Everything now depends on a new redemption option: In a small query from the CDU/CSU parliamentary group (Printed Paper 20/5156), the federal government has answered how the e-prescription should continue. When asked how the “progress and dynamics of the introduction of e-prescriptions” is evaluated, a reference to one million e-prescriptions issued follows. Even if the Federal Ministry of Health is celebrating the seemingly high number of e-prescriptions issued, there is still a long way to go before they are introduced across the board – with over 400 million prescriptions issued every year.
E-prescription in mid-2023
According to the federal government, everything now stands and falls with the availability of “another digital redemption option”. The Gematik also examines other possibilities. According to this, “intensive talks are currently being held with the industry” so that the e-prescription can continue quickly. The BMG is also currently examining “various measures to support the roll-out process”.
The federal government denied the question of planned incentives for the participating doctors. However, Gematik, which is responsible for digitizing the healthcare system, had considered various options in advance, such as an “e-prescription-ready flag” that signals that the doctor can issue the e-prescription or the free provision of information material. For doctors, the e-prescription is often associated with additional work, for example because patients need help using the app or because they come back because there were problems sending the prescription to the pharmacy. As a result, some doctors chose to print out the prescription during the active trial phase, as patients would then not threaten to come back to the practice.
Rocky paths
So far, the e-prescription app has been the only way for patients to receive the prescription digitally – as long as the doctor and patient are able to do so. The authentication for the app is associated with effort for many patients. First of all, an electronic health card version 2.1 as well as a PIN and an NFC-enabled smartphone or card reader are required, which the insured often only receive after personal authentication from the health insurance company. Since this turned out to be too cumbersome in practice, the two participating associations of statutory health insurance physicians announced that they would no longer actively participate in the “rollout” of the e-prescription.
In the meantime, the manufacturer Medisoftware had implemented a function in the practice management system that was not intended by Gematik, according to which the token for the e-prescription was sent from the system unencrypted to the e-mail address of the patient. The Association of Statutory Health Insurance Physicians in Schleswig-Holstein (KVSH) took this as an opportunity to have the sending of the token checked via email and SMS, which the independent state data protection officer there rejected, but suggested alternatives.
The withdrawal justified by the KVSH was in turn used by the Association of Statutory Health Insurance Physicians of Westphalia-Lippe to issue an ultimatum. Either there is an uncomplicated way, or they no longer participate actively. Gematik then made a proposal for this. Data protectionists rejected this, but also offered several alternatives. Gematik then specified a redemption method in the pharmacy for mid-2023 that was reinforced by an additional security function, for which, among other things, adjustments to the connectors – routers for connecting to the healthcare network – in the pharmacies are planned.
(mack)
