Pharmacy employees expressing dissatisfaction with problems in the digital prescription service
The German e-prescription system, intended to streamline the process of obtaining prescription drugs, is facing a series of challenges, with recurring downtime and instability primarily due to technical issues within the telematics infrastructure. These problems have led to significant operational issues in pharmacies and medical practices.
Starting from January 2024, e-prescriptions will become mandatory, raising concerns about the system's readiness. Gematik, the federal digital agency in charge of the telematics infrastructure, has acknowledged that there are rarely restrictions affecting the overall infrastructure of e-prescriptions. However, partial or complete outages of the telematics infrastructure, external service provider failures, and maintenance issues have been identified as key causes of instability.
In the past two weeks alone, there have been five days of complete outages or significant disruptions in the e-prescription system or the underlying telematics infrastructure, affecting tens of thousands of patients each time. These outages are often caused by failures in gateways managed by contractors like RISE or Medisign, a trust service provider responsible for signing e-prescriptions.
Thomas Preis, head of the Federal Association, has stated that the e-prescription system is currently outpacing Deutsche Bahn in terms of unreliability. In response to these issues, the German Foundation for Patient Protection has demanded an early warning system for disruptions in the e-prescription system. Eugen Brysch, board member of the German Foundation for Patient Protection, has proposed a "daily e-prescription radar" to inform doctors directly about the system's functionality.
Gematik has admitted that there have been components and services affected by recent disruptions. They are working to resolve such issues promptly and have acknowledged that many outages stem from third-party providers. Some stakeholders are evaluating legal actions for compensation due to operational losses caused by downtime.
Pharmacists are asking for regulatory flexibility to dispense medications through alternative means quickly during system downtimes to protect patient health. The German healthcare system is undergoing mandated upgrades under laws like the Hospital Future Act to modernize information systems by 2027, which may indirectly support greater system reliability as infrastructure improves in coming years.
Despite these challenges, Gematik emphasises that stable and secure operation is the top priority for the e-prescription system. Patients have the option to receive their prescription as a paper printout if they wish. The demand for an early warning system and monthly disruption reports is in response to the frequent downtime or instability of the e-prescription system.
In conclusion, the instability of the e-prescription system arises mainly from technical failures in the telematics infrastructure and reliance on external service providers. Calls for improved IT reliability, regulatory flexibility to maintain service continuity during outages, and systemic modernization efforts in Germany's healthcare digital infrastructure are necessary to address these issues and ensure the smooth implementation of e-prescriptions in 2024.
- The German healthcare system is in need of greater technology reliability, as the e-prescription system, set to become mandatory in 2024, has been facing recurring downtime and instability due to technical issues within the telematics infrastructure.
- The instability in the e-prescription system has led to concerns about patient health and wellness, prompting calls for an early warning system to inform doctors directly about the system's functionality, as proposed by the German Foundation for Patient Protection.
- The German healthcare system is undergoing modernization efforts, with laws like the Hospital Future Act requiring upgrades to information systems by 2027, aiming to improve infrastructure and indirectly support greater system reliability in the future for both e-prescriptions and general medical-conditions management.
