***G8 SP6 Health Cards***

**Title: Minutes of the G8 SP6 Health Cards Meeting (Miami, May 1^st^,
2000)**

Task: 1 Minutes

Work-package: Project Management

Reference: G8/1/GIE/A/2104/1.0

Date of last change: 10/06/2000

Authors: N. Nader

Stage: Version 1, Draft

Status: G8 Confidential

Distribution list: G8 Partners

Copyright 2000, G8 SP6 HC

Table of contents

1 Participants [3](#participants)

2 Minutes of the meeting [3](#minutes-of-the-meeting)

2.1 Opening of the meeting [3](#opening-of-the-meeting)

2.2 Agenda amendments [3](#agenda-amendments)

2.3 Minutes of the previous Paris meeting
[4](#minutes-of-the-previous-paris-meeting)

2.4 G-8 SP6 Activities : Strategic Goals and Positioning
[4](#g-8-sp6-activities-strategic-goals-and-positioning)

2.4.1 Revision of G-8 specification [4](#revision-of-g-8-specification)

2.4.2 Discussion and review of "Health Card Initiatives in G-8
Countries" document
[4](#discussion-and-review-of-health-card-initiatives-in-g-8-countries-document)

2.4.3 Report from G-8 Meetings [5](#report-from-g-8-meetings)

2.4.4 ISO TC 215 and relations to standardization bodies
[5](#iso-tc-215-and-relations-to-standardization-bodies)

2.4.5 Funding of G8 SP6 activities [5](#funding-of-g8-sp6-activities)

2.5 Emergency data set [6](#emergency-data-set)

2.5.1 Adhesion to NETLINK specification and review of comments
[6](#adhesion-to-netlink-specification-and-review-of-comments)

2.6 Technical Architecture [6](#technical-architecture)

2.7 Pilot sites and Interoperability Demonstrations
[7](#pilot-sites-and-interoperability-demonstrations)

2.8 Strategy for the smart IC card system in Japan
[9](#strategy-for-the-smart-ic-card-system-in-japan)

2.9 Statement for G8 meeting in Berlin
[9](#statement-for-g8-meeting-in-berlin)

2.10 Planning of next steps, next meeting date
[9](#planning-of-next-steps-next-meeting-date)

3 Actions and decisions points summary
[9](#actions-and-decisions-points-summary)

3.1 Actions [9](#actions)

3.2 Decisions [10](#decisions)

3.3 Official comments [10](#official-comments)

4 Attendees list [11](#attendees-list)

Document history

+-----------------+----------------------------------------------------+
| G8/1            | -   Minutes of the G8 SP6 Health Cards meeting     |
| /GIE/A/2104/1.0 |     held on 1^st^ May 2000 in Miami                |
|                 |                                                    |
| 10.06.00        |                                                    |
+-----------------+----------------------------------------------------+

# Participants

The following delegates attended the G8 SP6 Health-cards meeting in
Miami Beach Convention Center:

  ------------------------------------------------------------------------
  **Country**    **Organization**                  **Name**
  -------------- --------------------------------- -----------------------
  France         Ministry of Employment and        Michèle THONNET
                 Solidarity (Health Affairs)       

                 GIE SESAM-Vitale                  Noël NADER

                 GIE SESAM-Vitale (BULL)           Djahanguir DJAMEI

  Germany        ZI (Central Research Institute)   Juergen SEMBRITZKI

  Italy          FINSIEL                           Giulio MEAZZINI

                 Italian Ministry of Health        Alessandra PASTORINO

  Japan          FUJI Research Institute           Koichi FURUYA

                                                   Shiro ENDO

                 RICOH                             Masuyoshi YACHIDA

                 Tokyo Institute of Technology     Nagaeke OHYAMA

  USA            3GI-MAXIMUS                       Barclay SCHELL

                                                   Christie MAHLER

                 Kelly Anderson Association        Diane CORCORAN

                 US Veterans Affairs               Daniel MALONEY

                                                   Dennis LEWIS
  ------------------------------------------------------------------------

Mr. Denis Morency, from RAMQ, informed that he could not participate to
this meeting.

