Comment on the e-prescription stop: Unpopular, but correct – Lauterbach gives hope

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Lauterbach lends a hand: With the decision to pull the plug on the e-prescription shortly before the start and to test the product more intensively, the new Minister of Health shows that he is not afraid of unpopular decisions. At last a doer seems to be at the head of the Ministry of Health who, unlike his predecessor, does not build digitized castles in the air with promises that he cannot keep anyway.

Jonas Volkert has been writing online for iX and heise since 2021. He mainly looks after the areas of e-health, e-government and careers.

Even if stopping the e-prescription just two weeks before the mandatory start may seem like a hasty quick shot: It was the only right decision – and one that Jens Spahn would probably not have made. Admittedly, stepping down is not a good thing. But if a minister’s misconduct rattles so loudly even after his post has been vacated, hopefully it is allowed at this point.

Of course, the advantages of the e-prescription sound tempting: less paper waste, improved communication between medical institutions and pharmacies and a detailed overview of the drugs prescribed by patients. And (almost) nobody asks for a general stop. Only: The now averted compulsory introduction, which threatened to bring the already ailing health system to a standstill, would have really not been worth the little more comfort, right?

Spahn stuck to his plan for a long time, to his prestige project: “Only the electronic prescription makes telemedicine a successful project,” he explained in an interview with the Frankfurter Allgemeine Zeitung in 2018. That suggests that the e-prescription was in truth the last desperate attempt by a failed reform minister to push through one of his digitization projects. Trying to make sense of his term in office apart from the Corona crisis.

The list of e-health e-projects that were thrown into the sand during Spahn’s tenure is long: eAU (electronic certificate of incapacity for work), ePA (electronic patient record), eMP (electronic medication plan) and, to top it off, the e-prescription. Under Spahn, however, the BMG hardly presented any of these projects on time. And when they did see the light of day, nobody wanted them anymore, because either health insurance companies hardly took part or there was simply a lack of acceptance among the population. The minister promised a lot and fulfilled little. That was often disappointing and often dangerous from a security point of view.

With the e-prescription, however, the ego trip threatened to end in fiasco. As a poorly prepared construct, against which doctors in this country repeatedly resisted with all their might, but unsuccessfully, it had real apocalypse potential. Neither the software nor the hardware were ready for the drastic step in German practices at the turn of the year. Organizationally, the project was chaotic as usual: the dates for the mandatory start of the e-prescription and the upstream test phases have been postponed again and again. No one was really surprised that the latter remained without sufficient knowledge because of the lack of acceptance of the electronic prescription.

One would like to call out an old Tocotronic text after Spahn: Jens, the idea is good, but the (medical) world is not yet ready. This realization, however, actually applied to all of his projects, which turned out to be unachievable castles in the air. The solution was actually always obvious: Just talk to those affected before making extravagant promises to the population.

The ex-minister is of course not alone with his communication problem. It is the crux of most digitization projects in Germany. Still, that doesn’t free him from his guilt. Especially because Lauterbach is now listening to the medical world and showing that there is another way. Quite a few hoped for that, who had already seen him during the tenure of his ultimately failed predecessor in the ministry. At least with the e-prescription, he now seems to be keeping this promise.

Perhaps he will actually succeed in intensifying the exchange with those for whom he is responsible as Minister of Health: Ultimately, we would all wish it. A health minister who first speaks to the medical staff who have to pay for the decisions instead of making decisions over their heads, that would be something. You’ve rarely seen anything like this recently. And who knows, maybe it will still work out with the e-prescription, telematics and the reform of the healthcare system. Miracles are happening from time to time.

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