Is the breakthrough for e-prescriptions for everyone coming now?

Digitization - Is the breakthrough for e-prescriptions for everyone coming now?

After years of delays, electronic prescriptions are set to achieve a breakthrough in 2024 and become the standard for millions of patients. From January 1, all practices must be able to issue prescriptions for medication digitally, which can then be redeemed in several ways.

Consumer advocates see many practical advantages with e-prescriptions instead of the usual pink slips of paper, but are also urging doctors to implement them appropriately. Practices are relying on stable technical conditions when everyday use starts on a large scale.

"With the e-prescription, we are starting the race to catch up in digitization," announced Minister Karl Lauterbach (SPD) with a view to the German healthcare system, which has hardly been networked to date. A broad-based launch was delayed several times, partly due to technical problems. In mid-December, however, the Bundestag passed a law by the traffic light coalition that obliges practices to issue prescriptions electronically from January 1.

Law still has to go through the Bundesrat

The law still has to go through the Bundesrat at the beginning of February. However, the ministry has already pointed out to healthcare stakeholders that the conditions for the mandatory use of e-prescriptions will be met from January 1, 2024, meaning that they will come into effect from then. The background to this is that, according to previous legislation, the obligation would actually have been in place from the beginning of 2022.

Practices do not want to be a test laboratory

Expectations are now high that the showcase project will be up and running. The National Association of Statutory Health Insurance Physicians made it clear that the technical conditions must also be reliable. "Every working day, practices in Germany issue over 1.5 million prescriptions," a spokesperson told the German Press Agency. "This has to work reliably and securely; after all, surgeries are not digital test laboratories." The experience of the first few days will show whether the systems are stable enough to cope with mass use.

The practices have been able to prepare and adapt over the past few months, as the prerequisites for this were not yet in place everywhere. This includes a connection device for the protected data highway of the healthcare system. Every e-prescription also needs an electronic signature from the doctor. A certain amount of pressure to change over is also provided for by law: If practices do not comply, they may face across-the-board cuts of one percent in their remuneration.

Concrete benefits for patients

The consumer associations see many advantages for patients. Lucas Auer, a specialist at the federal association, told dpa: "The pharmacy can check in advance whether the medicine is in stock and order it if necessary." This saves unnecessary trips. There would also be no more guesswork about illegible handwritten notes on prescriptions. In addition, follow-up prescriptions can be issued digitally without having to go back to the practice. The biggest advantage is the minimization of risks: The digital recording of all medications would allow an easy overview of interactions.

However, the consumer advocates are also keeping an eye on the electronic signature processes. If practices only sign the issued e-prescriptions afterwards, for example collectively at the end of the day, people would not be able to redeem their e-prescription for so long. Such waiting times would be unacceptable, said expert Auer. It must therefore be ensured that patients can redeem their e-prescription immediately after visiting the practice.

Three ways to redeem prescriptions at the pharmacy

For some time now, e-prescriptions have been able to be redeemed via a special app instead of the usual pink slips of paper - or with a printed QR code on paper. However, this has not yet had a widespread effect. However, there is now a third, simpler way of redeeming prescriptions, which involves inserting the health insurance card into a reader at the pharmacy. The e-prescriptions are not stored on the card, but on a central server. When the card is inserted, the pharmacy is then authorized to retrieve them from there. In future, the e-prescription app will also be integrated into cash register apps.

Consumer advocate Auer points out that the electronic health card must be NFC-capable for this - i.e. suitable for wireless data exchange with other devices. This can be recognized by a symbol at the top of the card. "People who cannot or do not want to use digital services must not be left behind," he emphasized in general. Support services and analog alternatives must be considered for them. "In this respect, it is to be welcomed that paper prescriptions remain valid."