Pharmacy staff voice concerns over issues within digital prescription platform
The e-prescription system in Germany, set to become mandatory from January 2024, has been facing significant issues in recent weeks, with multiple days of complete outages and significant disruptions affecting tens of thousands of patients. These outages prevent pharmacies from accessing e-prescriptions in a timely and reliable manner, posing serious health risks.
The core challenge lies in the instability and partial failure of the Telematics Infrastructure (TI), which also affects electronic patient records and insured persons' data management. Repeated disruptions have affected access via TI gateways used by healthcare providers and pharmacies, causing operational challenges. Moreover, there is a lack of sufficient fallback procedures or flexibility for pharmacies to dispense medications quickly during system outages.
The German Pharmacists' Association has urged Gematik, the federal digital agency managing the system, to urgently improve the e-prescription system's stability and reliability. Gematik and stakeholders are investigating technical root causes, including issues with TI gateways managed by providers like RISE, and have resolved some failures temporarily.
There is a call for more flexibility to allow pharmacies to dispense medications during outages without bureaucratic hurdles, reducing risks to patient care. Broader digital healthcare reforms, such as the Hospital Future Act and other laws, are driving modernization and infrastructure upgrades by 2027, which may indirectly support more robust digital systems including e-prescriptions.
Efforts to increase trust in digital health systems, including addressing privacy, data protection concerns, and interoperability challenges, are underway. Some healthcare associations are considering legal approaches to hold Gematik accountable for losses caused by outages.
According to Brysch, the era of the "black box e-prescription" should end immediately. Eugen Brysch, a board member of the German Foundation for Patient Protection, has called for a "daily e-prescription radar" to inform doctors of system functionality. Those who wish can still receive the prescription as a paper printout.
Gematik, the responsible society for the e-prescription system, admitted that there have been components and services affected by recent disruptions. The e-prescription system's unreliability has been compared to that of Deutsche Bahn by Thomas Preis, head of the Federal Association. However, Gematik continues to work towards improving the reliability and stability of the e-prescription system.
The goal of the mandatory e-prescription is to provide more comfort and reduce trips to the doctor's office. Follow-up prescriptions can be issued without a repeat patient visit. Manual signatures and trips will be eliminated with the implementation of the mandatory e-prescription. Despite these challenges, the push towards digitization in healthcare remains inevitable.
The issues with the e-prescription system in Germany, particularly its instability and impact on medical-conditions, have raised concerns about its reliability in health-and-wellness matters. The German Pharmacists' Association has urged Gematik to address these concerns, as technology solutions like e-prescriptions are expected to improve efficiency and patient care, not pose risks. With broader digital healthcare reforms on the horizon, there's hope for improved e-prescription systems that ensure a robust and secure medical service.
