title: Interoperability and HealthGRID.
abstract: OBJECTIVE
  GRID technology, with initiatives like the GGF, will have the potential to allow both competition and interoperability not only among applications and toolkits, but also among implementations of key services. The pyramid of eHealth interoperability should be achieved from standards in communication and data security, storage and processing, to the policy initiatives, including organizational protocols, financing procedures, and legal framework. The open challenges for GRID use in clinical fields illustrate the potential of the combination of grid technologies with medical routine into a wider interoperable framework.
  
  
  METHODS
  The Telemedicine Alliance is a consortium (ESA, WHO and ITU), initiated in 2002, in building a vision for the provision of eHealth to European citizens by 2010. After a survey with more that 50 interviews of experts, interoperability was identified as the main showstopper to eHealth implementation.
  
  
  RESULTS
  There are already several groups and organizations contributing to standardization. TM-Alliance is supporting the "e-Health Standardization Coordination Group" (eHSCG).
  
  
  CONCLUSIONS
  It is now, in the design and development phase of GRID technology in Health, the right moment to act with the aim of achieving an interoperable and open framework. The Health area should benefit from the initiatives started at the GGF in terms of global architecture and services definitions, as well as from the security and other web services applications developed under the Internet umbrella. There is a risk that existing important results of the standardization efforts in this area are not taken up simply because they are not always known.
authors.affiliation: European Space Agency, Life Sciences Unit, Human Spaceflight, Microgravity and Exploration, ESA ESTEC HME-GA, P.O. Box 299, 2200-AG Noordwijk, The Netherlands. Cristina.Bescos@esa.int
authors.forename: C
authors.initials: C
authors.lastname: Bescos
authors.forename: D
authors.initials: D
authors.lastname: Schmitt
authors.forename: J
authors.initials: J
authors.lastname: Kass
authors.forename: M
authors.initials: M
authors.lastname: García-Barbero
authors.forename: P
authors.initials: P
authors.lastname: Kantchev
mesh_terms: D016494:Computer Security; D003625:Data Collection; D003628:Database Management Systems; D016208:Databases, Factual / Q000592:standards; D005060:Europe; D006265:Health Care Coalitions; D006801:Humans; D038622:Internationality; D020407:Internet / Q000592:standards*; D007407:Interviews as Topic; D008490:Medical Informatics / Q000592:standards*; D016730:Program Development; D018511:Systems Integration; D017216:Telemedicine / Q000592:standards*