<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.0 20040830//EN" "journalpublishing.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="2.0" xml:lang="en" article-type="letter"><front><journal-meta><journal-id journal-id-type="nlm-ta">JMIR Med Inform</journal-id><journal-id journal-id-type="publisher-id">medinform</journal-id><journal-id journal-id-type="index">7</journal-id><journal-title>JMIR Medical Informatics</journal-title><abbrev-journal-title>JMIR Med Inform</abbrev-journal-title><issn pub-type="epub">2291-9694</issn><publisher><publisher-name>JMIR Publications</publisher-name><publisher-loc>Toronto, Canada</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">v12i1e67429</article-id><article-id pub-id-type="doi">10.2196/67429</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letter to the Editor</subject></subj-group></article-categories><title-group><article-title>Authors&#x2019; Reply: The University Medicine Greifswald&#x2019;s Trusted Third Party Dispatcher: State-of-the-Art Perspective Into Comprehensive Architectures and Complex Research Workflows</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name name-style="western"><surname>W&#x00FC;ndisch</surname><given-names>Eric</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Hufnagl</surname><given-names>Peter</given-names></name><degrees>Prof Dr</degrees><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Brunecker</surname><given-names>Peter</given-names></name><degrees>Dr rer medic</degrees><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Meier zu Ummeln</surname><given-names>Sophie</given-names></name><degrees>CEng</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name name-style="western"><surname>Tr&#x00E4;ger</surname><given-names>Sarah</given-names></name><degrees>MA</degrees><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name name-style="western"><surname>Prasser</surname><given-names>Fabian</given-names></name><degrees>Prof Dr</degrees><xref ref-type="aff" rid="aff4">4</xref><xref ref-type="fn" rid="equal-contrib1">*</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name name-style="western"><surname>Weber</surname><given-names>Joachim</given-names></name><degrees>Dr med</degrees><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff5">5</xref><xref ref-type="aff" rid="aff6">6</xref><xref ref-type="fn" rid="equal-contrib1">*</xref></contrib></contrib-group><aff id="aff1"><institution>Core Unit Treuhandstelle, Berlin Institute of Health at Charit&#x00E9; &#x2013; Universit&#x00E4;tsmedizin Berlin</institution>, <addr-line>Charit&#x00E9;platz 1</addr-line><addr-line>Berlin</addr-line>, <country>Germany</country></aff><aff id="aff2"><institution>Digital Pathology, Charit&#x00E9; &#x2013; Universit&#x00E4;tsmedizin Berlin</institution>, <addr-line>Berlin</addr-line>, <country>Germany</country></aff><aff id="aff3"><institution>Core Unit Research IT, Berlin Institute of Health at Charit&#x00E9; &#x2013; Universit&#x00E4;tsmedizin Berlin</institution>, <addr-line>Berlin</addr-line>, <country>Germany</country></aff><aff id="aff4"><institution>Medical Informatics Group, Center of Health Data Science, Berlin Institute of Health at Charit&#x00E9; &#x2013; Universit&#x00E4;tsmedizin Berlin</institution>, <addr-line>Berlin</addr-line>, <country>Germany</country></aff><aff id="aff5"><institution>Center for Stroke Research Berlin, Charit&#x00E9; &#x2013; Universit&#x00E4;tsmedizin Berlin</institution>, <addr-line>Berlin</addr-line>, <country>Germany</country></aff><aff id="aff6"><institution>German Centre for Cardiovascular Research (DZHK)</institution>, <addr-line>Berlin</addr-line>, <country>Germany</country></aff><contrib-group><contrib contrib-type="editor"><name name-style="western"><surname>Iannaccio</surname><given-names>Amanda</given-names></name></contrib><contrib contrib-type="editor"><name name-style="western"><surname>Leung</surname><given-names>Tiffany</given-names></name></contrib></contrib-group><author-notes><corresp>Correspondence to Eric W&#x00FC;ndisch, MSc, Core Unit Treuhandstelle, Berlin Institute of Health at Charit&#x00E9; &#x2013; Universit&#x00E4;tsmedizin Berlin, Charit&#x00E9;platz 1, Berlin, 10117, Germany, 49 1523 1394295; <email>eric.wuendisch@charite.de</email></corresp><fn fn-type="equal" id="equal-contrib1"><label>*</label><p>these authors contributed equally</p></fn></author-notes><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>29</day><month>11</month><year>2024</year></pub-date><volume>12</volume><elocation-id>e67429</elocation-id><history><date date-type="received"><day>11</day><month>10</month><year>2024</year></date><date date-type="accepted"><day>16</day><month>10</month><year>2024</year></date></history><copyright-statement>&#x00A9; Eric W&#x00FC;ndisch, Peter Hufnagl, Peter Brunecker, Sophie Meier zu Ummeln, Sarah Tr&#x00E4;ger, Fabian Prasser, Joachim Weber. Originally published in JMIR Medical Informatics (<ext-link ext-link-type="uri" xlink:href="https://medinform.jmir.org">https://medinform.jmir.org</ext-link>), 29.11.2024. </copyright-statement><copyright-year>2024</copyright-year><license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on <ext-link ext-link-type="uri" xlink:href="https://medinform.jmir.org/">https://medinform.jmir.org/</ext-link>, as well as this copyright and license information must be included.