Health insurance doctors urge less bureaucracy and halt forced digitization

SHI-accredited physicians reiterate their calls for an end to forced digitalization and for beneficial digitalization to take place instead. "The further digitization process in outpatient care must be driven by targeted incentives instead of sanctions," said Dr. Sibylle Steiner at the last delegates' meeting of the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, KBV). From the delegates' perspective, there should be advantages for those who test the largely immature products of state digitization.

KBV board member Steiner is also calling for a stable telematics infrastructure – that is designed for secure data exchange – and user-friendly TI products. There is regular criticism of the lack of redundancy and availability of the telematics infrastructure. "The time has come to push ahead with digitization not only in hospitals [...] but also in practices via the new special fund," said Dr. Andreas Gassen. Steiner is therefore calling for a Practice Future Act.

The Chairman of the Board of the Association of Statutory Health Insurance Physicians in Bremen, Dr. Bernhard Rochell, highlighted the KBV surveys on the quality of practice management systems as helpful for digitalization. This would make it easier for doctors to choose a good practice management system. Digitization with positive incentives is needed and "not forced digitization from the closed cannabis cellars of the Federal Ministry of Health," said Rochell.

Electronic patient file stuck in "warm-up phase"

Currently, the ePA test phase is "gradually starting" in around 230 practices in the Hamburg, Franconia, North Rhine and Westphalia-Lippe regions and is stagnating in the "warm-up phase", according to Steiner. Of the test practices, "almost a quarter do not even have an ePA module" in their practice management system and around half of the practices "still have serious errors in the ePA module". Only a few could therefore work with the ePA. Steiner described the insight into the electronic medication list as a positive experience. However, this is not a reliable basis for a rollout in April. According to other delegates, the test phase should also be "significantly" extended.

In addition, the Federal Data Protection Commissioner, Professor Specht-Riemenschneider, had also expressed concerns that the security gaps identified at the 38th Chaos Communication Congress could be closed by April. "The ePA can only be launched nationwide once it has proven itself in practice in the test regions and all security gaps have been closed following an audit by the Federal Office for Information Security (BSI)," said Steiner. Without this, there is a risk of a loss of acceptance and trust "among doctors, psychotherapists and patients alike.

Dr. Christian Messer, Deputy Chairman of MEDI GENO Germany, pointed out that the ePA should not be the "next electronic scrap" after the misery with the TI connectors. Looking back, Dr. Sebastian Sohrab from the North Rhine Association of Statutory Health Insurance Physicians described the launch of the e-prescription as "cruel". The KBV is therefore calling for the test phase to be extended.

There should also be an exemption for children, as the KBV had already requested from the Federal Ministry of Health at the end of 2024. According to this, children should only receive an ePA upon application. In the past, paediatricians had already warned against the ePA as it endangers the privacy of adolescents. Children are only allowed to manage or object to their ePA themselves from the age of 15.

Bureaucracy is now a cancer

Doctors are also calling for a law to reduce bureaucracy, as they are spending more and more time on administrative tasks, some of which are unnecessary. According to Volker Schrage, Deputy Chairman of the Board of the Westphalia-Lippe Association of Statutory Health Insurance Physicians (KVWL), bureaucracy has become a cancer. Meters of informal inquiries are pelting into practices, some of them generated by "less intelligent AI. At best this is carelessness, at worst disrespectful treatment of the practices," says Schrage.

According to the KVWL, forms caused 55.8 million net working hours nationwide in 2020. To get to grips with the flood of forms, the KVWL has worked with colleagues in private practice and in cooperation with Barmer Ersatzkasse to make 60 forms more efficient. To this end, the KVWL set up the Westphalia-Lippe Forms Laboratory (FLWL) more than 10 years ago.

To reduce unnecessary bureaucracy, Steiner is calling on the new federal government to pass a law to reduce bureaucracy within the first 100 days. Among other things, this should stipulate that data can only be submitted once in accordance with the "once-only principle" and then exchanged within the health insurance funds.

(mack)