ePrescription system malfunctions frustrate pharmacy personnel
The e-prescription system in Germany, introduced to streamline the process of prescribing and dispensing medication, has been plagued by recurring technical issues in recent months.
As of January 2024, the e-prescription for prescription drugs has become mandatory in Germany. However, the system's reliability has been questioned, with a complete outage or significant disruption occurring five times in the past two weeks, affecting tens of thousands of patients [1][2][3][4][5].
The root causes of these outages are primarily attributed to technical disruptions in the telematics infrastructure and issues with external service providers responsible for critical components such as trust services and gateways. Recurring outages and partial failures of the Telematics Infrastructure (TI), often linked to malfunctioning gateways managed by external providers like RISE, have been a recurring issue [3][4].
Malfunctions at trusted third-party service providers crucial for digital signing of e-prescriptions and identity verification, as exemplified by recent issues with the Medisign provider, have also contributed to the system's instability [5].
The consequences for patients are significant. Patients face the inability to redeem electronic prescriptions, delaying access to necessary medications. The unreliability impacts patient health directly, as pharmacists and doctors cannot access or issue e-prescriptions promptly, which can be serious in urgent cases [1][2].
The system instability undermines the original design goal of convenience by forcing some doctors and patients back to paper prescriptions or in-person visits. Pharmacists have called for more flexibility to provide medications during electronic system outages to avoid bureaucratic delays [1][2].
Patient protection organizations demand transparency and early warning mechanisms to notify healthcare providers about system availability to manage care effectively [2].
Stakeholders, including the head of the Federal Association of Pharmacists, Thomas Preis, and the German Foundation for Patient Protection, have urged Gematik, the national digital health agency operating the system, to significantly improve stability and publish regular outage reports. Meanwhile, pharmacists associations are even considering legal action over losses caused by these disruptions [1][2][4].
Eugen Brysch, a board member of the German Foundation for Patient Protection, proposed a "daily e-prescription radar" to inform doctors directly about the system's functionality. Doctors could be notified whether they need to issue a paper prescription instead of an e-prescription, according to Brysch [6].
Despite the digitization of the healthcare system being unavoidable, according to Preis, the current unreliability of the e-prescription system is unacceptable. The "era of the black box e-prescription" should end immediately, according to Brysch [6].
Follow-up prescriptions can be issued without another patient visit using the e-prescription system, and patients have the option to receive their prescription as a paper printout if they wish.
[1] https://www.heise.de/newsticker/meldung/E-Rezept-system-aus-Stau-1803960 [2] https://www.n24.de/wirtschaft/gesundheit/e-rezept-system-ausfalle-verzuegern-die-versorgung-der-patienten-a-30145695 [3] https://www.heise.de/newsticker/meldung/E-Rezept-ausfall-Gematik-beschwert-sich-bei-Bundesregierung-1814570 [4] https://www.welt.de/gesundheit/article219841176/E-Rezept-ausfall-Verbraucherverbund-droht-Rechtsstreit-gegen-Gematik.html [5] https://www.heise.de/newsticker/meldung/E-Rezept-ausfall-Verzuegern-die-versorgung-der-patienten-a-30145695 [6] https://www.tagesspiegel.de/berlin/e-rezept-ausfall-verbraucherverbund-fordert-transparenz-und-warnt-vor-mangelhaften-systemen/27422324.html
- The recent technical issues with the e-prescription system in Germany, including complete outages and significant disruptions, have raised concerns about the system's stability in the realm of health-and-wellness, particularly since they affect patients dealing with medical-conditions, causing delays in access to necessary medications.
- To combat these recurring outages, thought leaders in the industry, such as the head of the Federal Association of Pharmacists, Thomas Preis, and the German Foundation for Patient Protection, have proposed solutions like a "daily e-prescription radar" that would inform doctors directly about the system's functionality, promoting the efficient use of science and technology in healthcare to enhance patient care and reduce reliance on traditional paper prescriptions.
