The e-prescription will probably start in around 250 practices in the test region. We asked a family doctor from one of the pilot practices about the start.
The e-prescription is now to start in around 250 practices in Westphalia-Lippe – unfortunately, it is not known how many and which practices actually belong to it. The other test region, Schleswig-Holstein, no longer wants to actively participate in the test phase – the trigger was an opinion from the state’s data protection officer. But Westfalen-Lippe wants to “stay on board” if the e-prescription can be redeemed with the electronic health card (eGK) in the next three months. Since there were still some uncertainties at the start of the e-prescription, we asked Kai Kleinholz from the Heeperholz general practice in Bielefeld about the electronic prescription.
voonze online: How is the e-prescription going so far?
Kai Kleinholz: In our practice there are no problems with issuing e-prescriptions. Unfortunately, not all pharmacies can process the e-prescriptions – despite the existing hardware. There are still some software or server problems here. Another major problem is that many patients do not yet have the e-prescription app on their smartphone or cannot yet have it because the hurdles are very high. Not only does a modern smartphone with NFC (Near Field Communication) function have to be available on which the app can be installed. An electronic health card version 2.1 with NFC function is also required. However, due to the lack of chips at some health insurance companies, there may be delays in the delivery of the insurance cards.
In addition, a PIN from the health insurance company is required, for which the insured person must identify themselves at the office of the respective health insurance company. The procedure from home via the videoident procedure has been banned for security and data protection reasons. When you finally have everything, you can receive an e-prescription digitally as a patient.
Since this has only been the case for 0.6 percent of patients so far, our practice system prints out a 2D code similar to a QR code on paper, which can then be read by the pharmacies. Digitization in Germany 2022: QR codes printed on paper. In the rest of Europe, people just shake their heads. But there should also be an alternative that is better than a paper printout to bridge the gap until everyone has a usable e-prescription: the e-prescription should be able to be saved on the insurance card, which can then also be read in pharmacies. However, this will not be possible until December at the earliest.
How is the e-prescription communicated to the patient? Are the patients informed or rather not?
We will inform our patients with notices in the practice and with publications on our homepage about the possibility of receiving the prescriptions as e-prescriptions in the future. So far, practically no patient knows about it, even though there have been a few articles in the local press on the subject since the pharmacies went live. In the next few days we should also receive information material from the Westphalia-Lippe Association of Statutory Health Insurance Physicians (KVWL) and the National Association of Statutory Health Insurance Physicians (KBV), which we can then also distribute in our practice.
Whose job do you think it is to inform patients?
This should have been tackled much earlier by the Federal Ministry of Health (BMG) and the KVWL. As a result, there is now a stuttering start, but that will develop over the course of the next few weeks and months.
Is the family function used?
Due to the low distribution of the app I can’t say anything about it yet.
How does the time commitment differ from the traditional Sample 16 form?
With our system there is no increased expenditure of time, so far we had to print form 16, instead white paper is now printed. If you have an e-prescription app, it’s even quicker because you don’t have to wait for the printout.
How many e-prescriptions have you issued so far and if so, how?
So far we have only issued about 10 e-prescriptions for testing purposes. From next week it will suddenly increase when we gradually switch to e-prescriptions, but for that I still need feedback from the surrounding pharmacies that the software and server problems have been fixed.
Why did you decide to participate in the test phase?
In our practice, we generally have a great interest in our work becoming more digital. This is for two reasons: First, because it will dramatically improve the quality of treatment. The e-prescription is just a small building block. This also includes the electronic certificate of incapacity for work (eAU), the electronic medication plan and, above all, the electronic patient file (ePA) with its contents such as emergency data, vaccination card, maternity card and other documents. By switching to digital data, which should then also be available to the treating physicians, we can finally offer patients the best possible treatment. The status quo is that no doctor knows what the other is doing unless the patient brings us a doctor’s letter stating what has been done. This is rarely the case.
Currently, every doctor’s office and hospital is a desert island in a vast ocean. Although I know how I treated my patient and what medication I prescribed for him, what treatments were carried out by other doctors, I do not know. Among other things, this could be dangerous in terms of interactions with the medications that other doctors have prescribed. This information is collected again each time.
Every patient – when they come to a practice – usually has to fill out a more or less extensive questionnaire. Then the information important for a treatment is collected. If there were an electronic patient file now, I could get the information from it and it would save me a lot of work. Also, not every patient always knows everything about their own history or forgets things, and that can sometimes be very dangerous. If a patient does not tell a doctor before the MRI, for example, that he has a pacemaker, this can lead to the pacemaker failing and, in the worst case, to death. Or if the patient is embarrassed to tell their cardiologist that they are taking Viagra and the cardiologist then prescribes a certain heart medication, that too can have deadly side effects.
And secondly, another benefit of digitization is environmental friendliness. Working digitally means working without paper. Huge amounts of paper are saved, printer toner and other materials. In addition, patients do not always have to drive to the practice to get their prescription because it is transmitted digitally. This leads to less traffic. All of this is incredibly important these days and is of great importance to us in practice.
Where do you see potential for improvement in the e-prescription?
It should be easier to get the e-prescription app. The hurdles are so high that it takes a very long time before everyone has a working app. This is incredibly exhausting for everyone involved, because the insured are actually constantly waiting for something.
