E-prescription system faults prompt discontent among pharmacy staff
The German e-prescription system, set to become mandatory in January 2024, is undergoing significant changes to ensure its reliability and stability. The system, aimed at providing more comfort and fewer trips to the doctor's office, has faced challenges in recent weeks with multiple crashes and disruptions affecting tens of thousands of patients [1][3][5].
To address these issues, several key measures are being implemented. Firstly, the technical infrastructure needs improvement, particularly the TI gateway components, to strengthen the underlying telematics infrastructure and ensure robust, redundant systems [3].
Secondly, enhanced system monitoring and rapid incident resolution are crucial. Recurring issues linked to external service providers have caused instability, and implementing advanced real-time monitoring, faster fault detection, and dedicated rapid response teams can reduce outage duration and prevent escalation [5].
Pharmacies also need more flexibility during downtime to supply medications quickly and without bureaucracy. This might include temporary fallback procedures using paper prescriptions or offline authentication modes to avoid patient care delays [1].
Clear communication and transparency are also essential. Frequent disruptions have frustrated both healthcare professionals and patients, and Gematik and other stakeholders should communicate clearly about current system status, planned maintenance, and contingency protocols to maintain trust [1][5].
Stakeholder coordination and accountability are of utmost importance given the complex network of providers, insurers, and IT contractors involved. Stronger coordination mechanisms and clear accountability (including possible legal or financial liabilities) for service interruptions are necessary for continuous improvement [3].
Eugen Brysch, a board member of the German Foundation for Patient Protection, has demanded an "early warning system" and a "daily e-prescription radar" to inform doctors of system issues [4]. He has also called for Gematik to submit a monthly disruption report to Health Minister Nina Warken (CDU) [2].
Thomas Preis, the head of the Federal Association of Pharmacists, compared the e-prescription system's unreliability to that of Deutsche Bahn [4]. Meanwhile, Brysch has demanded that the era of the "black box" e-prescription ends immediately [4].
Despite the challenges, Gematik is continuously working to improve the reliability and stability of the e-prescription system. One positive aspect is that those who wish can still receive their prescriptions as a paper printout. Additionally, follow-up prescriptions can be issued without another patient visit [1].
Handwritten signatures and trips will be eliminated with the e-prescription system, making healthcare more efficient and convenient for everyone. However, it is crucial that these improvements are made to ensure the system can sustainably support mandatory digital prescriptions without risking patient health due to outages or delays [1][3][5].
References: [1] Gematik [2] Brysch fordert Monatsbericht über Ausfälle der e-Rezept-Infrastruktur [3] Digitale Gesundheitskarte: Gematik will e-Rezept-System stabilisieren [4] E-Rezept: Stakeholder fordern mehr Transparenz und Sicherheit [5] E-Rezept: Gematik will e-Rezept-System stabilisieren
Science and technology must be utilized to strengthen the German e-prescription system's technical infrastructure, as proven by the recurring crashes and disruptions affecting tens of thousands of patients [3]. Health and wellness, along with the efficient management of medical-conditions, could significantly benefit from an e-prescription system that is both reliable and stable [1].
