After years of delays, electronic prescriptions are expected to make a breakthrough in 2024 and become the standard for millions of patients. From January 1st, all practices must be able to issue medication prescriptions digitally, which can then be redeemed in several ways.
Consumer advocates see many practical advantages with e-prescriptions instead of the usual pink slips, but are also urging doctors to implement them appropriately. The practices are relying on stable technical conditions when everyday use begins on a large scale.
“With the e-prescription, we are starting to catch up in digitalization,” announced Minister Karl Lauterbach (SPD), referring to the German healthcare system, which has hardly been networked to date. A start across the board was delayed several times due to technical problems. In mid-December, the Bundestag passed a law from the traffic light coalition that requires practices to issue prescriptions electronically from January 1st.
The law has to go through the Federal Council again
The law still has to be finalized in the Federal Council at the beginning of February. The ministry has already pointed out to those involved in the healthcare system that the requirements for the mandatory use of the e-prescription will be met from January 1, 2024, so that it will take effect from then on. The background is that according to the current legal situation, the obligation would actually have existed from the beginning of 2022.
Practices don’t want to be a testing laboratory
Now expectations are high that the showcase project will be up and running. The National Association of Statutory Health Insurance Physicians made it clear that the technical conditions must also be reliable. “Practices in Germany issue over 1.5 million prescriptions every working day,” said a spokesman for the German Press Agency. “This has to work reliably and securely; after all, the practices are not a digital test laboratory.” The experiences of the first few days would show whether the systems were stable enough to handle mass application.
The practices have been able to prepare and adapt over the past few months because the conditions for this were not yet there everywhere. This includes a connecting device for the protected healthcare information highway. Every e-prescription also needs an electronic signature from the doctor. The law also provides for a certain amount of pressure to change: If practices do not take part, they can face flat-rate reductions in remuneration of one percent.
Concrete benefit for patients
The consumer advice centers see many advantages for patients. The specialist consultant at the federal association, Lucas Auer, told the dpa: “The pharmacy can check in advance whether the medication is in stock and order it if necessary.” This saves unnecessary journeys. There is also no more guesswork about illegible handwritten notes on recipes. In addition, follow-up prescriptions could be issued digitally without having to go to the practice again. The biggest advantage lies in minimizing risks: the digital recording of all medications enables an easy overview of interactions.
But consumer advocates also keep an eye on the electronic signature processes. If practices only sign the issued e-prescriptions later, for example collected at the end of the day, you would not be able to redeem your e-prescription for that long. Such waiting times would not be acceptable, said expert Auer. It must therefore be ensured that patients can redeem their e-prescription directly after visiting the practice.
Three redemption options at the pharmacy
E-prescriptions have long been redeemable via a special app instead of the usual pink slip – or with a printed QR code on paper. But it hasn’t had a widespread impact so far. There is now a third, simpler redemption method where you insert your health insurance card into a reader at the pharmacy. The e-prescriptions are not stored on the card, but on a central server. When you insert the card, the pharmacy is then authorized to retrieve it from there. In the future, the e-prescription app will also be integrated into cash register apps.
Consumer advocate Auer points out that the electronic health card must be NFC-enabled – i.e. suitable for wireless data exchange with other devices. This can be recognized by a symbol at the top of the map. “People who cannot or do not want to use digital offerings must not be left behind,” he emphasized in general. Support offers and analogue alternatives would have to be considered for them. “In this respect, it is to be welcomed that paper prescriptions remain valid.”
