Start of the electronic health card

Slim version of the electronic health card started

28/09/2011

The Association of statutory health insurance announced today in Berlin that from now on the electronic health cards are issued. By the beginning of 2012, approximately seven million health insurance patients will receive the new health insurance card, including the chip and image. The health insurance companies hope that the change will result in improved patient care and cost savings in the millions. Critics continue to complain about a lack of data protection. For this reason, there will be only a stripped down version of the digitized health card for the time being.

For a long time, the electronic health card of the statutory health insurance companies was announced. Previously, numerous field trials took place to test the performance of the new cash cards. Several smaller health insurances had already issued electronic health cards to a few insured persons in the course of the year in order to test the technical functioning and practical procedures. Well, you should „a new era in the German health system“ begin, as it says in the announcements of the statutory health insurance. But even if the official start of the distribution has begun, it is still unclear when and how the information stored on the card will be exchanged.

By the end of the year, around seven million insured people will receive a new health card. According to the responsible project officer of the umbrella association of statutory health insurance, Rainer Höfer, the new card is one of the „world's largest and most significant IT projects“ our time.

Privacy concerns could still be completely eliminated
Already eight years ago, the introduction of the new chip card had been decided. The new card is supposed to contain emergency data such as the insured person's blood type, chronic illnesses and can also save an electronic medical letter. In a further development of the card could therefore also electronic drug prescriptions, organ donation data and the digital patient record on the cash cards additionally be deposited. Again and again, there were concerns about privacy. The liberal medical profession and some data protection experts had repeatedly criticized that confidential medical data can be stored on the card and read out at any time. The health insurance hopes, however, with the storage of patient data the prevention of unnecessary duplicate examinations. Critics say that with the card employers could in future gain a precise insight into the health status of the employee and draw appropriate conclusions. This not unjustified criticism, organizational constraints and technical problems had delayed the start of the electronic health insurance card again and again.

To ensure data protection, a key to data attraction is created. In practice this means that access can only be made by authorized physicians if they have an access key. Nonetheless, significant doubts persist because the highly sensitive data could still be stolen by bypasses. Due to the lack of data protection, at first only a very slimmed-down variant is distributed to the citizens until all ambiguities have been eliminated.

Online connection for electronic health card
The electronic card will avoid unnecessary examinations in the future. In addition, physicians receive a larger overview of the therapeutic process at doctors and hospitals while scanning the card, and ultimately, substantial costs can be saved in the healthcare sector, as the cashier IT expert Höfer emphasized. Especially for this purpose, the health card should be connected to the Internet, so that the stored data can be better exchanged among doctors. When this actually happens is still uncertain. Today one did not want to call specific dates at the press presentation. With an online connection for all doctors and clinics Experts expect only in the earliest 4 to 5 years. Because even here safe ways must be explored that can not be seen by third parties.

The first insured already have an electronic cash card
The first insured have already received the new card. In return, the old health insurance card should be returned to the insurer or destroyed by hand, as Höfer explained. „For the insured changed nothing for the first time.“ After the project faltered again and again, the policy put pressure on the participating project groups from health insurance companies, doctors and clinics. The health insurance companies have to pay sensitive fines if they did not spend any new insured cards by the end of the year. This is how the black-and-yellow federal government decided in the course of the current health care reform in 2010. Without project work and innovation, the cash registers will cost the new cards and readers about 300 million euros, according to the expert. How much cost will be saved by the introduction in the future, is still unclear. The financing of the medical practice equipment with card readers is taken over in the form of lump sums by the health insurance companies.

Encrypted insight into the patient files
Doctors and therapists should get encrypted insight into the patient's file. These contain, for example, laboratory findings, doctor's letters, MRI or X-rays and drug prescriptions. The currently issued health cards contain a microchip processor, which is activated for later innovations. Currently, however, the cards only contain the insured person's address, some key data and a photo of the patient. On the back of a European health insurance card for medical care in other EU countries is printed. At the request of the insured person, however, emergency data such as allergies and previous illnesses should also be stored. Currently it is in the discussion, whether a living wills for organ donation is additionally integrated.

A connection to the Internet is not yet planned at the start. When the activation takes place, the first step is to be able to change the master data online. This happens when the insured changed his address, for example by moving. As a result, the health insurance companies can save the shipping of a new card. According to Höfer, there is still no concrete start date for the online connection. It will take some time until the cards are fully functional as planned. After all, the project has been running since 2006 and was already launched by the former Federal Minister of Health Ulla Schmidt. (Sb)

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