Health - What are the benefits of the e-prescription and the e-patient file for everyone?
Electronic prescriptions and digital files for important health data are to become standard for millions of patients. This is provided for in a law passed by the coalition government in the Bundestag. E-prescriptions are to be mandatory in surgeries from the beginning of 2024. At the beginning of 2025, all patients with statutory health insurance are to receive e-patient files - unless they refuse.
Minister Karl Lauterbach (SPD) spoke of a "quantum leap", with which Germany is catching up with digitalization in the healthcare sector after many delays. However, doctors, health insurance companies and patient advocates also warned of pitfalls.
Lauterbach made it clear that after 20 years of debate, it was time to catch up. Until now, important data had been distributed on servers of practices and hospitals where patients had been treated in the past. For example, when a chronically ill patient visits a new specialist, some of the findings or X-ray images are usually not available. Treatment then often takes place without the data, which leads to errors and in any case to "suboptimal therapy". "This must not be allowed to continue."
The new regulations would have very specific benefits for patients, said the minister. Green Party health expert Janosch Dahmen said that in future, not only would all treating professions be able to see relevant information in one place, but also patients themselves for the first time. FDP expert politician Andrew Ullmann said that data sovereignty would remain with the people.
The opposition CDU/CSU abstained from the vote and called for further digital steps, while the AfD voted no. Left-wing MPs expressed data protection concerns.
E-patient records for all
Specifically, a breakthrough is to be achieved for electronic patient files (ePA) - as a personal data storage system that accompanies you throughout your life. The bundled data should also avoid drug interactions and multiple examinations. E-files were already introduced as an optional service in 2021, but so far only around one percent of the 74 million people with statutory health insurance have one.
The declared goal is 80 percent by 2025, and the government is switching to the "opt-out" principle to achieve this: According to the law, health insurers are to provide broad information and automatically set up an e-file for everyone by January 15, 2025 - unless they actively object to this.
The e-file is to be accessible with certain identification rules via health insurance apps. Doctors will be able to decide for themselves what to set and who can access what. Initially, an overview of medication will be available, followed by laboratory results, among other things. It should be possible to take the data with you when you change health insurers. People without a smartphone will be able to view their ePA in selected pharmacies, the ministry explained. Health insurance ombudsman offices are to support insured persons who do not manage their ePA via app.
E-prescriptions on a broad front
Instead of the usual pink slips of paper, e-prescriptions have also been available for some time via a special app or a printed QR code. However, a large-scale launch was delayed several times due to technical problems. In the meantime, there is a simpler way to redeem the card, which involves inserting the insurance card into a reader at the pharmacy. By law, it will now be mandatory for doctors to issue prescriptions electronically from January 1, 2024.
The obligation was actually already in place from the beginning of 2022, but practices should now make the change, as the requirements were not yet in place everywhere. This includes a connecting device for the protected data highway of the healthcare system. E-prescriptions are stored on a central server and the pharmacy is authorized to retrieve them from there when the health insurance card is inserted. In future, the e-prescription app will also be integrated into health insurance apps.
Easier data research
Research using health data is also set to make progress. To this end, a law should make it possible to link data from different sources at a central access point - for example from cancer registers and health insurance companies. Data is to be encrypted (pseudonymized).
Another opt-out model is planned for data stored in e-patient records: In other words, they are initially to be given a setting for "data donations" for research purposes, which can be rejected. Lauterbach said that this would be a breakthrough for research to improve care - for example in cancer and dementia studies.
Telemedicine and health apps
Telemedicine services such as video consultations are to be expanded - this can also close gaps in rural regions. To this end, regulations are to be abolished that previously only guaranteed practices remuneration from the health insurance funds for a limited range of services. The range of certain health apps that patients can obtain on prescription is also to be expanded.
The practical implementation
Healthcare associations welcomed the push for e-records - but also pointed out difficulties. To date, the technology works so poorly that it usually takes several minutes before the ePA can even be viewed, according to the Association of General Practitioners. The German Patient Protection Foundation warned of disadvantages for the seriously ill and those in need of care, for example with regard to the current right to a medication plan on paper.
The National Association of Statutory Health Insurance Funds called the timetable, with an introduction at the beginning of 2025, too tight. The short deadline is the right signal to the industry to launch well-engineered products as quickly as possible. In order to give insured persons enough time to make an informed decision and the insurance companies enough time to prepare, the ePA for all should rather be introduced in July 2025.
Draft law on e-patient records and e-prescriptions Explanatory notes on the regulations Draft law on the use of health data Explanatory notes on the regulations
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- Despite warnings from doctors, health insurance companies, and patient advocates, the German government, led by SPD's Karl Lauterbach, is pushing for electronic prescriptions and digital health files to become standard, as outlined in a law passed in the Bundestag.
- According to Lauterbach, this move represents a "quantum leap" in Germany's digitalization of healthcare, making it possible for all treating professionals and patients to access relevant health data in one place.
- The opposition CDU/CSU abstained from the vote, while the AfD voted against the proposal, citing concerns over data protection.
- The new regulations would see a significant increase in the number of e-patient files (ePA), which are currently only used by about 1% of the 74 million people with statutory health insurance in Germany.
- By 2025, the government aims to have 80% of people with e-patient files, using an "opt-out" principle where health insurers provide e-files to all patients by default unless they actively object.
- E-patient files can be accessed via health insurance apps, with doctors having control over what data is shared and with whom.
- Andrew Ullmann, an FDP expert politician, emphasized that data sovereignty would remain with the people, while the Green Party's health expert, Janosch Dahmen, highlighted how this would enable patients to access their health data for the first time.
- The new regulations also include a requirement for doctors to issue prescriptions electronically, with a mandatory mandate set to begin in January 2024.
- This move could greatly improve the efficiency of healthcare, as e-prescriptions would be stored on a central server and can be retrieved by pharmacies when the health insurance card is inserted.
- The new regulations also include provisions for telemedicine services and the expansion of the range of health apps that patients can obtain on prescription.
- Despite widespread support for the move towards digital healthcare, there are concerns over the practical implementation, with healthcare associations warning of technical issues and difficulties for patients who are not tech-savvy.
Source: www.stern.de
