The Electronic Health Card
Nowadays, the quality of medical treatment depends to a greater and greater extent on whether the doctor has all of the information necessary to provide his/her patient with the right medical care. If the patient so wishes, the eHealth Card, together with an electronic health care network (telematics infrastructure) that is separate from the internet, will be able to make the health data needed for treatment available safely and rapidly in the future. The aim is to improve the quality of medical care, strengthen the role of patients and reduce costs.
The foundation has been laid. Since 1st January 2015, the new eHealth Card is the only admissible proof of entitlement to medical and dental benefits and services.
The applications that go along with the new eHealth Card will be introduced gradually. In an initial step, administrative data relating to the insured person, such as their name, date of birth, address as well as health insurance data including their personal health insurance number and insurance status (member, affiliated family member or retiree) have been stored. The eHealth Card carries a photograph. Exceptions are made only for young persons up to the age of 15 years and insured persons who are unable to co-operate in the taking of a photograph, such as immobile patients in need of long-term care. The photograph helps to avoid the risk of confusion and serves to control the abuse of benefits and services. Another new aspect is the information regarding gender. Used in conjunction with the photograph, it is meant to rule out additional sources of confusion. The back of the eHealth Card can be used for the ‘European health insurance card’ and renders unbureaucratic treatment and health care possible within Europe.
The next step will be an online comparison of the insured person’s master data that is stored on the eHealth Card with the data on the insured person that is actually at the disposal of the health insurance fund. As a result, changes of which the insured person has already informed his/her health insurance fund, such as a change of address, can be automatically updated on the eHealth Card at the push of a button at the next doctor’s visit. The health insurance funds thus save money because they do not have to issue a new card. A the same time, invalid cards – as well as cards that have been reported as lost or stolen – can be more easily recognised. This will help to continue to reduce instances of the system being abused at the expense of the community of the insured. An up-to-date eHealth Card automatically ensures up-to-date information at the doctor’s office.
The main utility of the new eHealth Card lies in its medical applications that are voluntary for the patient. Patients can benefit from the emergency data stored on the card, for example. If emergency treatment becomes necessary or a patient needs to be referred to a specialist by his/her family doctor, it is important that the attending physician has quick access to information on allergies, implants, chronic diseases or medication.
An increasing number of persons are taking an increasing number of medicines at the same time. This is why it is vital for the physician to have access to information on all of the medicines his/her patient is taking. This can help to reduce unwanted adverse effects and drug interactions and to achieve greater drug treatment safety. The aim is to introduce medical applications as soon as possible.
Every insured person will decide for him/herself when the time comes, whether and to what degree they wish to make use of the new possibilities offered by the eHealth Card for storing medical data. He/she will also decide whether, and to which degree, use is to be made of an application such as the emergency data, whether the card is to be used to document his/her willingness to donate organs, or whether the electronic patient record is used at a later stage. The prerequisite is that the applications prove themselves in practice and meet strict safety regulations.
Furthermore, patients will have access to their data and be able to print them or have them deleted. As was the case with the previous card, only the insured person’s administrative data is to be mandatorily stored on the eHealth Card.
The Act on secure digital communication and applications in the health care system (E-Health Act) aims to leverage the opportunities brought by technological progress to enhance patient care. The Act includes a master plan for the swifter introduction of useful applications.
Following its successful trial run, the first online application of the electronic health card to be introduced nationwide by mid-2018 is the online synchronisation and updating of patient master data. This sets up the online structures for medical applications such as emergency data, the electronic medication plan and the electronic patient record.
The first medical application that, from 2018 onwards, the insured can opt to have stored on their e-health card will be their emergency data. Storage on this card vastly improves medical access to these potentially life-saving data in case of emergency.
Starting October 2016, persons who take three or more medicines will be eligible to a medication plan. Mainly elderly persons and persons who live alone will benefit from the medication plan that is also scheduled to be electronically retrievable from the e-health card by 2018. Doctors are required to inform the insured about this right. Pharmacists will be involved from the outset and obliged to update the plan whenever medications change if the patient asks them to.
The E-Health Act promotes the launch of the electronic patient record. By the end of 2018, the gematik must create the prerequisites for patient data (such as discharge letters, emergency data, medication data) to be made available to the patients in an electronic patient record. This will enable the patients to share key health data with their care providers.
Patient benefit and empowerment are paramount. By 2019, therefore, each patient will be given a personal e-folder for them to file and access data from available applications and documentations. The patients can also use their e-folders to file their own data, such as blood glucose logs.
The E-Health Act is based on a simple premise: Those who go along with progress reap benefits, those who stand in its way face sanctions.
Major emphasis is being placed on data protection which is guaranteed by both statutory and technical means. The transmission of sensitive medical information does not take place through the internet but via a secure health network set up for this specific purpose. Medical data is encoded even before it leaves the doctor’s practice. In the process, two safety precautions are in use simultaneously. Just like with a bank card, the insured patient determines who has access to the data by inserting his/her card into the card reader and entering a PIN code. Unlike the bank card, however, a second safety precaution then comes into play. The doctor in question requires his/her health professional identification card to obtain final access. Only in an emergency situation can a doctor gain direct access to the emergency data with the use of his/her medical professional identification card, without the patient entering the PIN code.
These data protection measures provide a great deal of protection for sensitive medical data. They are constantly being further developed technically and are closely co-ordinated with the Federal Commissioner for Data Protection and Freedom of Information.
- Better quality of medical care thanks to better information on medical data
- More data protection and self-determination for patient
- More efficiency and less bureaucracy
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