Doctors reject connection to the “data superhighway” of the healthcare system

Doctors’ associations criticize Gematik GmbH’s pressure to digitize the healthcare system. They repeatedly emphasize that they are fundamentally open to digital progress. However, according to some medical associations, there is still room for improvement with the electronic prescription (e-prescription), the electronic certificate of incapacity for work (eAU) and the electronic patient file (ePA).

The head of the Professional Association of Dermatologists (BVDD), Dr. Ralph von Kiedrowski called Gematik’s efforts the “dark side of digitization” in a podcast. On the other hand, he described therapies and applications that simplify and improve care as the bright side of power – such as digital consultation hours or an app to determine the risk of skin cancer.

According to von Kiedrowski, doctors need digitization. However, many things are still “in their infancy” in the politically driven digitization. Attempts have been made for years to “whip ahead” processes in connection with the telematics infrastructure. In day-to-day business, however, it fails because of fundamental things such as the functionality of the systems.

Digitization must not worsen patient care

Von Kiedrowksi also admitted that it would certainly not be easy to integrate 130,000 contract doctors with the health insurance companies and insured persons, but digitization should improve patient care and at least not make it worse. In practice, the colleagues would experience again and again that the systems are unstable and that the process of reading in the insurance card alone – which otherwise takes ten to twelve seconds – takes up to a minute. According to Kiedrowski, a practice is “put on hold” at the time.

Gematik should pay in advance

The Professional Association of Pediatricians (Bvkj) also welcomes digitization, but rejects the telematics infrastructure (TI) in its current form. The association demands that Gematik “do their homework” – products should first be extensively tested. Doctors had repeatedly complained that they were beta testers for immature systems. The secure transmission of patient data between pharmacies, health insurance companies and practices should take place via the TI.

The displeasure of the doctors increased recently that the 130,000 necessary and particularly secure hardware routers (connectors) for the connection to the TI are to be replaced because their crypto certificates expire after five years. In connection with an analysis of the connectors, c’t suggested alternatives to replacing the devices.

Crypto certificates can be extended until 2025

One of the alternatives, the extension of the crypto certificates by means of a software update, had already been implemented by two of the three connector manufacturers. This would make further connectors unnecessary until the introduction of the purely software-based TI 2.0, which is to come in 2025. The Federal Office for Information Security recently confirmed to c’t that it is possible to extend the crypto certificates until the end of 2025. However, Gematik and the Federal Ministry of Health declined to examine these alternatives due to a lack of new findings.

In this context, the Association of Statutory Health Insurance Physicians of Bavaria (KVB) even threatened to withdraw from the TI, and the medical association MEDI had also spoken out in favor of stopping the exchange campaign. The professional association of ear, nose and throat doctors (ENT professional association) also showed its anger at the additional effort generated by the TI. “Doctors’ practices are not willing to go through the hassle, hassle and additional costs of replacing the TI connector that has been decided on a second time,” says Dr. Dirk Heinrich, President of the ENT professional association.