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Health Insurance Companies are not Prepared for Digitalization

Health Insurance Companies are not Prepared for Digitalization

Eva Janik
4/6/20 11:20 AM
In January 2021 it is scheduled to come into force - the electronic patient file (ePA). According to the decision, which was initiated by Federal Health Minister Jens Spahn with the German Appointment and Care Act, all those with statutory health insurance will receive an electronic patient file from their health insurance company. It provides information on what medications a patient is taking, provides data on previous treatments and previous illnesses and contains information on blood values. In the event of a change of doctor, this important data can also be viewed by a doctor providing further treatment. The ePA not only aims to provide vital data more quickly in an emergency, but also to avoid duplicate and therefore unnecessary examinations.


Each insured person decides for himself whether he wants an electronic patient file, which data is stored there at all and what exactly can be viewed by whom. All information contained in the file should be controllable by the insured at any time via app. 

In the future, the electronic patient file is to be stored:

  • Findings
  • Diagnostics
  • Therapy measures
  • Treatment reports
  • Vaccinations
  • Electronic medication plans
  • Electronic doctor's letters
  • Emergency data sets

In addition, the doctor can also create his own data (such as a diary for blood glucose measurement, etc.).

Furthermore, with the coming into force of the Digital Supply Act (DVG), which was passed by the German Bundestag on 7 November 2019, digital health applications per app are to become a health insurance benefit for those with statutory health insurance in future. These apps can help, for example, to take medication, combat back pain or even depression. However, the costs for these apps will only be covered by the insurance companies if the app in question has been tested by the Federal Institute for Drugs and Medical Devices (BfArM) for data protection, functionality and data security, if the tested app has been prescribed by a physician in charge and if a well-founded diagnosis is available as a prerequisite.

However, these requirements pose a great challenge for IT managers at service providers in particular. In the course of this, the so-called Telematics Infrastructure Act (TI) is to be introduced in September 2020, making it mandatory to network all parties involved in the health care system, such as doctors, dentists, psychotherapists, hospitals, pharmacies and health insurance companies.


Pseudonymised Data for Research

The new law will also provide massive support for health research. For example, digital accounting data from health insurance companies will be pseudonymised and, upon request, transferred to research as anonymised results. In this way, science will in future have access to even more up-to-date and, above all, more data in a protected space, which in turn should lead to a significant improvement in health care.


Lack of Networking and Different Standards Cause Problems

The biggest challenge currently is the lack of networking in the health care system. Due to the many different data solutions and the varying systems of the service providers, media breaks often occur. Data often has to be entered several times, which - in addition to the increased effort - often leads to data entry errors. The DVG is intended to create the basis for open, standardized interfaces that will make it possible to exchange data more quickly and easily in the future, based on international standards.


>>> Regardless of whether it's electronic patient files or the law for better care through digitalization and innovation - health insurance companies must expand their range of services to include digital services. The best way to do this is to have your own app.


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