Norwegian e-Health Infrastructure based on XML, ebXML and PKI

Norway's National Insurance Administration (NIA) upgraded the EDI-based communications infrastructure it used to connect to its business partners with a new architecture based on open standards, including the ebXML Messaging OASIS Standard, ISO 15000-2.

NIA's ebXML Message service was built using the Xenos terminalONE end-to-end, transaction gateway solution.

To date, NIA's system is in production with four applications, and has transported several million ebXML messages corresponding to transactions totaling more than 10 billion Norwegian Kroner (equivalent to 1.2 billion EURO, or 1.5 billion USD).

At present the four applications using the new architecture are :

• Medical certificate. Currently, 900 general practitioners at 350 offices (out of a total of 1850 offices) are using this application, covering access to 20% out of a total of 3.5 million medical records. The expectation is that this will double in 2006, as more and more suppliers of software to general practitioners add ebXML Messaging capabilities to their products, thus enabling their customers to connect to the e-Health infrastructure.
• Requests for payment from general practitioners to the NIA. This is currently used by 500 doctors at 200 offices.
• Requests for payment from pharmacies to the NIA. All pharmacies in Norway are using this application, and transactions totaling 10 billion Norwegian Kroner (equivalent to 1.2 billion EURO, or 1.5 billion USD) annually are transacted using this application.
• The EHIC (European Health Insurance Card) is a European standard card format for European Union, European Economic Area or Swiss nationals traveling or staying temporarily in another EU/EEA country or Switzerland, indicating they are entitled to receive medical care should they become ill or have an accident. The order process between the NIA and the card producer uses ebXML Messaging. Currently, two million cards have been produced using this application.

The report states "The use of open standards has been a strategic choice that has worked well for the project. The National Insurance Administration would certainly recommend ebXML Messaging for other sectors looking for reliable messaging to handle sensitive information. As other projects of similar scope and nature are found, the real challenges in deploying and extending the Norwegian e-Health infrastructure are not technical, but related to the organizational complexity of connecting large numbers of partners that use a diversity of enterprise and legacy systems, but are required to converge on a common interface".

More details are available from the case study website and links to the whitepaper.