Demands on Health Digital Agency Act: Sanctions should be imposed

Today the draft Health Digital Agency Act (GDAG) is to be discussed in the Bundestag, with which Gematic, which is responsible for digitalization in the health care system, will become the digital agency of the Federal Health Ministry. The BMG has high hopes that digitalization will improve the healthcare system, and the SPD has also talked about “now it is the working agency in Germany”. But the National Association of Statutory Health Insurance Practitioners (KBV) and the umbrella association of statutory health insurance companies (GKV-Spitzenverband) are criticizing the draft, which has already been widely discussed.

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The KBV is calling for significant reforms and the removal of threats of sanctions, as can be seen from a statement from the KBV. “There are certainly positive attitudes, but the draft law still reflects a clear sense of distrust towards colleagues in private practice. There are still threats of sanctions against doctors and psychiatrists. They should be removed – without any ifs and buts. Of,” KBV Board of Directors saysIf doctors do not have a connection to the telematics infrastructure (TI) – the “information highway” of the health care system – including the components, they are being charged more.

Zematic plans to come up with its own products

But criticism of GDAG comes from other directions as well. In a statement from the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), its chairwoman Doris Pfeiffer particularly criticized “the conflict-prone grouping of the new digital agency as a market partner with its own products, which At the same time the industry should continue to approve its competitors’ products, he warned, adding that this could weaken the competition needed for digital solutions. The option for the agency to source its own components and services from TI should apply only to those centralized products that are available or needed only once in the system.” Experts have no expectation that health care will be implemented through more procurement processes. The high availability of IT plans is contrary to previous experience;

Financial burden on contributors

Pfeiffer also emphasized the financial challenges. He criticized the fact that the future digital agency should be given more tasks and its powers should be expanded without taking into account cost increases in the draft law. He criticized the fact that 93 percent of the new digital agency’s rising expenses still have to be covered by those paying statutory health insurance contributions. Pfeifer warned of additional one-sided burdens on contributors as a result of the Health Digital Agency Act.

Regulations for Online Appointments

Pfeifer supported the proposal that the National Association of Statutory Health Insurance Funds and the National Association of Statutory Health Insurance Practitioners should decide on specifications for portals for arranging appointments digitally. He advocated further developing the existing portal of the National Association of Statutory Health Insurance Practitioners and setting up an appointment directory that could also serve as the basis for commercial platforms to arrange doctors’ appointments. Another point of criticism from KBV relates to the offering and use of appointment platforms. Although the KBV basically supports the same requirements, it sees problems in the implementation of the draft law.

Statutory health insurance associations do not have a federal data protection authority

The KBV still sees a need for clarification, especially with regard to data protection of the various platform providers and financing. “We have neither the ability nor the means to monitor the data protection of various platform providers. KBV and KVN are not federal data protection authorities. The financing issue is also completely unresolved,” the KBV explains.

The Digital Agency for Health provided for in the draft law aims to ensure user-friendliness. KBV sees this as one of its central demands. However, she asks for clarification that the digital agency’s responsibility should also include primary systems. “Digital processes can only be successful when user orientation is a priority,” says KBV.

Electronic patient file: Industry calls for postponement of deadline

Furthermore, the KBV emphasizes the importance of interoperability, performance, stability and user-friendliness of information technology systems, especially with regard to the electronic patient file from version 3.0, which is actually planned for January 2025. But now it can be anticipated that changes in the time limit will continue. The Federal Association of Health IT (BVITG) has sent a letter to the Federal Ministry of Health (BMG). As reported in the medical newspaper,

In the letter, BVTG has pointed out various problems and suggested adjusting the program. Originally, version 3.0 of the electronic patient file was to be rolled out in selected model areas starting January 15, 2025, followed by a nationwide rollout by the end of the first quarter. A comprehensive update to so-called EPA version 3.1 was planned for mid-2025.

Delayed due to technical problems

However, the IT industry expresses clear skepticism about these timelines. One reason for this is that according to the developers the so-called reference environment, which is necessary for testing EPA modules, is not yet fully available. Actually this should have happened in mid-October. Additionally, an unscheduled change was made to the EPA specification in late October, which initially postponed the integration of image files into EPA.

Proposal for gradual implementation

The industry suggests that the roll-out begin gradually and with limited operations in selected practices. A broader roll-out should therefore occur only in the second quarter, which in turn will postpone the planned EPA update 3.1, which is also aimed at, for example, transferring data to the Health Research Data Center.

Warning of deteriorating telematics infrastructure

Despite the problems identified, the federal association insists that it intends to stick to the timetable for the introduction of the EPA as originally planned. However, at the same time, they warn of the loss of the entire telematics infrastructure (TI) and potential problems in outpatient care if the introduction of EPA 3.0 is rushed.

(Mac)