Background: For years telemedical systems have been presented as potential contribution for tackling the increasing incrimination on healthcare systems due to related costs of chronic diseases. Especially interoperable personal health de-vices (PHDs) are expected to facilitate the successful implementation of telemedical systems. Continua Health Alliance has published implementation guidelines for end-to-end device communication chains based on existing international standards and frameworks (IEEE, HL7, OASIS, IHE).
Objectives: Based on the experience of multiple projects imple¬menting the Continua guidelines and the Continua architecture this paper identifies, examines and discusses the open issues that have to be solved for an effective, efficient and broad use of PHD communication.
Methods: The developed Continua conform software components were tested with Continua certified devices, open source IHE software compo¬nents and within a simulated environment using Continua's test tools. Exchanged messages were manually reviewed and security observations were recorded. Regulatory and management questions were addressed by researching available literature, observing discussions among stakeholders and recording opinions of individuals within the project partner institutions.
Results: The software components were successfully tested for conformance according to the Continua guidelines including their underlying standards and security requirements. Issues concerning security requirements, patient identification, regulatory aspects, market integration and EHR integration were identified.
Conclusions: The Continua guidelines and tools enable technically complete implementations of telemedical solutions especially for most chronic diseases, but a number of issues still remain open. Technical obstacles are likely to be solved on international and standardized bases whereas regulatory issues and local regulation might result in locally limited solution biotopes.