Digital healthcare: Cloud service criticizes distortion of competition

Since the crypto certificates of the first connectors for connecting to the telematics infrastructure (TI) of the healthcare system are about to expire, the devices are to be replaced. The TI is intended for the secure transmission of patient data between practices, pharmacies and health insurance companies. The Association of Statutory Health Insurance Physicians of Westphalia-Lippe (KVWL) sent a newsletter to doctors and asked them to accept the offer from the connector manufacturer CGM. The connector-as-a-service provider Red Medical and a lawyer interviewed by the medical newspaper criticize this. They see this as a violation of the neutrality of competition because the KVWL did not point out the cheaper alternatives from other providers.

Not only CGM, but also Secunet and RISE offer connectors. There is also the significantly cheaper alternative of using connectors in data centers – in addition to Red Medical, Concat AG also provides connectors in the cloud. It is cheaper, for example, because several practices can be connected to one connector.

There is currently no signed financing agreement between the Central Association of Health Insurance Funds and the National Association of Statutory Health Insurance Physicians – so the exact conditions under which the corresponding reimbursement will be paid out are not yet known.

Associations of panel doctors must be non-competitive

Red Medical Managing Director Jochen Brüggemann finds the “one-sided presentation in the newsletter” “very unfortunate”. Otherwise, the KVen would always “put great value on market neutrality”. In the email from the KVWL, the doctors – whose connector certificates are expiring – were advised to exchange their connectors “and to get in touch with your local service provider (DVO)”.

The doctor and lawyer Professor Alexander Ehlers confirmed to the Ärzteblatt that “corporations under public law […] urged to be as competitive as possible [sind]in order to comply with the requirement of objectivity and neutrality”. As soon as “collaboration with a single company” proves to be more prominent and other providers are not named, “an unfair commercial act by the public-law corporation”.

According to Ehlers, there have already been cases in the past in which public corporations did not behave in a competition-neutral manner. Due to the “particular credibility and trustworthiness, caution is advised with regard to specific product recommendations,” says Ehlers. The KBV had already pointed out in its practice news on connector exchange that there are other providers besides CGM.

Alternatives to connector replacement are not checked

Previously, the first connectors from CGM had to be replaced this year – due to the expiring certificates. The National Association of Statutory Health Insurance Physicians (KBV) has now announced that replacing the hardware is the only option. c’t had previously suggested alternatives for replacing the hardware – but according to the KBV, the Federal Ministry of Health had refused to examine the alternatives.

According to CGM, 31,000 connectors will have to be replaced by February because changing the hardware is “the only way” to ensure the connection to the so-called telematics infrastructure. In order to accommodate the doctors, CGM had already reduced the costs to the amount that the practices are reimbursed by the health insurance companies.