Telematics infrastructure: Doctors criticize missed availability targets

After pharmacies complained about the lack of availability of the telematics infrastructure (TI), doctors are now following suit. In a letter to Gematik and the Federal Ministry of Health, which is available to Ärztenachrichtendienst, board member Dr. Sibylle Steiner complains about the latest TI outages: "The seven-hour disruption at Arvato at the beginning of July recently demonstrated the serious impact this has on practices and thus on patient care for approx. 45,000 affected facilities", the letter states. Arvato Systems is still analyzing the causes and has not yet responded to a further inquiry from heise online. Inadequacies at other service providers also cause disruptions, and the public is often not informed of all the reasons.

According to Steiner, it makes no difference to practices whether a single service of the telematics infrastructure is unavailable or whether the entire connection is cut, reports the Ärztenachrichtendienst. Mostly affected are the e-prescription, the electronic certificate of incapacity for work or the electronic patient file. The lack of availability of services has been criticized for years.

High availability?

In an evaluation covering the period between April 29, 2025 and July 9, 2025, there were constant problems. "In these 1704 hours, there were 21 EPA-related disruptions, each lasting a median of 3.22 hours. During this time, the ePA was therefore unavailable for some users for a total of 67.62 hours, which corresponds to an availability of around 96.0% for these practices. Calculated over a year, this would correspond to an unavailability of 348 hours, i.e. 14.5 days", the Ärztenachrichtendienst quotes from the letter. According to Steiner, the availability rate for e-prescriptions is 96.3 percent and 97.6 percent for electronic certificates of incapacity for work.

As doctors are obliged to fill the ePA from October, Steiner is concerned. She is therefore calling for those involved to focus on very high availability (99.9 percent and above), which is already standard in other critical infrastructures. So far, availability according to the availability classes of the Federal Office for Information Security has tended towards "no assured availability", which is around 95% and below. Steiner is therefore calling for more redundancy. Otherwise, not only would acceptance of the TI and its services suffer, but supply would also be jeopardized.

(mack)