What is the audit ID for the health card

Terms and regulations relating to the electronic health card

Doctor's letter

The doctor's letter is used for the targeted exchange of information between the doctors who are also treating or continuing treatment. The electronic doctor's letter is intended to replace conventional transmission by post, messenger or courier service.

A secure transmission process is necessary for the sending of electronic doctor's letters, so that the electronic letter is protected against unauthorized access by appropriate technical measures in accordance with the current state of the art. The first secure transmission method established by the Society for Telematics (gematik) is "Communication in Medicine" (KIM). KIM providers are approved by gematik.

Electronic doctor's letters can be exchanged quickly and reliably via the telematics infrastructure using KIM - with or without attachments - using a secure e-mail process. KIM is aimed at everyone who works in the healthcare sector and ensures the secure exchange of sensitive information such as findings, notifications, bills or X-ray images via the telematics infrastructure.

Electronic doctor's letters are financially supported if an electronic health professional card with an electronic signature is used for this. The connection and operating costs to be reimbursed for the connection to the telematics infrastructure are therefore increased by a flat rate for each transmission of an electronic letter. The amount of the lump sum is agreed by the National Association of Health Insurance Funds and the National Association of Statutory Health Insurance Physicians. The details of the requirements for a secure electronic procedure and information technology systems are specified in a guideline.

Drug Therapy Safety / Medication Plan

Elderly and chronically ill people in particular are often treated by several doctors and take different medications. It is not uncommon for problems with adverse drug effects that can also be life-threatening. On the one hand, because patients are not following the instructions correctly due to the number of medications, and on the other hand, because the individual doctors do not always know what medication their patients are still taking.

A uniform medication plan in which the medication and instructions for use are clearly presented and understandable for the patient can provide more security. Therefore, it was regulated by law that patients who take three or more prescribed drugs are entitled to a medication plan in paper form. The self-administration partners in the statutory health insurance have specified the regulation in such a way that only those drugs are relevant that are taken over a period of at least 28 days. With the medication plan that is given to the patient, the treating physicians can see which medication the patient is currently taking. In this way, dangerous interactions can be avoided. Elderly and chronically ill people in particular benefit from the medication plan. This is created by the doctors who have to inform the insured about the right to a medication plan. Pharmacists are involved from the start and are obliged to update the medication at the request of the insured if the medication changes.

 

The medication plan can now also be created and updated electronically. It is saved on the electronic health card (eGK) and is voluntary for the insured.

Data protection and data safety

Data protection and data security are very important in the telematics infrastructure. Ensuring data protection and data security in the telematics infrastructure is therefore one of the core legal tasks of the Gesellschaft für Telematik (gematik) and includes high requirements for all technical components used and also for the organizational procedures in the telematics infrastructure. The components and services of the telematics infrastructure are therefore approved by gematik. At the same time, proof of security is provided in accordance with the specifications of the Federal Office for Information Security.

In addition, the sensitive health data is encrypted. Two keys are used at the same time. Similar to the bank card, patients have to activate the medical data using their electronic health card (eGK) and a personal identification number (PIN). Doctors need a second key for access, namely their health professional card and also a PIN.

The patient alone decides which medical applications he or she wants to use and who is allowed to access his or her data. For each medical application - be it for the emergency data, the electronic medication plan or the electronic patient file - he or she can determine at any time whether this is to be accessed. There is an exception for emergency data: If the patient has voluntarily decided to create emergency data, doctors can read this out in a medical emergency without the patient having to enter a PIN.

Only authorized service providers, such as doctors or dentists, can access the data with the consent of the insured person. However, access to the medical data is only permitted for the purpose of supply. Third parties, such as insurance companies, have no access. Abuse is a punishable offense. For reasons of traceability, accesses are stored on the card.

European Health Insurance Card

The back of the electronic health card (eGK) can be used by the health insurance companies for the "European health insurance card" and enables unbureaucratic treatment within Europe.

Medical professional ID

Service providers, such as doctors or dentists, who are authorized to access data on the electronic health card (eGK) or data from certain applications in the telematics infrastructure, receive an electronic health professional card for this purpose. To access the medical data of insured persons, doctors have to authenticate themselves with their electronic health professional card using a card terminal by entering a personal identification number (PIN) for access.