</p></license><self-uri xlink:type="simple" xlink:href="https://medinform.jmir.org/2024/1/e67429"/><related-article related-article-type="commentary article" ext-link-type="doi" xlink:href="10.2196/53075" xlink:title="Comment on" xlink:type="simple">https://medinform.jmir.org/2024/1/e53075/</related-article><related-article related-article-type="commentary article" ext-link-type="doi" xlink:href="10.2196/65784" xlink:title="Comment on" xlink:type="simple">https://medinform.jmir.org/2024/1/e65784/</related-article><kwd-group><kwd>architecture</kwd><kwd>scalability</kwd><kwd>trusted third party</kwd><kwd>application</kwd><kwd>security</kwd><kwd>consent</kwd><kwd>identifying data</kwd><kwd>infrastructure</kwd><kwd>modular</kwd><kwd>software</kwd><kwd>implementation</kwd><kwd>user interface</kwd><kwd>health platform</kwd><kwd>data management</kwd><kwd>data privacy</kwd><kwd>health record</kwd><kwd>electronic health record</kwd><kwd>EHR</kwd><kwd>pseudonymization</kwd></kwd-group></article-meta></front><body><p>We would like to thank the authors of the letter [<xref ref-type="bibr" rid="ref1">1</xref>] for their comments and for taking the time to engage with our work [<xref ref-type="bibr" rid="ref2">2</xref>]. Their remarks provide us with the opportunity to clarify a key aspect of our article, and we are pleased to address the points they raised.</p><p>Most of the comments from the authors refer to functionalities provided by the TTP Dispatcher component. As mentioned in our article, our work focused on building a trusted third party (TTP) platform using <italic>open</italic> components, that is, software that is publicly available to the community [<xref ref-type="bibr" rid="ref2">2</xref>]. For this reason, we built our platform around the core components Enterprise Identifier Cross-Referencing (E-PIX), Generic Pseudonym Administration Service (gPAS), and Generic Informed Consent Service (gICS), and we are grateful that these components are available as open versions. Consequently, we only covered the functionalities supported by these core components in the <italic>Requirements</italic> section. However, we did describe the TTP Dispatcher in the <italic>Comparison With Prior Work</italic> section and explicitly noted that it supports some of the functionalities we implemented, though not as open software at the time of writing.</p><p>Regarding authentication and authorization, we would like to note that the second table in our article [<xref ref-type="bibr" rid="ref2">2</xref>] describes additional requirements that we elicited, which apply not only to the core components but also to the broader platform we envisioned [<xref ref-type="bibr" rid="ref2">2</xref>]. Consequently, these requirements are not limited to the core components, and we note that E-PIX, gPAS, and gICS are not mentioned in the table. For example, the <italic>User interfaces and services</italic> requirements category, which lists the need for a &#x201C;[c]ommon authentication and authorization framework with single-sign-on and associated rights and roles with the ability to connect to institutional directory services,&#x201D; also includes the requirement for an &#x201C;[i]ntegrated user interface across all services.&#x201D; The Keycloak-based authentication and authorization mechanism we describe in the paper integrates with this user interface as well [<xref ref-type="bibr" rid="ref2">2</xref>].</p><p>The additional information provided in the letter regarding the TTP Dispatcher&#x2019;s functionalities and Keycloak support for E-PIX, gPAS, and gICS could be valuable to interested readers of our article, and we thank the authors for offering these insights. We look forward to further exchanges with the authors on the topic of TTP services, including the adoption of HL7 FHIR (Health Level Seven International Fast Healthcare Interoperability Resources).</p></body><back><fn-group><fn fn-type="conflict"><p>None declared.</p></fn></fn-group><glossary><title>Abbreviations</title><def-list><def-item><term id="abb1">E-PIX</term><def><p>Enterprise Identifier Cross-Referencing</p></def></def-item><def-item><term id="abb2">gICS</term><def><p>Generic Informed Consent Service</p></def></def-item><def-item><term id="abb3">gPAS</term><def><p>Generic Pseudonym Administration Service</p></def></def-item><def-item><term id="abb4">HL7 FHIR</term><def><p>Health Level Seven International Fast Healthcare Interoperability Resources</p></def></def-item><def-item><term id="abb5">TTP</term><def><p>trusted third party</p></def></def-item></def-list></glossary><ref-list><title>References</title><ref id="ref1"><label>1</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bialke</surname><given-names>M</given-names> </name><name name-style="western"><surname>Stahl</surname><given-names>D</given-names> </name><name name-style="western"><surname>Leddig</surname><given-names>T</given-names> </name><name name-style="western"><surname>Hoffmann</surname><given-names>W</given-names> </name></person-group><article-title>The University Medicine Greifswald&#x2019;s trusted third party dispatcher: state-of-the-art perspective into comprehensive architectures and complex research workflows</article-title><source>JMIR Med Inform</source><year>2024</year><volume>12</volume><fpage>e65784</fpage><pub-id pub-id-type="doi">10.2196/65784</pub-id></nlm-citation></ref><ref id="ref2"><label>2</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>W&#x00FC;ndisch</surname><given-names>E</given-names> </name><name name-style="western"><surname>Hufnagl</surname><given-names>P</given-names> </name><name name-style="western"><surname>Brunecker</surname><given-names>P</given-names> </name><etal/></person-group><article-title>Development of a trusted third party at a large university hospital: design and implementation study</article-title><source>JMIR Med Inform</source><year>2024</year><month>04</month><day>18</day><volume>12</volume><fpage>e53075</fpage><pub-id pub-id-type="doi">10.2196/53075</pub-id><pub-id pub-id-type="medline">38632712</pub-id></nlm-citation></ref></ref-list></back></article>