This project has been shortlisted for the DPH 2025 Innovation Prize – Best Scale-Up
Team: Harald Kornfeil and Christian González
Outline: With the amendment to the Austrian Health Telematics Act (GTelG 2012) that came into effect on January 1st, 2025, the last remaining legal exceptions allowing the transmission of health and genetic data via fax were revoked. Until then, fax remained a widely used and critical communication tool within Austria’s healthcare sector. This change created an urgent demand for an universal, interoperable, and legally compliant alternative.
In response to this need, the medSpeak communication platform was established – a secure, user-friendly, and standards-based solution exclusively for healthcare communication. From the beginning, medSpeak was built on three guiding principles:
- Cross-sector usability: The platform must serve all healthcare professionals – physicians, pharmacists, therapists, nursing staff, hospitals, public health institutions, and private providers – offering low barriers to entry in terms of usability and cost.
- Cooperative governance: The platform’s structure as a cooperative ensures that users are also stakeholders, giving them a voice in development and policy decisions and fostering long-term sustainability.
- Open-source foundation: medSpeak is based on the Matrix protocol, an open, decentralized standard for real-time, end-to-end encrypted communication and file transfer. This open-source approach enhances transparency, supports broader adoption, reduces vendor lock-in, and lowers service and software costs.
medSpeak’s core strengths lies in its openness and interoperability. Matrix ensures robust data protection through device-based, end-to-end encryption. Unlike traditional secure email solutions such as S/MIME or PGP, medSpeak eliminates the need for complex certificate management, simplifying communication and enabling task delegation across staff members. The platform supports integration with existing IT infrastructure, including LDAP, Active Directory, and other Single Sign-On solutions, and also offers command-line tools for automation. It can be used for a wide range of healthcare documents (e.g. prescriptions, referrals, insurance approvals, lab results, and administrative records) as well as image files. While communication with patients – for sharing vital signs, health updates, or participating in teleconsultations – is generally of course technically feasible, it currently lies outside the scope of medSpeak’s initial implementation.
In comparison medSpeak offers significant advantages over existing messenger and encrypted email platforms in terms of usability, openness, cost, transparency, participant validation, and automation support. Where competitors often face limitations due to proprietary architectures or usability hurdles, medSpeak distinguishes itself as a standards-compliant, open-source platform exclusively for healthcare communication.
Since the pilot launch in October 2023, over 500 healthcare providers, including general practitioners, specialists, pharmacies, radiologists and different care facilities including one hospital, have joined the network. The pilot phase has run smoothly, with no service interruptions or significant issues. Plans are now underway to transition to a high-availability infrastructure and expand usage nationwide. The project aligns with the Austrian Ministry of Health’s strategic goal of prioritizing digital communications. As a result of medSpeak’s ongoing collaboration with official bodies and due to growing interest, the Matrix protocol was included in Austria’s Digital Health Standards Catalogue in 2024 and the ELGA GmbH (the organization jointly owned by key stakeholders in Austria’s healthcare sector and responsible for the development and operation of the national electronic health record infrastructure) has been officially commissioned to develop a specification for Matrix-based, point-to-point communication within the Austrian healthcare system. We believe that the Matrix-platform could serve as a valuable solution not just for high-income countries but also for regions with limited budgets, enabling secure transmission of messages, images, reports, video conferences, and more between health care providers – and of course possibly patients.
