The next stage for electronic patient files starts in July

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The major digitization project of the German health system, the electronic patient record (ePA), has reached an important milestone: By July 1st, all medical practices must be connected to the digital telematics infrastructure of the health system (TI). According to the National Association of Statutory Health Insurance Physicians (KBV), “almost all practices of resident doctors and psychotherapists” are connected to the TI, which enables secure and fast data exchange in the healthcare system.

The devil in introducing the EPR, however, lies in the details. In order to be able to use the digital file, the practices still need an update for their connector. This is a piece of hardware that connects them to the protected TI. “There are three manufacturers on the market, one of which is currently offering the necessary, certified update,” says KBV spokesman Roland Stahl. The update has been announced for the other two. Here, however, it is questionable whether it will be available to the practices on time.

It can take a few more weeks before all medical practices can actually fill out the electronic patient file. These can be digital x-rays or other documents, doctor’s letters, findings or medication plans. The planned e-prescription also ends up in the ePA cloud. The pink-colored prescriptions that were previously used to prescribe medicines will soon be a thing of the past.

A pilot test will also start on July 1st in Berlin and Brandenburg: around 50 medical practices and 120 pharmacies will test and evaluate the new digital e-prescription. The e-prescription simplifies the process in the doctor’s practice, says Markus Leyck Dieken, managing director of Gematik GmbH, which is majority-owned by the federal government and is responsible for setting up a secure health data network. “We know from the pilot phase that management as an e-prescription also saves time for the doctor’s assistant. For the patient, it often means not having to go certain ways at all.”

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“In the future, the digital prescription will soon open up far more services for everything to do with prescriptions, such as checking my medication plan for tolerance,” says Gematik boss Leyck Dieken. This also includes the function that all preparations received are documented so that, for example, you can tell the doctor straight away which medication you have been prescribed. It is also possible to remember a follow-up recipe.

The e-prescription should be mandatory for all practices by January 2022. A quarter earlier, in October 2021, the digital version of the “yellow note”, i.e. the electronic certificate of incapacity for work (eAU), is mandatory.

The KBV doubts that the pilot test will be sufficient to lead the ambitious digital project to success. “In order to ensure the start of the e-prescription throughout Germany in January 2022, the technology must be reliably available to everyone in good time,” says KBV spokesman Stahl. The practices must be able to rely on the fact that the technology is mature. The KBV would have liked a larger pilot test.

Prof. Heyo K. Kroemer, CEO of the Berlin Charité, on the other hand, considers the introduction of the digital workflow to be overdue: “The e-prescription in Germany certainly means significant progress. But progress would of course have been even better if it had come in 2011 and not until 2021, “he told the German press agency. “We absolutely have to create awareness that comprehensive digitalization of the health system is urgently needed.”

The Charité boss emphasized that the situation with the digitization of the health system was “no glory for our country”. “No one-sided accusation of blame helps”, it was due to data protection or blockades from different parties. “Together, many factors have led to us being where we are today.” An awareness must be created that comprehensive digitization of the health system is urgently needed. “On the one hand, demographic developments are forcing us to do this: In the next eight years, so many medical professionals will be retiring that we will under no circumstances be able to maintain the services that are taken for granted in Germany without consistent digitization. We can no longer afford to do double examinations all the time. “

Kroemer also referred to the “new competition that sits virtually at the table via the Internet and health gadgets”. “An Apple Watch, for example, can use a kind of EKG to determine whether a patient has atrial fibrillation, a frequent cardiac arrhythmia, or not. Three jobs in a hospital like the Charité have so far been linked to such a diagnosis: a doctor, a nurse and an administrator. ” You will not be able to compete directly with Apple. “But even if we wanted to work with such providers in the sense of a system partnership, that would of course only work if we can meet on an equal footing.”

This presupposes that the hospitals are largely digitized, which is often not yet the case. However, the starting point at the Charité is not bad, said Kroemer. “We should greatly improve our digital efforts. Players like Amazon and Apple only have the digital part and do not have the hardware – in the sense of hospitals equipped with staff and equipment – that we in turn have.” The key to future success will be to combine both aspects. “That means we definitely have the opportunity to be competitive in the long term.”


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