Digitalizing the German healthcare system is one of Europe’s largest IT projects. At the heart of this ambitious and challenging undertaking is the telematics infrastructure. This is a secure space for the health records of more than 83 million people. The telematics infrastructure will allow all stakeholders to perform their tasks even more effectively and optimize patient care. We are paving the way forward – with a pragmatic, pioneering, and passionate approach.
Our shareholders are the German Federal Ministry of Health (BMG), the German Medical Association (BAK), the German Dental Association (BZÄK), the German Pharmacists’ Association (DAV), the German Hospital Federation (DKG), the German National Association of Statutory Health Insurance Funds (GKV-SV), the German National Association of Statutory Health Insurance Physicians (KBV), the German National Association of Statutory Health Insurance Dentists (KZBV), and the Association of German Private Healthcare Insurers (PKV).
National agency for the digitalization of the healthcare system
We consider ourselves the national agency for the digitalization of the healthcare system. We are developing the concept of the telematics infrastructure as an all-encompassing and secure data room, setting the standards for the use of this data room, and coordinating its reliable operation and establishment in line with market requirements. In the process, we work to ensure that the interplay between the various components, services, and applications functions within the telematics infrastructure.
We undertake key tasks
We write the technical specifications for components, services, and providers of operational services in the healthcare system that make up the telematics infrastructure. Industrial businesses develop their products based on our guidelines. Before these industry products can be used in the telematics infrastructure, they must be authorized by us or present certification. We also define the parameters for the operation of the telematics infrastructure and monitor their compliance.
The term telematics combines the words telecommunications and informatics. It refers to the interplay between various IT systems needed to link together information from various sources.
The telematics infrastructure is therefore a special data room, which interconnects all the stakeholders in the healthcare system. As a result, it is possible to guarantee the secure exchange of information between sectors and systems – whether between doctors’ offices or other medical professionals, pharmacies, and hospitals where statutory health insurance is involved. It is a closed data room which can only be accessed by registered users (individuals or institutions) with an electronic health professional card or SMC-B card for medical practices.
In order to satisfy the requirements of data protection and data security and, in particular, to protect patients’ medical data, very strong security mechanisms are a high priority in the telematics infrastructure. Secure, encrypted communication between known partners and protection against access to sensitive information are therefore the cornerstones of the telematics infrastructure.
To guarantee secure communication and the protection of sensitive information in the telematics infrastructure in the long term, the German Federal Office for Information Security (BSI) regularly reviews the cryptographic techniques that are used. These techniques are also constantly adapted in line with the latest technological developments.
A digital healthcare system requires technical standards. After all, a national – and European – data room needs common specifications with regard to data models, data communication channels, and a standardized codification system for as much information as possible. Only by having these standards in place can the interplay between patients, providers of medical services, health insurers, and many other stakeholders work effectively. This will also allow us to create the basis for international, data-driven applications – because diseases know no borders.
In the past, communication between doctors – whether by mail, fax, or even just e‑mail – often involved a delay. Analog documents had to be digitized in time-consuming processes in order to make the data available in the software used in the doctor’s office. By using KIM, important information, such as reports, decisions, and X-rays, can now be quickly exchanged and are always available when needed. In this way, KIM turns health management into a team effort.
Individuals can choose whether to have emergency information stored on their health insurance card. This data can be useful in an emergency situation. Doctors, dentists, and their staff as well as certain other health professionals (e.g., paramedics) can access this data in an emergency and thus obtain a rapid overview of preexisting conditions and possible medical connections.
Individuals can choose whether to have information about their medication stored as an electronic medication plan on their health insurance card. This allows doctors, dentists, psychotherapists, and pharmacists to be fully informed about their patient’s medication at all times. Possible drug–drug interactions can be taken into consideration.
The purpose of this application is to check online whether a patient’s administrative data is up to date on their electronic health insurance card and whether they are registered with a statutory health insurance fund. The information can then be updated where necessary. A patient’s administrative data includes their name, date of birth, address, and insurance status. This online comparison is obligatory during the patient’s first visit to the doctor in each quarter.
The electronic health record (EHR) is a record intended for patients, giving them a transparent overview of their health data for the first time. It is voluntary and free. If members of statutory health insurance funds wish to use the service, they will be able to contact their fund about this starting January 1, 2021. Each patient will be able to use their record to make their health-related data available to all those involved in their medical treatment – whether doctors, dentists, psychotherapists, or pharmacists. It will be possible to access the documents held in the EHR from any location and share them between the various medical institutions including doctors’ offices and hospitals. All of the medical documents will be available whenever the data is actually needed by doctors to treat patients, giving those involved an insight into the treatment given so far and supporting them in making an individual therapeutic decision. It will be possible to enter data in the record in a variety of ways, with the patient able to upload documents themself, save them locally, or even remove them from the record. Medical personnel will also be able to add to the data in the EHR – even without the patient actually being present. This will remove the need for the patient to return to the doctor’s office or hospital simply to have laboratory results recorded in their EHR after a blood test, for example.
E-prescriptions will be available soon. Starting in July 2021, it will be easier to generate, present, and process prescriptions. This will improve everyday healthcare provision for everyone involved because electronic prescriptions will give staff at doctors’ offices and pharmacists more time to focus on their patients and customers. Patients will have the option to be more flexible with respect to their medication and to actively participate in their treatment. It will be up to the patient to choose whether to have their prescription sent to their smartphone or receive it as a printout with a 2D code.