eHealth: Draft law for mandatory interoperability in digitization

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ehealth draft law for mandatory interoperability in digitization.jpg
ehealth draft law for mandatory interoperability in digitization.jpg

The Hospital Care Relief Act (KHPflEG) is intended to regulate neuralgic points of digital health care in addition to the financing of nursing staff.

The federal cabinet has passed the draft law “on the assessment of nursing staff in hospitals and on the adaptation of further regulations in the hospital system and in digitization” – Hospital Care Relief Act (KHPflEG) for short. Even if the name does not suggest it, the law is also intended to regulate important areas of digital healthcare. Among other things, the Federal Government wants to make digital applications more user-friendly and increase the spread of central applications in the telematics infrastructure (TI). The latter is intended to ensure a “secure exchange” of patient data in the healthcare sector.

With the regulations on digital health care in the Hospital Care Relief Act, the federal government wants to counter the trend that many providers keep their systems closed. Some providers would only cooperate with selected other providers. If doctors use the services of other providers, the costs are deliberately higher. With this market behavior it is hardly possible to combine different services with each other.

The federal government sees this as a delay in the “wide-spread implementation of the TI”. Services such as the electronic patient file (ePA), the e-prescription and the electronic certificate of incapacity for work (eAU) could therefore not be introduced on time.

Specifically, paragraph 332a of the draft law serves to remove hurdles for service providers such as doctors and pharmacies. For example, competition-distorting practices that currently exist “due to restrictions by providers and manufacturers of information technology systems in the context of the telematics infrastructure” are to be ended.

Providers of hardware, software and services therefore have an obligation, subject to a fine, to ensure the “non-discriminatory integration of all components and services”. These components and services must be integrated without additional costs for the user. The draft law prohibits indirect costs in the context of choosing a manufacturer or supplier.

The federal government estimates that doctors and other service providers can save an average of 550 euros in fees each year; overall, the government estimates the savings at eight million euros a year. The obligations are to take effect one year after the law comes into force.

In addition, paragraph 332 b of the draft law prohibits “unreasonably long notice periods” on the part of providers and manufacturers. These ties delayed changing the practice management system or certain access services and thus the digitization of the healthcare system as a whole. Inappropriately long periods of notice are one-sided contracts in favor of the providers and manufacturers, the bargaining power of the customers is very low, according to the materials on the draft law.

In addition, the user-friendliness of digital applications should be strengthened so that more people use central TI applications. For example, patients should be able to identify themselves in the pharmacy in the future, possibly for the e-prescription app.

After Gematik banned the use of the videoident procedure, insured persons can currently only identify themselves in a branch of their health insurance company for the ePA and the e-prescription app. The draft law passed by the federal cabinet will now be forwarded to the Bundesrat and the German Bundestag, where they will be discussed.

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(mack)