With the decision of the shareholders of Gematik that electronic prescriptions can now also be redeemed with the health card, the technology returns to its beginnings. The first pilot projects began 20 years ago with a chip card intended to make the filling of prescriptions and the dispensing of medicines more secure. The sentence of the then Minister of Health Ulla Schmidt became legendary: “With the map we will bring something forward that other countries can learn something from.” Other countries learned how not to do it.
Back to the e-prescription on the electronic health card
On July 22, 2022, the shareholders’ meeting of Gematik again decided that electronic prescriptions can be redeemed with the electronic health card. This completes a circle: 20 years ago, on August 21, 2002, the pilot project for the Schleswig-Holstein health card started, followed by a second pilot, the Düren health card. Health Minister Ulla Schmidt was present in both cases and has been promoting an electronic health card since she took office. With this health pass, Germany should play an international pioneering role from which other countries can learn.
At the time, the Ministry of Health wanted to draw conclusions from the so-called Lipobay scandal and improve drug therapy safety (AMTS) with the health passport. A smart card should help keep a history of all drugs a patient is taking. Gradually, a secure medication history for every patient should be created on the server, wrote the German Pharmacy Newspaper on the Düren project.
Pioneer Germany confidently announced that the electronic health passport would come in 2006. It should also be inexpensive at one billion euros, since up to 5 billion could be saved annually. Of course, that was calculated in DM and was in a report published in 1998 on “Telematics in Health Care” by the consulting firm Roland Berger.
It is hardly surprising that the IT industry promptly responded to the self-declared “largest German IT project” with a willingness to milk the healthcare system. However, doctors and dentists also spoke up and insisted on the protection of patient data, which started a debate about data protection and the anonymization or pseudonymization of disease data that has lasted to this day. But that shouldn’t stop the IT development of this telematics.
With the Health Modernization Act that came into force in 2004, it was decided that the electronic health card would be introduced in 2006, and in the first pilot projects as early as 2005. At CeBIT 2004, Minister Ulla Schmidt presented a large cardboard disc, symbolic of the documents of the “framework architecture” that industry consortium biT4health on a CD-ROM. The costs have now been estimated at one billion, a sum that will be amortized after two years at the latest, the minister explained.
Nevertheless, discussions began about who would finance the health card. There was a whole series of suggestions as to how the technology in medical practices and pharmacies could be financed. The fact that not everything is going smoothly and that the introduction of the card and telematics could be significantly delayed was discussed at the first crisis summit in the Ministry of Health in autumn 2004. Alternatives to the map, such as a mini CD-ROM, were discussed on it. Again it was Minister Schmidt who calmed her down and explained that the health card would really come on time.
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