e-patient record: "It's an outrage that the prices are in there"

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Digitization in the German healthcare system is not yet providing relief. This became clear in the discussion "Where is the digital journey heading in outpatient care?". While the will to progress is there, frustration over regular disruptions of the telematics infrastructure – the data highway of the healthcare system – complicated processes, and a lack of information remain ubiquitous.

Moritz Eckert from the practice group Eckert & Poppe reported from his practice. The electronic patient record and e-prescription were introduced early for him – initially for testing purposes. He cited the electronic medication list as a positive example. It "fills itself passively through the e-prescription. There's no effort involved, it's relatively good." However, many other functions are unstable, difficult to use intuitively, and developed far from practical needs.

Billing data does not reflect actual remuneration

The service overviews from health insurance companies contained in the ePA are particularly causing anger. Dr. Christiane Wessel from the Kassenärztliche Vereinigung Berlin (KV Berlin) found clear words for this: "It is actually an outrage that it is presented like this." The displayed prices do not reflect the actual, budgeted remuneration and create a false impression for patients. She also called for greater reliability of the systems.

Florian Hartge, a managing director of Gematik, admitted that the systems still fail too often. However, he emphasized Gematik's role as a supervisory body: "We monitor it and make it transparent," but Gematik does not operate the telematics infrastructure (TI) itself. At the Digital Health Conference (DHC), another Gematik managing director, Florian Fuhrmann, had already addressed the unfair market of practice management systems (PVS).

According to doctors, the choice of PVS is guided by a deceptive logic: "Many have it, so it must be good." According to Eckert, this is not the case with the market leader. This likely refers to products from Compugroup Medical, which was also criticized at the DHC. "We have great practice management systems that can do a lot. We also have a lot of junk, no question," said Eckert. If you can't even operate the junk, "then the problem is something else entirely."

According to Dr. Philipp Stachwitz, KBV's digital expert, the benefit of digital applications is still limited, but the potential is great, especially with regard to research. The debate about data protection and transparency is not just a doctor's issue, but a fundamental societal question that must now be addressed, as the ePA has become a reality.

"Digi-Managerin"

At the same time, there is great interest in AI in practices, as Christiane Wessel reported. The Berlin "Digi-Praxis" shows how AI applications can save time on routine tasks and relieve staff. To better support practices in digitization, plans are also underway to establish training for medical assistants as "Digi-Managerinnen" – following the example of KV Westfalen-Lippe. These are specially trained practice employees who take responsibility for digitization, analyze the practice's degree of digitization, search for new tools, and train the team.

Stable systems desired

At the end of the round, there was consensus: a lot has been achieved, the ePA is finally a reality. But more training, more support, and stable technology are needed. Eckert was pessimistic: "We want to plan further, but we don't want to drown at the traffic light." He wishes for a breathing space after the stress, for example, due to the TI components that need to be replaced. First, the systems need to run stably. Florian Hartge, however, remarked regarding the pace of development: "If you go any slower, you won't get anywhere."

(mack)