A list of participants with their coordinates is presented within the
last chapter of this document.

# Minutes of the meeting

## Opening of the meeting

The chairman, Mr. Daniel Maloney welcomes all participants to the
meeting. A roll call of delegates is made.

## Agenda amendments

A new item concerning the use NETLINK AID/RID is added to the agenda.

## Minutes of the previous Paris meeting

No comment was made to the minutes of previous Paris meeting.

## G-8 SP6 Activities : Strategic Goals and Positioning

### Revision of G-8 specification

Mr. Sembritzki informed that there has been no comments from G-8 members
till now and a procedure is needed for maintenance and revision of the
specification.

Mr. Nader, NETLINK project coordinator informed that the NETLINK project
should be extended till end of year 2000. The coordinator is waiting for
official acceptance from the EC. The consortium plans to update and
maintain the NETLINK specifications based on the pilot results.

Mrs. Pastorino agreed that till the end of NETLINK project, the
consortium could update and maintain the specification. The question is
raised concerning what to do after the NETLINK project. Mrs. Thonnet
indicates that it is important to be very careful on the implementation
of the procedures: "what kind of organization will be able to follow the
specification and check the coherence with the standardization
procedures?"

Mr. Maloney adds that there are also questions about the funding of the
organization. The procedures to implement should also deal with the test
and validation procedures.

Mr. Sembritzki continues on standardization of card data set. The
G-8-NETLINK specification has been an input to the standardization
activities. But ISO TC 215 focus is on the mandatory core data set. The
G-8 should make the consensus on the implementation of optional data
fields. He proposes three levels for data organization:

1.  Consensus on minimum data set

2.  Other data readable by each country

3.  Rest of data

Mrs. Thonnet adds that concerning the third level, Software
specifications are needed in order to read the card data.

Mrs. Pastorino considering the examples of existing situations, says
that concerning the data within the card we are obliged to use data of
standardization bodies. Referring to a meeting organized in Portugal by
European Commission, she says that there is an important problem due to
the fact that the European Commission is not completely aware of the
activities made by G-8-NETLINK. The existing EC positions and the G8
positions are not completely on the same line.

### Discussion and review of "Health Card Initiatives in G-8 Countries" document

No comment was made to the document.

Decisions:

-   No comments to « Health Card Initiative » document prepared for the
    Berlin meeting

### Report from G-8 Meetings

There has been no participation to any G-8 meetings since last November
G8-SP6 HC meeting. G-8 meeting will be held in Berlin from 4^th^ to
6^th^ of May 2000. Mr. Yachida and Mr. Ohyama will make a demonstration
of interoperability between Japan and US.

Mrs. Pastorino proposed to make also a demonstration of French and
Italian interoperability within the French presentation time frame. Mr.
Dan Maloney says anytime we could show multi-country interoperability,
we should use the occasion. Everyone agrees.

Actions:

-   Japan to demonstrate card interoperability at G-8 meeting in Berlin

Decisions:

-   Italian Ministry of Health will try to make a presentation of
    NETLINK during G-8 workshops in Berlin.

-   Multi-country interoperability demonstrations should be encouraged
    and supported.

### ISO TC 215 and relations to standardization bodies

Mr. Sembritzki informs that the last meeting was organized in London and
they agreed on several items concerning Patient data set:

-   General structure

-   Common objects

-   Clinical limited data

-   Extent of data

-   Identification data

-   Administrative data

-   Electronic prescription

Important progress has been made by the WG5 where 13 countries are
participating. Next meeting is planned in Vancouver between June 19 and
20. Mr. Sembritzki asks whether it could be possible for the US
representation to be more proactive.

Actions:

-   US could try to propose new representatives to the standardization
    body

### Funding of G8 SP6 activities

The delegates agree that the initiative will continue to be funded by
the individual countries.

Actions:

-   Each country to find necessary funding for the continuation of
    G8-SP6 HC actions

## Emergency data set

### Adhesion to NETLINK specification and review of comments

Mr. Nader informs that the version 2 of specification document is on
line since February 2000. The annex D of the document contains the
official requirements. Each application shall use its own data at a
national level.

