to use cases 29 8.2 eHealth actors.30 8.3 Non-specific eHealth scenarios 31 8.4 Generic use cases33 8.4.1 Telemedicine.34 8.4.1.1 Therap
19、y intervention .34 8.4.1.2 Emergency intervention 34 8.4.2 eHealth monitoring .36 8.4.2.1 Remote monitoring36 8.4.2.2 Mobile monitoring 36 8.5 Objectives and requirements arising from use cases (general).37 8.5.1 Objectives arising .37 8.5.2 Requirements arising 37 9 Gaps in standardization for eHea
20、lth .38 9.1 Overview of the gaps and filling them .38 9.2 General eHealth architecture 38 9.3 Specific eHealth support network architectures .39 9.4 Development of existing standards to support eHealth 39 9.5 Development of support of the abstract user service model.39 9.6 General .39 9.6.1 eHealth
21、Device Safety 39 9.6.2 Context Awareness .40 9.7 Control Plane40 9.7.1 Quality and Grade of Service for eHealth.40 9.7.2 Security.41 9.7.3 Personal Networks 41 9.7.4 Personal Network Federations 42 9.8 Application Layer.42 9.8.1 Actor role and access control42 9.9 Middleware Layer 43 9.9.1 eHealth S
22、ystem Dependability43 ETSI ETSI TR 102 764 V1.1.1 (2009-02) 5 9.10 Connectivity Layer.43 9.10.1 Body Area Networks and Radio Interface 43 9.10.2 Interworking .44 9.10.3 Asymmetric vs. Symmetric links44 Annex A: Summary of M/403 .45 Annex B: Bibliography47 History 48 ETSI ETSI TR 102 764 V1.1.1 (2009
23、-02) 6 Intellectual Property Rights IPRs essential or potentially essential to the present document may have been declared to ETSI. The information pertaining to these essential IPRs, if any, is publicly available for ETSI members and non-members, and can be found in ETSI SR 000 314: “Intellectual P
24、roperty Rights (IPRs); Essential, or potentially Essential, IPRs notified to ETSI in respect of ETSI standards“, which is available from the ETSI Secretariat. Latest updates are available on the ETSI Web server (http:/webapp.etsi.org/IPR/home.asp). Pursuant to the ETSI IPR Policy, no investigation,
25、including IPR searches, has been carried out by ETSI. No guarantee can be given as to the existence of other IPRs not referenced in ETSI SR 000 314 (or the updates on the ETSI Web server) which are, or may be, or may become, essential to the present document. Foreword This Technical Report (TR) has
26、been produced by Advisory Committee Operational Co-ordination Group (OCG) (eHEALTH). NOTE: ETSI Project eHEALTH has been assisted by STF355 through the ETSI Funded Work Programme in completing this work. Introduction eHealth includes the application of information and communications technologies acr
27、oss the whole range of functions that affect the health sector in an international (e.g. cross-border) perspective, from the doctor to the hospital manager, including nurses, data processing specialists, social security administrators and - of course - the patients. eHealth systems include tools for
28、 health authorities and professionals as well as personalized health systems for patients (individuals) and citizens (community). Examples include health information networks, electronic health records, telemedicine services, personal wearable and portable communicable systems including those for me
29、dical implants, health portals, and many other ICT-based tools assisting disease prevention, diagnosis, treatment, health monitoring and lifestyle management (this description is based on text at the Europes Information Society eHealth portal i.1). The paper on “Home telehealth-Current state and fut
30、ure trends“ presented in the “International Journal of Medical Informatics“ i.2 summarizes the important overall problems regarding healthcare services that most countries are facing such as: increased demand of healthcare due to an increased number of elderly and changed life styles leading to an i
31、ncrease in chronic diseases; demand for increased accessibility of care outside hospitals, moving health services into the patients own homes; need for increased efficiency, individualization and equity of quality-oriented healthcare within limited financial resources; difficulties of recruiting and
32、 retaining personnel in the healthcare services in general and in home and elderly care in particular. It is expected that eHealth will provide partial but significant solutions to the above issues, as it has been recognized as a potential tool to provide access to timely, efficient, and high qualit
33、y healthcare. Driving forces exist for implementing new solutions such as the migration to self-managed care and allowing increased patient mobility at an international level (e.g. cross border). However, there are numbers of hindrances and restrictions when it comes to practical and sustainable use
34、 of eHealth, which include interoperability, security and privacy. ETSI ETSI TR 102 764 V1.1.1 (2009-02) 7 A key ambition of the EU policy is the provision of better care services at the same or lower cost. eHealth is regarded by Europes Information Society eHealth portal i.1 as “todays tool for sub
