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Germany is currently in the throes of implementing a national IT infrastructure to support the transformation of patients’ existing health insurance cards into fully functional eHealth cards.
One of the goals of the project is to ensure that practitioners can exchange electronic patient data more effectively, in order to improve the quality of patient care - and prevent the recurrence of a pharmaceutical disaster similar to the Lipobay scandal that occurred in 2001. Then, the interaction of different types of prescribed medication resulted in a number of accidental deaths. This led to legislation being passed in 2004 requiring that all citizens carry an eHealth card, to guard against this type of situation.
Pablo Mentzinis at Bitkom, the industry body representing companies operating in the IT, telecoms and new media fields, explains the rationale behind the move. “It’s all about the exchange of patient histories and crosschecking the medicines used,” he says. “This means ensuring that a single file holds a patient’s entire medical history, rather than several that originate from different points, are not interlinked and haven’t been exchanged between different doctors or hospitals. Having one file ensures that dangerous ‘pharmaceutical conflicts’ simply cannot happen.”
Other goals are to prevent misuse of the healthcare system and to cut costs. The German Ministry of Health stated in a 2004 report that the country spent €200 million each year on employing staff at different agencies to manually transcribe medical records and prescriptions, and pass them back and forth between one another, making such activity prone to administrative errors.
An umbrella organization called Gematik was set up in 2005 to coordinate the project. It will also operate the new IT infrastructure, which will connect 123,000 GPs, 21,000 pharmacies, 65,000 dentists, 2,200 hospitals and 300 public and private health insurance companies, to enable them to exchange information.
As a key part of the project, AOK, Germany’s largest health insurance provider, has commissioned Gemalto to provide and personalize 25 million eHealth cards for its customers. Gemalto is also supplying medical practitioners with eHealth terminals – its next generation of card readers.
The electronic health cards, which include digital certificates for identification purposes in order to reduce fraud, will initially be used to hold insurance data, but in due course they are also expected to incorporate emergency information such as blood group, allergies, ongoing treatment and insurance details. Further into the future, it is anticipated that the scope of the cards will broaden to hold all types of patient data.
Medical professionals will likewise be issued with their own digital certificate based cards to enable them to securely access electronic medical files. The move will also reduce administrative and operational costs for insurance providers, not least by preventing duplicate examinations, which should cut the unnecessary use of healthcare services.
Rolf Hoberg, Chairman of AOK Baden-Württemberg, says: “Gemalto won the Europe-wide pitch, as it was able to demonstrate the best offer in terms of both cost and benefits. It has supported AOK Baden-Württemberg in its tests in Heilbronn, contributing both test cards and knowhow.
“Together, we introduced and tested the personalization process, the cards’ look and feel and mechanisms for secure data communication. Gemalto really proved themselves here, thanks to their strong solution focus and their ability to deal proactively with our requirements.”
Pilot projects have already taken place in seven regions of Germany. The nationwide rollout is expected to take place in 2009, starting in a single region of North Rhine-Westphalia and spreading out from there.
Gemalto and the German Healthcare system
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