eHealth: Statutory health insurance physicians in the test region stop the introduction of e-prescriptions
Due to data protection problems, the Association of Statutory Health Insurance Physicians in the Schleswig-Holstein test region is withdrawing from the planned introduction of the e-prescription.
Shortly before the planned introduction of electronic prescriptions in the Schleswig-Holstein test region, the local data protection officers warn against unprotected electronic transmission of e-prescriptions by e-mail and SMS. The Association of Statutory Health Insurance Physicians (KVSH) in the northernmost federal state has therefore decided not to introduce the e-prescription for the time being. That was supposed to happen in September.
According to Schleswig-Holstein’s data protection authority, the sending of 2D codes for electronic prescriptions corresponds to the transmission of health data, so this must either be end-to-end encrypted using suitable methods or secured with other security functions, say the data protection officers. They rate the proposed method of printing out the 2D code as permissible. It is still unclear whether Westfalen-Lippe – the second test region – will also pull the ripcord for the electronic prescription.
The KVSH explains the exit in a letter to its contract doctors as follows:
“In the analogue world, the responsibility for the formal handling of a prescription passes to the recipient when the practice is handed over. What he/she does with it is entirely his/her business. In the digital world, as a doctor, you can too be held liable for misconduct or misuse of dataless QR codes by third parties, as we now learn. Therefore, for your protection, the functionality must be stopped immediately after becoming known.”
While the simple printout of an e-prescription is unproblematic, there are also secure procedures for the electronic transmission of the e-prescription to the pharmacy. One is an app developed by the project company Gematik, which requires an NFC-enabled smartphone and an NFC-enabled electronic health card (eGK). It can be recognized by the designation “G 2.1” at the top right on the front. In combination with the app, insured persons can prove to the pharmacy that he or she is the legal owner of the token represented by the 2D code. Due to the lack of chips, which also affects some health insurance companies, NFC-capable eGK have not yet been put into circulation for all insured persons.
Another method would be for the doctor’s office to send the QR code to a pharmacy via KIM. KIM stands for “Communication in Medicine” and is an encrypted e-mail system with POP3 mailboxes. For this, both the doctor’s practice and the pharmacy must have a KIM email address. However, only a few pharmacies currently have such an address because, unlike medical practices, the costs for this service are not yet reimbursed.
The third method is to use the e-prescription with the help of the eGK. How exactly this method is supposed to work is not yet clear. In addition, it should not be available until 2023.
In the letter to their contract doctors, the Association of Statutory Health Insurance Physicians expressly warns against a fourth method: “Also, avoid sending the printed e-prescription by fax, because this is also not permitted in terms of data protection.”
The Gematik dashboard counts printed recipes
In addition, KV Schleswig-Holstein warns against taking the e-prescription numbers on Gematik’s TI dashboard at face value. The printed 2D codes would be counted here. “The KVSH will step in again to provide support if, through legislative amendments and/or technical Gematik activities, a reduction in bureaucracy for practices and suitability for everyday use is foreseeable,” the refusal concludes.