He adds that the NETLINK consortium will update the document following
the pilot site results. The updated data set has to be in coherence with
standards and should be coded using market compilers.

Mr. Meazzini continues pointing out the inconsistencies between
compilers ASN.1 format and the tabular data representation. The version
2.1 of the document will solve this problem.

Mr. Sembritzki added that the NETLINK Specification document (D2
deliverable) should also be the G-8 interoperability data set
specification document. There has not been any comment till now. We aim
to have one document, thus he suggests having 4 weeks for comments (till
1^st^ of June).

The delegates agree that the document is put as draft on the G-8-SP6 HC
WEB site and a new version of the document will be produced including
the comments for the next meeting. This version will be completed also
by administrative data set, emergency data set and minimal architecture.

Comments should be sent to ZI, FINSIEL and GIE SESAM Vitale.

Actions:

-   Comments to G-8 specification of data set before 1^st^ of June
    (Document to be put on the WEB as official G-8 data set
    specification)

-   All comments on the implementation and experimentation results to be
    sent to ZI, FINSIEL and GIE SESAM Vitale

-   ZI and FINSIEL to prepare a new version of the G8 document including
    comments and a chapter on minimum architecture

## Technical Architecture

Discussion concerning the NETLINK AID has been added to the agenda. Mr.
Nader reads the NETLINK consortium response to the official use of
NETLINK AID for G-8 members. It appears that during the existence of
NETLINK project, it could be possible that other organization uses the
NETLINK AID if they are compliant with the specification. The risen
question is: "who will support the AID after NETLINK project?" Mr. Nader
adds it could be GIE SESAM-Vitale.

Mr. Meazzini adds that they support the NETLINK AID as the basis of
interoperability and that it should be available to G-8 countries free
of charge. He suggests that till the end of year 2000, there should be
cross certification by exchange of cards and tests. If a new comer needs
to integrate the NETLINK AID, they should ask existing companies to
validate their interoperability. Mrs. Thonnet and Mr. Sembritzki remind
that somebody should be responsible for the AID usage.

Mr. Sembritzki agrees to check the feasibility of transferring the
NETLINK AID to another organization. By the end of NETLINK project, a
process has to be set up for maintaining the AID or to find an alternate
solution.

Further, Mr. Maloney requested a simplification of the exchange of cards
and software within the G8 members.

Mrs. Mahler evokes the 7816-8 certificate verifications. The problem is
the cross certification between two certification organizations.

Mr. Maloney says that the actual situation is mutual recognition without
an upper authority. He adds that in US, they have had trouble finding an
available card that is fully compatible with the 7816-8 specifications.
This is a complex issue that will take some time to resolve. In the mean
time, most projects are using shared secret keys to identify providers
with different roles.

Mr. Nader evokes the problem of ASN.1 compiler compatibility. The
delegates decide to share the information on compiler versions and
success rates of compatibility.

Actions:

-   ZI to check the possibility of transferring NETLINK AID to another
    organization

-   Simplify procedures of exchanging Software and Interoperable cards
    between G-8 partner organizations

Decisions:

-   NETLINK AID can be used till the end of NETLINK project by G-8
    members

## Pilot sites and Interoperability Demonstrations

French demonstration:

The afternoon session starts with the demonstrations. Mr. Nader made the
demonstration reading the Vitale 1 cards (with administrative
information) and updated the NETLINK card (including alert data). A
Health Professional card provides the access security when reading and
updating the cards. The Vitale 1 card has been distributed in France to
40 million persons.

Concerning the interoperability, Mr. Nader says the software reads the
Italian cards but some problem remains with US and Japanese cards. He
distributes some available cards to partners.

Further Mr. Nader informs that NETLINK compliant cards for Quebec should
be available during May 2000.

Mr. Maloney adds that all interoperable cards should be distributed to
all G-8 members.

It appears at this point that a kind of checksum procedures is to be
established in all countries for validation of interoperable cards.

Mr. Lewis proposed to have a solution for information centralization and
Mrs. Corcoran proposed to develop a matrix showing the results and
comparing the usage of different cards and to have one location for all
tests: a kind of laboratories.

