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• GARR overall interested in the TF activities
• Emphasis should be added on Storage : providing storage services
  for the eHealth community is a key objective for GARR, and in this
  sense synergies and exchanges of best practices should be
  pursued within the TF activities. Storage means also the need
  for the eHealth community to archive their data in a safe manner
  and perform backups.
• Mirroring of Relevant eHealth Data Sets is also an option NRENs 
  could consider to support the eHealth community
• Informed consent and related tools targeting the possibility for users
  to express it is one relevant item of interest TF could be involved in
• To clearly separate and distinguish the various specific domains in 
  dealing with eHealth is fundamental:  eIDAS and eduGAIN in this 
  respect have different target communities and needs
• IRODS (irods.org)  is a key emerging technology to be considered in eHealth support

• organise a thematic TF meeting 
  devoted to Storage Services for 
  eHealth

• very limited direct
  manpower available
  to directly work on the
  current TF workplan

•  SURF currently engaging as key IT partner in the Dutch national eHealth initiative,  https://health-ri.nl  focusing 
  on health data sharing and implementing new data-based services for health. Goals of Health-RI are:
  
  • Build an integrated health data research infrastructure accessible for researchers, citizens and care providers.
  • Facilitate and foster the optimal use of knowledge, tools, facilities, health data and samples to enable a learning healthcare system and accelerate sustainable and affordable personalized medicine and health.
• SURF is helping with. procurement and governance too.
• Current main focus for SURF is more on  the  secondary  use of health data:  share of medical data to support research
• An archiitecture is being defined and possible approaches to data sharing  being evaluated (centralized vs decentralized), the role to be played in the model by the individual health institution
• Data Sovereignty is a key feature  of SURF strategy 
• With respect to the required  IT sevices for health, both acces to computing resources and storage are relevant. However there is an acknowledgement that emphasis should go above all on Storage. Storage needs, options, available services to support Health Research.
• Computing will become also increasingly. important in relation to AI
• For primary usage of Health data, interoperability is still the main issue to solve.  Current focus necessarily on secondary usage of Health data for medical Research. At this level interoperability is (a bit)   less of an issue.
• About what can be done of useful with  other NRENs via the eHealth task force:
  • Since other countries are also in the process of defining the IT architecturre of their national eHealth infrastructures, it would be good to share plans and ideas across NRENs - given the main  constraints and requirements are similar 
  •  Liaising with the EC Commission and provide information to all NRENs about new regulations, communications, strategic plans and funding opportunities for NRENs like nel calls frorm the main EU Programmes on eHealth. (EU4Health, HorizonEurope...etc) - Focus is on secondary usage of Health  data for research, also  in relation to key Life Science and  Health Research Infrastructures,  starting from EOSC-Life.
  • Also getting to know/being able to contribute to the plans for eHealth. in GN5 would be interesting and useful.
  • IRODS for federated storage is an interesting option, SURF would be interested to gather forces on this topic, share experiences, also,  possibly, through the. organisation of a dedicated event.

Rdovan Radovan Igliar

• CESNET connects Universities with also medicine faculties, Faculty hospitals (teaching and research hospitals) and also regional/municipal hospitals.Hospitals are regular users of e-infrastructure - CESNET provides them with connectivity,  storage, AAI, some computing; services like AAI-a-a-S. Basically the full stack of e-infrastructure services. CESNET is also leading activities related to COVID, security, cyberattacks. 
• hSOC
  • CESNET has established Hospitals SOC, hSOC: Security operations team: a lot of activities on Security and Disaster recovery for hospitals:  Hospital SOC - hSOC [HSOC] (cesnet.cz)  (  https://hsoc.cesnet.cz )
  • established for the user community a set of  of working groups.  We are involved mostly in the TECH and Emergency  working groups of HSOC. Topics these group are working on are: how to do  disaster recovery, also human resources in cybersecurity and digitalization.
  • CESNET also established a private network: HSOC VRF. Hospitals have own VRF in CESNET so that hospitals can interchange data safely.
• eHealth
  • The ministry is preparing national ministry  strategy on eHealth (national eHealth initiative) - started several weeks ago, very recently) : Coordinate by the Ministry of health; a new deputy /Mr. Blaha/ appointed appx. 1 month ago for digitalization of eHealth; they are discussing the future calls, financing sources and the strategies - now the ministry is working on the strategy document . They are working on the strategy document 2021-2025 several goals….responsibilities…resources…
  • CESNET is providing consultations on interoperability, standards. CESNET is not directly involved in topic of medical records. However there is ongoing discussion regarding interoperability (FAIR) of Medical data between Research infrastructures and Research hospitals, how  to use Identity Management (IdM).
  • Another part of activities is: government has a  body called Research and education  board, responsible to  head of the government - they discuss how Health should be working more closely with research - research in medical areas, there are some research infras (BBMRI, BioImaging, ELIXIR ( there are around 7-10 Health ResInfras in Czech republic). There are 2 tracks of  activities and  they are discussing now how these  tracks should combine.
    • Research funded by project - discussion how Health Sector and  ResInfras should share data too ! - For example: Some  genetic  research, they do does  not combine the data from the hospitals: research people do not have data from hospitals.
    • Hospitals funded by public health insurance - how to share data between these 2 branches of activitie.
• CESNET is leading the national EOSC initiative, we are  the national coordinator of EOSC: there is a WG related to Health in the EOSC national node
• Services - connectivity, data storage services (du.cesnet.cz), sensitive cloud
• Projects - interoperability od data, i.e.  https://www.cesnet.cz/projects/data-infrastructure-capacity-for-eosc/?lang=en
  • not related to Health in particular

What would be useful to do with other NRENs ?

• In General  knowledge sharing, best practice sharing ;There are similar activities in all states. National relations mainly.
  
• EU funding opportunities and strategies - regulations / communications - monitor those, to follow those, info sent to the list, : forward this info from the list, this is very interesting - We think EU and national strategies should interact (Our ministry of health was not aware of the initiative) - eHealth is not fully dealth with - Ministry of health did start the Competence Centre on Health
• National Competence centre - established by the ministry -INFO ON WHAT GOES ON AT EU LEVEL IN  GENERAL

• Also: within the community, we  work with guys providing NIX-ZD - They are building eHealth eID - And interchange  for medical  data. : Cross-border medicine.  -This is led by one of the municipalities, a region. several hospitals involved. - But it is actually under the  CEF programme of EU: buidling a National eHealth centre - we provide connectivity and  also STORAGE for them - NIX-ZD are not hosted in the ministry -hosted  in Jihlava
• CESNET has at the moment ISO 27001 certification in place. Potentionally a support for certification process. Also to learn  from others  how certification for health infrastructure will be  good to know.

CESNET is building a  new service called sensitive cloud - sensitive cloud (based on Openstack) in future will be the potentially also a service to interchange data. CESNET do support Elixir AAI, also working on EOSC-Life. Certifications in relation to might be Sensible in future.

Future funding 2023 - 2029 will be divided into:

1. Infrastructures 
2. Data sets and repositories to store in FAIR principles 
3. And  integration of  all this under EOSC https://www.e-infra.cz/eosc
   

• About  irods: we are in a project called  DICE for EOSC: about interoperability of data storages 
  ( see https://dice-eosc.eu/ )

• We have currently no knowledge regarding interest in iRods overall.

In summary, a shortlist of what is interesting for CESNET: (final wrap up):

• STORAGE  YES
• FAIR principles in eHealth
• eIDAS services which are seek  by some hospitals
• Data Sovereignty is also a key for us
• share plans and ideas
• linking health systems together (cross-border medicine)