17.10.2025 –, Alan Turing
Germany’s digital health infrastructure has long been built on the principles of sovereignty, open standards, and interoperability. With the electronic patient record (ePA) and KIM for secure data and document exchange, Germany established a federated ecosystem using standards such as FHIR and OIDC with sectoral identity providers. The recent introduction of the TI-Messenger (TIM) extends this ecosystem to real-time communication — now connecting over 25 million insured citizens through the RISE TI-Messenger, directly integrated into their ePA app (ePA FdV).
Matrix serves here not as the foundation of sovereignty, but as a loyal enabler within an existing sovereign architecture. Operating own Matrix instances (e.g. via the RISE Cloud) ensures data locality and governance under German regulatory control, while federation allows secure inter-institutional communication. This approach balances federated flexibility and controlled trust domains, distinguishing Germany’s model from purely centralized or global platform solutions.
The talk discusses the integration of Matrix within the sovereign health stack — ePA, sIDP, KIM, TIM, and OIDC — and explores risks and resilience in large-scale federation. It illustrates how Germany’s health communication layer evolves from document exchange to conversational care, preserving sovereignty while embracing interoperable, open technologies.
Univ.Prof. Dipl.-Ing. Dr. techn. Thomas Grechenig (TG) is an architect of very large, complex, and innovative information systems, and a distinguished R&D and digitalization personality with professional activities in Berlin, Paris, Vienna, the Arab economic region, and India.
He is the founder and CEO of RISE, an R&D-driven company originally spun out of TU Wien. Since 2004, RISE has been responsible for the continuous development and software maintenance of Austria’s e-Card infrastructure, driving the technical evolution of its security devices. Between 2005 and 2013, RISE contributed decisively to the architecture of Germany’s national telematics infrastructure (TI) and has since carried out ongoing technical, planning, and implementation work for gematik and various partners in Germany. Since 1990, RISE and its research groups have been active in large-scale e-Health projects across Europe, the Arab world, and the DACH region, contributing to more than 100 master’s theses and dissertations in medical informatics and health information systems.
RISE maintains close cooperation with national IT-security institutions and holds recognized expertise in data protection, privacy, GDPR compliance, and high-security architectures for personal health data. Its teams have delivered core specifications and reference implementations for critical TI components — including connectors, brokers, audit services, and specialized applications — and contributed to the overall TI security concept, eHealth card terminal specification, and PKI and system testing methodologies. RISE also developed certified security tools, such as the BSI-certified eHealth G2 COS Consistency Check Tool (TR-03143) and the PVTe G2 Personalization Validation Tool.
Today, RISE plays a leading role in Germany’s sovereign e-Health ecosystem — providing core infrastructure for electronic patient records (ePA), secure medical messaging (KIM), sectoral and central identity services (IDP), and the TI-Messenger (TIM). The RISE TI-Messenger, approved by gematik in 2025, enables more than 25 million insured citizens to securely and intuitively communicate with healthcare providers directly from their ePA app, marking a major milestone in Germany’s journey toward a secure, federated, and sovereign digital health infrastructure.