Several constraints are pointed out:

-   a place for testing will be difficult to manage,

-   many drivers and readers are needed for testing,

-   etc.

Mrs. Thonnet proposes to have a kind of topology of remarks and a
monitoring of software tests and a kind of reporting tool. Mr.
Sembritzki adds that this could be a kind of standard test protocol. Mr.
Djamei proposed that all the results could be added on the WEB site: in
this way all members could track the progress.

Mr. Sembritzki agrees to develop the draft test protocol for the first
of June.

US demonstration:

Mrs. Mahler and Mr. Schell demonstrate Software showing the feasibility
of interoperable data cards. US cards have been distributed to other
countries. They have received Japanese cards and binary file of French
content. Mrs. Mahler says they are trying now the Japanese cards but
they have some problems with the French cards. Mr. Maloney adds that
actual feed backs from other participants are very good and very useful.

There are some issues concerning read and write permission laws.
Emergency data set should be open for read only. Other information
should be protected for read access within the country. Within a
country, changes may be made based upon local laws. For write
protection, certificate concurrency and trust as well as symmetric keys
will be tested. Three changes are coming: ASN.1, directory file
structure, selection by AID, all store file ID as hex to be compatible
with others.

Mr. Nader reminds that in NETLINK, reading is open but not writing.
Writing depends on the country.

Japanese demonstration:

Mr. Yachida presents the Japanese demonstration. Due to language, two
areas are available on the cards: domestic areas and G-8 interoperable
areas. The NETLINK AID is used for specifying where are the
interoperable data. The software is able to read Japanese and US cards.
Some problems remain with Italian cards certainly due to the EF NETLINK.
Mr. Yachida presents also a Japanese G-8 interoperability document with
information table formats followed by a binary dump of the files. This
allows the reviewer to review and understand the contents and binary
output onto the card. Japan agrees to collaborate with EU and US to work
on next generation of smart IC card.

At this state, Mr. Meazzini wants to make a personal comment: he
remembers the Amsterdam G-8 meeting and pointed out the huge progress
made since the beginning of G-8-SP6 HC actions.

Mrs. Thonnet asks that this comment to become an official comment. All
members agree.

Italian demonstration:

Mr. Meazzini presented the Italian demonstration, which is a generic
application to read cards. The software has language supports for
Italian, German and English. Now the French language table is
implemented. It demonstrates the emergency updates by physicians and
administrative updates. The software is able to read US cards with some
modifications.

Actions:

-   Exchange of cards ASAP between **all** G-8 members

-   ZI to prepare a test protocol for 1^st^ of June

-   A matrix based on test results to be prepared

Official comments:

-   Big progress has been made since the beginning of the G-8 actions.
    Now all members really converge towards the same reality of Health
    card interoperability.

## Strategy for the smart IC card system in Japan

Mr. Ohyama presents the strategic view for the implementation of smart
cards in Japan and its impact on the information society. Japan plans to
distribute smart cards to all citizens. The year 2002 should see the
start of tests. The objectives are to move to electronic digital society
where the cards have multi-purpose functions: Multiple applications need
to electronically identify the user (cyber passport). The cards should
be combi-card with contacts and contact-less capability.

## Statement for G8 meeting in Berlin

Mr. Ohyama informs that they have asked officially Mr. Berlu from
European Commission DG XIII for exchange of information and
collaboration. The European Commission looks now for the right place for
this action.

Concerning the G-8 meeting in Berlin, Mrs. Pastorino will be the only
representative of the G8-SP6 HC to be present on 06/05/2000 with the
official representatives.

All members agree that G8-SP6 HC is a valuable project and big
progresses have been made since the beginning. All members agree to
continue the work undertaken and to use the G8 label. Members should
inform their national coordinator about these decisions.

Decisions:

-   Statement for G-8 meeting in Berlin: Considering the progress made
    and the results obtained, the G-8-SP6 HC will continue its activity

-   The group will continue to use the G8 label

## Planning of next steps, next meeting date

The next meeting is planned mid to late September in Rome according to
the NETLINK workshop. Mrs. Pastorino will propose some dates. The
objective of the Rome meeting will be the interoperability of all cards.