Interoperability

An important prerequisite for smooth electronic communication or the exchange of information in the healthcare system is that the systems used speak the same language, i.e. are interoperable.

Since July 2017, the interoperability directory called "vesta" has made the standards used by the various IT systems in the healthcare sector transparent and thus ensures more standardization. New electronic applications may only be financed from the funds of the statutory health insurance if the stipulations and recommendations of the Society for Telematics (gematik) published in the interoperability directory are taken into account.

The directory also contains an information portal for telemedical applications and electronic applications.

Children and adolescents

Children and young people who are also insured receive an electronic health card (eGK). EGKs of children and adolescents up to the age of 15 do not require a photo.

communication

With the introduction of the electronic health card (eGK), a secure "health network", the telematics infrastructure, was set up. Like a data superhighway, the telematics infrastructure connects those involved in the healthcare system in such a way that they can exchange the medical information important for treatment quickly, safely and practically. Unnecessary double examinations and multiple anamneses are avoided, medical decisions are made more understandable for the patient and the communication options with the patient are expanded.

Electronic communication makes it possible to transfer findings faster and more securely from doctor to doctor and then to transfer them to the practice systems in an uncomplicated manner. This improves the quality of treatment and saves time, which can then be used for the patient. With the electronic communication service "Communication in Medicine" (KIM), digital documents and messages can be exchanged quickly and reliably - with or without attachments - using a secure e-mail process. KIM is aimed at everyone who works in the healthcare sector and ensures the secure exchange of sensitive information such as findings, notifications, bills or X-ray images via the telematics infrastructure.

The rollout of the first medical applications of the telematics infrastructure, such as KIM, the electronic medication plan and emergency data management has already started. The electronic patient record will be offered by the health insurance companies from January 1, 2021 and the electronic prescription will be available from January 1, 2022 at the latest.

Photograph

The photo on the electronic health card (eGK) helps avoid mix-ups and curb abuse. Exceptions to the photo on the eGK exist for children and adolescents up to the age of 15 and insured persons who cannot participate in the creation of their photo, for example immobile patients in need of care.

emergency

Insured persons can have the important health data saved on the electronic health card (eGK) in an emergency. In the case of the emergency data, the contact details of a relative who is to be notified in the event of an emergency can also be saved. In an emergency, this data can then be read out by doctors. In contrast to the other medical applications, it is not necessary to enter a personal identification number (PIN) for the insured person in order to read out the emergency data in a medical emergency. Insured persons can also make this emergency data available to their practitioner as part of standard care. You are entitled to the creation and updating of the electronic emergency data from doctors who are involved in your treatment.

Organ donation

At the request of the insured person, information on the existence of a written declaration on organ donation and on its storage location can also be electronically documented. Access by service providers generally requires the consent of the insured person. However, doctors can also access without consent if the death of the insured person has been determined and access is necessary to clarify whether the deceased person has consented to the removal of organs.

Electronic patient record

The health insurance companies are obliged to provide their insured persons with an electronic patient file in several stages from January 1, 2021. First, patient data from existing applications and documentation, such as emergency data, medication plan or doctor's letters, can be made available to the patient in such an electronic patient record. Patients can use it to inform their practitioner about these important health data to improve the quality of medical treatment.

Insured persons can also store their own data, such as a diary of blood sugar measurements, in an electronic patient file. In future, you will also be able to view your data independently outside the doctor's office. The inspection can take place via a suitable mobile device such as a smartphone. This means that patients are much more precisely and comprehensively informed about diagnosis and therapy and can make decisions about their health better than before. This is the best prerequisite for a successful therapy.

Important detailed regulations for the introduction of the electronic patient record, such as data protection-compliant access management, claims of the insured, obligations of doctors, questions of financing, use for research, involvement of nursing staff and requirements from the coalition agreement - such as the option of digitally using the vaccination certificate, maternity record and examination booklet to save and manage the dental bonus booklet digitally - were legally regulated and specified with the Patient Data Protection Act - PDSG, which came into force on October 20, 2020.

pin code

Similar to the bank card, patients have to enable access to their medical data using their electronic health card (eGK) and a personal identification number (PIN). The insured receive the PIN from their respective health insurance company.

Qualified signature

The qualified electronic signature of a doctor corresponds in the legal sense to his or her handwritten signature. This ensures that it is always possible to identify who made certain entries.