TI-Messenger (TI-M) is the official standard for secure communications across the German healthcare system. Built on the open Matrix standard, TI-M ensures digital sovereignty, interoperability and end-to-end encryption for the entire sector.
TI-M is mandated by Gematik, the National Agency for Digital Medicine that is majority-owned by Germany’s
Federal Ministry of Health
. It’s a world-leading initiative connecting over 150,000 healthcare organisations and 74 million patients within a private, federated network. By combining secure professional identity verification with a unified medical directory, TI-M provides a trusted and seamless foundation for the future of digital medicine.
A secure and scalable backend to suit gematik’s TI-Messenger standard for German healthcare.
Element Server Suite Pro for TI-Messenger (ESS Pro for TI-M) is the only enterprise-grade Matrix server built specifically to suit gematik’s TI-Messenger solution for German healthcare.
Learn moreCompliant with the latest versions of TI-Messenger Pro and ePA. Also compliant with ISO 27001 and the Cyber Resilience Act.
Built by the creators of Matrix, it delivers outstanding performance, continuous security updates and enterprise-grade features.
Can operate with any TI-Messenger compliant frontend, supporting TI-Messenger federation for healthcare providers.
ESS Pro for TI-M is built on an optimised Matrix homeserver called Synapse Pro that delivers the scalability for nationwide deployments. For large-scale deployments, Synapse Pro delivers over 80% greater efficiency compared to community Synapse implementations.
Designed specifically for TI-Messenger providers, Synapse Pro delivers:
ESS Pro for TI-M can be used to support all types of TI-Messenger deployments, from the largest of individual deployments, through to multi-tenancy to serve thousands of small hosts.
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For health insurance companies and other huge deployments.
Performance and efficiency
Reliability and accessibility
Increased security at lower costs
Synapse Pro offers significant resource savings
For service providers supporting hundreds of healthcare organisations.
Sharing resources across small specialist services
Manage thousands of deployments
Personnel and hardware savings
Host with up to 50 tenants per shard allows 
reduction of RAM costs by up to 90%
TI-Messenger operates as a private Matrix-based federated network, restricted exclusively to Gematik-approved organisations. To maintain this closed ecosystem, all connections are managed by a TI-Messenger Proxy. This secure border gateway enforces strict communication rules and ensures total compliance with Gematik specifications. Element’s Secure Border Gateway is the foundational building block for this proxy, serving as a core, integrated component of our ESS TI-M solution.
Benefits from modern memory safety and concurrency models, eliminating data races and reducing operational risk.
With an idle memory footprint of just 10 MB compared to 800 MB in the TI-M reference implementation.
Provides all functionality as demanded by the latest TI-M Pro and TI-M ePA specifications.
Dedicated Federation List Service to obtain and manage the federation list from Gematik.
Supports automatic, load-dependent scaling and high availability.
Learn moreESS Pro for TI-M gives T-Systems a complete backend for its TI-Messenger solution, allowing T-Systems to focus on building its frontend client.
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Sovereign, interoperable and secure communications, built on the Matrix open standard.
