Pharmacy staff express dissatisfaction with issues in the electronic prescription system
The German e-prescription system, designed to streamline healthcare and reduce patient trips, has been marred by recurring technical disruptions and partial outages. These issues stem primarily from the underlying Telematics Infrastructure (TI), affecting electronic prescriptions, patient records, and communication systems within the healthcare sector.
The outages have caused significant operational difficulties for pharmacies and patients, with multiple days of complete or partial system unavailability hampering timely medication access. This has been a concern for tens of thousands of patients across the country [1][2][3].
Key factors contributing to the instability include system outages linked to the TI gateway, notably the gateway managed by service provider RISE, which has led to recurring failures impacting access to electronic health services. The dependence on external service providers has also been identified as a major cause, with their technical issues often leading to frequent outages [3].
As the digital infrastructure becomes increasingly relied upon, disruptions have a significant impact on healthcare delivery. In response to these issues, several measures and demands have been voiced by stakeholders.
The German pharmacists’ association and the ABDA (Federal Union of German Pharmacists) have called for urgent improvements to the stability and reliability of the e-prescription system by the federal digital agency Gematik [1][3]. Pharmacies are also requesting greater flexibility during downtime, allowing them to dispense medications quickly and with less bureaucracy even if the e-prescription system is offline [1].
Discussions of legal actions are underway by pharmacist associations to seek compensation for operational losses caused by the outages, potentially holding Gematik liable [2]. Gematik has acknowledged the issues and partially attributed them to external providers. Efforts to resolve recent major disruptions have succeeded, but the recurring nature of outages has prompted calls for strengthening infrastructure resilience and improving oversight of service providers [2][3].
Starting from January 2024, the e-prescription for prescription drugs becomes mandatory in Germany. Despite the challenges, Gematik prioritizes a stable and secure operation of the system and is continuously working to improve its reliability and stability.
In a recent development, the e-prescription system in Berlin has experienced five days of complete outages or significant impairments in the past two weeks. Thomas Preis, head of the Federal Association, has compared the unreliability of the e-prescription system to that of Deutsche Bahn, Germany's national railway.
Eugen Brysch, board member of the German Foundation for Patient Protection, has called for an immediate end to the "era of the black box e-prescription." He has suggested the implementation of a "daily e-prescription radar" to inform doctors directly about the system’s functionality. Brysch has also requested Health Minister Nina Warken (CDU) to instruct Gematik to submit a monthly disruption report.
Patients have the option to receive the prescription as a paper printout if they wish. Gematik denies that there are restrictions affecting the overall infrastructure of the e-prescription system.
In conclusion, the German e-prescription system's reliability problems are driven by technical failures in the critical telematics infrastructure and external provider issues. Authorities and pharmacy representatives are pressing Gematik to enhance system stability and provide operational contingencies for pharmacies to better maintain healthcare services during outages.
The recurring technical disruptions and partial outages of the German e-prescription system, which primarily originate from the Telematics Infrastructure (TI), have raised concerns about patients' health-and-wellness, especially in regards to timely access to medications [1][2][3]. These issues have led to multiple days of system unavailability, causing significant operational difficulties not only for pharmacies but also for patients dealing with medical-conditions [3]. The unreliability of the e-prescription system has been compared to that of Deutsche Bahn, highlighting the need for science and technology to play a more significant role in ensuring its stability and security [3].
