KBV and KVen want a new plan for the introduction of e-prescriptions

/picture alliance, dpa

Berlin The National Association of Statutory Health Insurance Physicians (KBV) and the 17 Associations of Statutory Health Insurance Physicians (KVen) are trying to achieve a change of course in politics when introducing electronic prescriptions (e-prescriptions). In a letter to Federal Minister of Health Karl Lauterbach (SPD), they clearly criticized the approach of the gematik and ask that the planned introduction concept be fundamentally revised.

The professional representatives of contract doctors feel that they are supported by the Federal Ministry of Health (BMG) deceived: On March 9th, it assured that digitization in the healthcare sector would in future only be promoted in coordination with the stakeholders and that applications would only be introduced after sufficient testing.

Exactly two months later, however, this promise already seemed to have lapsed: on May 9th, Gematik submitted a draft resolution that stipulated the mandatory introduction of e-prescriptions in Schleswig-Holstein and Bavaria from September 1st and an extension to six more federal states from December 1st. From February 1, 2023, it should therefore become mandatory nationwide.

In the proposed resolution, the shareholders of Gematik are asked to agree to a procedural proposal for the rollout of the e-prescription that has not previously been agreed with the parties involved, the letter says German Medical Journal (D) is present. Gematik announced last week that the shareholders’ meeting wants to vote on the proposed resolution at the end of May.

The KVs in Schleswig-Holstein and Bavaria were also not informed, according to the letter to Lauterbach. There were neither talks nor votes, the proposed procedure was flanked by press reports instead, which caused considerable incomprehension and irritation among the doctors concerned.

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The self-government therefore sees itself as a duty. According to KBV and KVen, we cannot and do not want to leave this again uncoordinated and unforeseeable acting of the Gematik neither uncommented nor uncontradicted.

In contrast to what Gematik and Lauterbach claim, the practicability of the e-prescription in the test projects has by no means been proven at the present time. Due to the large number of systems and participants, a complex process chain has to be run through. Last week, the BMG, at the request of D confirms that only 224 medical practices have issued an e-prescription so far. Accordingly, testing on a broad basis has not yet taken place.

The previous concept of Gematik, which is based on the fiction of transferring the e-prescription with only 30,000 prescriptions without further intermediate stages in a nationwide rollout process and in this way being able to replace a process of around 750 million prescriptions per year, is clearly on the verge of failure condemns and jeopardizes the practice processes considerably, the professional representatives warn.

As a KV system, they feel obliged to fulfill the legal mandate to ensure medical care for patients with a billion patient contacts, which can only be ensured with reliable processes. KBV and KVen claim that processes that work today should only be replaced by processes that can be proven to also work smoothly.

A current survey by the KBV among 6,000 doctors, to which it also refers in the letter, shows that this is by no means the case: According to this, the introduction fails in most practices due to technical problems.

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For example, 59 percent of participants stated problems with the telematics infrastructure (TI) when asked why they were not yet issuing e-prescriptions. A third (32 percent) have not yet been able to install the corresponding update for the practice management system, while another third (30 percent) have not yet received the pharmacies in the area.

Against this background, the management of KBV and KVen Lauterbach would like to ask to counter further losses of acceptance in the digitization. He should influence Gematik to withdraw their proposed resolution and ask them to design a rollout process for the e-prescription that can be used to ensure that it does not affect patient care. © lau/aerzteblatt.de

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