E-prescription up and running, but processes still need to be improved
The e-prescription is now running better, the participants of the final e-prescription summit agree, but there is still room for improvement.
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The e-prescription has become a reality. From the beginning of 2024, not only pharmacies but also all panel doctors will be obliged to issue e-prescriptions. For various reasons, however, it got off to a bumpy start, which some of those affected described as an "imposition". According to Sebastian Zilch, sub-department head for Gematik, e-health and telematics infrastructure at the Federal Ministry of Health (BMG), some initiatives formed during this time even made the "absurd" demand to "go back to paper".
The launch of the e-prescription was already celebrated in 2021, with four copies issued. Meanwhile, more than 220 million e-prescriptions for prescription medicines have been issued over the entire period, the majority this year. Other prescription types, such as for narcotics, are to be added in the future, and nursing care is also to be connected. This was discussed by participants at the fifth and final e-prescription summit, which was supported by the healthcare industry and health insurance companies, among others.
E-prescription is going better
The experts agree that things are going better overall. The e-prescription is intended to improve the quality of care and drug safety, but cost-effectiveness and efficiency also play a role. "You no longer have to push kilos of paper from A to B", Zilch explains about the e-prescription and other applications of the telematics infrastructure. What's more, there is no need to wait days for the information required for treatment to reach those involved.
Zilch admitted that not all subcomponents of the e-prescription had been considered. In the care sector, electronic health cards sometimes have to be transported around the country because doctors are generally not permitted to transmit the token required to redeem the e-prescription directly to the pharmacies. The majority of care facilities are not connected to the telematics infrastructure, which is intended for the exchange of patient data. From 2025, the care sector will also be obliged to have a TI connection, and this is set to change.
Majority of e-prescriptions via electronic health card
One milestone for the e-prescription was that doctors insistently demanded that prescriptions be filled via the electronic health card. Most e-prescriptions are redeemed via this, whereas very few are redeemed via the e-prescription app from Gematik, which is responsible for the digitalization of the healthcare system. The health insurance companies are currently integrating an e-prescription function into their app for the electronic patient file; Techniker was the first to do so, closely followed by AOK. Many doctors are not yet aware of the digital identities required for these and other TI applications, Nicole Löhr explained, Director of the Association of Statutory Health Insurance Physicians in Lower Saxony.
Doctors have to cope with ambitious projects
For doctors, all these obligations pose some major challenges. The Ministry of Health has set itself ambitious goals for the "digital transformation of the healthcare system". Processes need to be thought about digitally. There has been repeated criticism that PDFs are only being electrified, and the electronic patient file planned for 2025 will initially be filled with PDF files. With the integration of the e-prescription function into the health insurance apps, Zilch hopes for more "fully digital" e-prescriptions.
Access to digital healthcare services should also become increasingly low-threshold to ensure wider acceptance among the population. At the same time, Zilch promises to "keep an eye on data security" – because nobody wants "their data to disappear somewhere". Gematik is to be expanded into a "digital health agency" to accelerate the digitalization of the healthcare system and be given a mandate for incidents and interoperability, including the right to sanction software manufacturers. "It hurts every time a deadline has to be postponed," said Zilch.
Private health insurance companies monitor plans
Private health insurers are continuing to monitor developments in healthcare digitization, explained Christian Hälker, Managing Director of the Association of Private Health Insurers. The first private health insurance companies are already e-prescription-capable, and added value can be recognized. According to Hälker, this cannot currently be seen in the electronic patient file. However, the versions are being monitored. "We'll get on board at some point".
(mack)