35、stantial productivity gains, while providing tomorrows instrument for restructured, citizen-centred health care systems and, at the same time, respecting the diversity of Europes multi-cultural, multi-lingual health care traditions. There are many examples of successful eHealth developments includin
36、g health information networks, electronic health records, telemedicine services, wearable and portable monitoring systems, and health portals“. ETSI ETSI TR 102 764 V1.1.1 (2009-02) 8 1 Scope The present document describes the eHealth user service models for the identification of interoperable solut
37、ions for healthcare data collection, transmission, storage and interchange. The supporting analysis for this work is found in SR 002 564 i.3. The model identifies the requirements for ubiquity, security, privacy and reliability across the eHealth system and the supporting ICT technologies. The prese
38、nt document may be used in support of the ETSI contribution to mandate M/403 i.4. The present document identifies where additional standardization is required in ICT generally and in ETSI in particular to support eHealth. The present document is intended for the following audience: standards develop
39、ers; developers and equipment manufacturers and providers in the eHealth related area; developers and providers of eHealth related services. NOTE: The present document is published as a TR but in the context of being a guide to future standardization may on occasion provide indications of where futu
40、re standards are required by using the mandate “shall“. Such mandates are to be considered only in the guidance for future standardization and not as normative in the scope of the present document. 2 References References are either specific (identified by date of publication and/or edition number o
41、r version number) or non-specific. For a specific reference, subsequent revisions do not apply. Non-specific reference may be made only to a complete document or a part thereof and only in the following cases: - if it is accepted that it will be possible to use all future changes of the referenced d
42、ocument for the purposes of the referring document; - for informative references. Referenced documents which are not found to be publicly available in the expected location might be found at http:/docbox.etsi.org/Reference. NOTE: While any hyperlinks included in this clause were valid at the time of
43、 publication ETSI cannot guarantee their long term validity. 2.1 Normative references The following referenced documents are indispensable for the application of the present document. For dated references, only the edition cited applies. For non-specific references, the latest edition of the referen
44、ced document (including any amendments) applies. Not applicable. ETSI ETSI TR 102 764 V1.1.1 (2009-02) 9 2.2 Informative references The following referenced documents are not essential to the use of the present document but they assist the user with regard to a particular subject area. For non-speci
45、fic references, the latest version of the referenced document (including any amendments) applies. i.1 “Europes Information Society eHealth portal“. NOTE: Available at: http:/europa.eu.int/information_society/activities/health. i.2 “Home telehealth-Current state and future trends“, Uppsala University
46、, International Journal of Medical Informatics (2006) 75, p. 565-576, Sabine Koch. i.3 ETSI SR 002 564: “Applicability of existing ETSI and ETSI/3GPP deliverables to eHealth“. i.4 Mandate M/403 of the European Commission Enterprise And Industry Directorate-General: “Mandate to the European Standardi
47、sation Organisations CEN, CENELEC and ETSI in the field of Information and Communication Technologies, applied to the domain of eHealth“. i.5 Freeband homepage. NOTE: Available at: http:/pnp2008.freeband.nl. i.6 GRIFS: “Global RFID Interoperability Forum for Standards“. NOTE: Available at: http:/ ww
48、w.grifs-project.eu/. i.7 CASAGRAS: “Coordination and Support Action (CSA) for Global RFID-related Activities and Standardisation“. NOTE: Available at: http:/www.rfidglobal.eu/. i.8 ETSI TR 187 011: “Telecommunications and Internet converged Services and Protocols for Advanced Networking (TISPAN); NG
49、N Security; Application of ISO-15408-2 requirements to ETSI standards - guide, method and application with examples“. i.9 ISO/IEC 27001: “Information technology - Security techniques - Information security management systems - Requirements“. i.10 EMC list. NOTE: Available at: http:/ec.europa.eu/enterprise/newapproach/standardization/harmstds/reflist/emc.html. i.11 “Mobile e-Health monitoring: an agent-based approach“, V. Chan, P. Ray, N. Parameswaran, IET Communications, Volume 2, Issue 2, pages 223 - 230, Februar
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