Pharmacy employees air grievances over difficulties in digital prescription management
In the heart of Germany's digital healthcare transformation, the e-prescription system, designed to offer convenience and reduce doctor visits, has been facing persistent issues. The system, mandatory since January 2024, has experienced several outages and disruptions, causing significant concerns for patient care.
Thomas Preis, the head of the Federal Association of Pharmacists, has openly criticised the system's unreliability, comparing it to the delays often encountered with the Deutsche Bahn. However, he emphasised that the stakes are much higher in healthcare, as failures in e-prescriptions can have serious health implications[1][2].
To address these concerns, several measures and calls for action are underway. Pharmacists are demanding increased operational flexibility, allowing pharmacies to dispense medications quickly and unbureaucratically during system downtimes, thereby reducing patient impact[1][2].
Transparency is another key concern. The German Foundation for Patient Protection proposes an "early warning" or "daily e-prescription radar" to inform doctors when the system is offline, enabling them to revert to paper prescriptions when necessary. They also push for Gematik, the responsible digital agency, to publish monthly outage reports to end the current "black box" situation[1].
Gematik has acknowledged outages related to the underlying telematics infrastructure, with partial failures of key components such as the TI gateway. The Free Pharmacists' Association is exploring possible legal claims for compensation due to losses caused by these technical failures[3].
In an effort to prevent widespread failures and improve stability, Gematik is conducting model region testing, such as the TIMO telematics infrastructure project in Northern Germany, to evaluate and refine digital health tools, including telematics infrastructure, before full rollout[5].
Despite these efforts, persistent issues and calls for urgent remedies indicate that improvements are still in progress. Each disruption affects tens of thousands of patients[1][2][3][5]. In case of outages, patients still have the option to receive their prescriptions as paper printouts if they wish.
Follow-up prescriptions can also be issued without another patient visit through the e-prescription system. However, the current unreliability, as described by Preis as unacceptable, remains a concern for patient safety[1][2]. As Germany continues to navigate these challenges, the focus remains on enhancing infrastructure reliability, increasing operational flexibility during outages, implementing transparency through monitoring and reporting, and thorough testing of system components prior to nationwide deployment.
[1] [Source 1] [2] [Source 2] [3] [Source 3] [5] [Source 5]
The science behind the e-prescription system's technological infrastructure requires a thorough examination to ensure health-and-wellness, as persistent issues have raised significant concerns. To mitigate these issues, there is a growing need for increased flexibility in pharmacy operations, improved transparency through regular reporting, and rigorous testing in model regions before nationwide deployment.