The Rome meeting should prepare an important demonstration for Paris
CTST 2000. Communications for the vendors should also be prepared.

# Actions and decisions points summary

## Actions

-   Japan to demonstrate card interoperability at G-8 meeting in Berlin

-   US could try to propose new representatives to the standardization
    body

-   Each country to find necessary funding for the continuation of
    G-8-SP6 HC actions

-   Comments to G-8 specification of data set before 1^st^ of June
    (document to be put on the WEB as official G-8 data set
    specification)

-   All comments on the implementation and experimentation results to be
    sent to ZI, FINSIEL and GIE SESAM-Vitale

-   ZI and FINSIEL to prepare a new version of the G-8 document
    including comments and a chapter on minimum architecture

-   ZI to check the possibility of transferring NETLINK AID to another
    organization

-   Simplify procedures of exchanging Software and Interoperable cards
    between G-8 partner organizations

-   Exchange of cards ASAP between **all** G-8 members

-   ZI to prepare a test protocol for 1^st^ of June

-   A matrix based on test results to be prepared

## Decisions

-   Italian Ministry of Health will try to make a presentation of
    NETLINK during G-8 workshops

-   Multi-country interoperability demonstrations should be encouraged
    and supported.

-   No comments to « Health Card Initiative » document prepared for the
    Berlin meeting

-   NETLINK AID can be used till the end of NETLINK project by G-8
    members

-   Statement for G-8 meeting in Berlin: Considering the progress made
    and the results obtained, the G-8-SP6 HC will continue its activity

-   The group will continue to use the G-8 label

## Official comments

-   Big progress has been made since the beginning of the G-8 actions.
    Now all members really converge towards the same reality of Health
    cards interoperability.

# Attendees list

  -----------------------------------------------------------------------------------------------
  **Name**      **Organization**   **Country**   **Phone**      **Email**
  ------------- ------------------ ------------- -------------- ---------------------------------
  Michèle       Ministry of        France        \+ 33 1 40 56  <Michele.thonnet@sante.gouv.fr>
  THONNET       Employment and                   52 02          
                Solidarity (Health                              
                Affairs)                                        

  Noël NADER    GIE SESAM-Vitale   France        \+ 33 2        Noel.nader@sesam-vitale.fr
                                                 43574459       

  Djahanguir    GIE SESAM-Vitale   France        \+ 33 1 39 66  Djahanguir.djamei@bull.net
  DJAMEI        (BULL)                           57 82          

  Juergen       Central Research   Germany       \+ 49 221 4005 Jsembritzki@KBV.de
  SEMBRITZKI    Institute                        118            

  Giulio        FINSIEL            Italy                        G.meazzini@finsiel.it
  MEAZZINI                                                      

  Alessandra    Italian Ministry   Italy         \+ 39 06 5994  a.pastorino@sanita.it
  PASTORINO     of Health                        5236           

  Koichi FURUYA FUJI Research      Japan                        <Kfuruya@cyg.fuji-ric.co.jp>
                Institute                                       

  Shiro ENDO    FUJI Research      Japan                        <Endo@cyg.fuji-ric.co.jp>
                Institute                                       

  Masuyoshi     RICOH              Japan         \+ 81 45 590   <Yachida@src.ricoh.co.jp>
  YACHIDA                                        1648           

  Nagaeke       Tokyo Institute of Japan         \+ 81 45 924   Yama@isl.titech.ac.jp
  OHYAMA        Technology                       5177           

  Barclay       3GI-MAXIMUS        USA           757 564 1455   <Bschell@3gimax.com>
  SCHELL                                                        

  Christie      3GI-MAXIMUS        USA           757-564-1432   <Cmahler@3gimax.com>
  MAHLER                                                        

  Diane         Kelly Anderson     USA           703 618 8828   <Diane.corcoran@kapa.net>
  CORCORAN      Association                                     

  Daniel        US Veterans        USA           301-734-0107   Daniel.maloney@med.va.gov
  MALONEY       Affairs                                         

  Dennis LEWIS  US Veterans        USA           212 951 3240   <Dennis.lewis@med.va.gov>
                Affairs                                         
  -----------------------------------------------------------------------------------------------