News Roundup [abridged Versions Appear In The Paper Journal]

Germany plans to introduce electronic health card

BMJ 2004; 329 doi: (Published 15 July 2004) Cite this as: BMJ 2004;329:131
  1. Annette Tuffs
  1. Heidelberg

    The German government will start what it describes as the most extensive e-health communication project in the world next year, a spokesperson from the health ministry has announced.

    From 1 January 2006 all 72 million customers of the health insurance companies in Germany, which give access to state health care, should be using a “health card” with a microchip when they see a doctor, attend a clinic, or buy a drug. It will replace the present membership card of the health insurance companies and should make about 700 million handwritten prescriptions redundant.

    Also, all doctors, hospitals, pharmacists, and service providers in the health system will be equipped with a matching professional card allowing them to read their patients' cards, put prescriptions on the cards, and sign all entries.

    The information on the health card for patients is in two parts. The administrative part contains compulsory data about patients' insurance status, their rights to be treated abroad, and their prescriptions. The medical part is optional and contains only information to which the patient agrees, such as drug intake, data for emergencies (blood group, chronic diseases, and so on), previous operations, radiography findings, or doctors' letters. Patients can also include their own health documentation, such as a disease diary.

    One aim of the cards is to improve the safety of medical treatment, such as by registering all prescriptions. It should also strengthen patients' responsibility, because patients decide whether certain information is put on the card and used.

    The health ministry expects more transparency and efficiency in the health system as a result of the initiative. The estimated costs of €0.7bn (£0.5bn; $0.9bn) to €1.4bn should be saved within three years, the ministry says.

    However, critics, especially among doctors, are sceptical of whether the start date of January 2006 can be met, for logistical reasons. Just to equip all patients, doctors, and pharmacies will demand an output of about 250 000 personalised cards each day. Additionally, in an initial trial phase in 2005, several regions in Saxony and Bavaria will test the cards before they are finally released.

    The German health card will be fully compatible with the EU-wide health card that is due to be introduced by 2008. However, a number of European countries, such as Ireland and the United Kingdom, are not yet using the necessary technology.