We recently reported how the health care system in Germany is set to become more digital in the coming years. Here we take a closer look at changes, as well as other things you should know about.

Extended medical on-call service

Since January 2nd, the medical on-call service (Ärztliche Bereitschaftsdienst) has been available around the clock by calling the number 116 117. After a recorded message, callers can choose whether they need medical assistance or want to make an appointment with a doctor. The on-call service is intended to relieve the burden on doctors and emergency departments.

The number should be used if people become sick when normal surgeries are closed and can’t wait until the next working day, but do not feel that emergency services need to be called.

The staff either connects the patient to a doctor by telephone, informs them about an open on-call practice nearby or sends a doctor to their home.

READ ALSO: How Germany plans to revamp emergency care to beat overcrowding

Measles vaccination

A child being vaccinated in Hanover. Photo: DPA

The measles vaccination will be compulsory in Kitas (day care centres/Kindergartens), schools, refugee accommodation and medical facilities from March 1st, 2020. Parents must prove that they have had their children vaccinated before being admitted to a day care centre or school. 

For children living in care, as well as employees in refugee homes or in the health sector, there is a transitional period until July 31st, 2021.

Parents who do not comply with the compulsory vaccination face a fine of up to €2,500 as well as being banned from Kitas or schools.

Digital changes

Germany’s health care system is set to be modernized after Health Minister Jens Spahn passed the Digital Supply Act (DVG), reported Welt.

Apps on prescription

For the first time doctors will be able to prescribe health-orientated digital apps to patients, which can then be reimbursed by the statutory health insurance. For example, developers are creating more specialized paid apps, such as those designed for conditions like diabetes.

The Federal Institute for Drugs and Medical Devices (BfArM) will check the quality and safety of the apps. The app developer must then prove within a year that the app improves care.

Spahn previously said the move was a “world first”. However, the move has come up against some criticism.

“I am very critical of the fact that the manufacturer initially receives approval without proof of benefit,” Maria Klein-Schmeink, health policy spokesperson for the Green party, told Welt.

She expects that doctors, too, will react “rather reservedly” to the apps. The legal framework for this development still has to be given the green light.

READ ALSO: How German health care is set to become more digital in 2020

Online consultation

The new laws mean that doctors can now receive money for speaking to patients through video consultations online.

Doctors will also be allowed to provide information about video and online consultations on their websites – before they had only been able to discuss these in private conversations.

Since the beginning of October, health insurance companies have been providing funding for doctors and psychotherapists to carry this out.

This format could be particularly useful for long journeys or for routine checks after operations, said Andreas Gassen, the head of the National Association of Statutory Health Insurance Physicians (KBV).

“The gold standard, however, will always be the personal contact between doctor and patient,” he added.

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

Electronic prescriptions

A prescription on a smartphone in Stuttgart. Photo: DPA

In order to reduce the amount of paperwork in the health care system, the new laws also aim to phase out the ‘pink paper prescription’ (rosa Papierrezept), which people are given from the doctor to get access to medication.

It’s set to be replaced by an electronic version. Various pilot projects across Germany have already been testing this move.

However, there are some technical hurdles to overcome before this can be rolled out.

The Federal Association of Pharmacists’ Associations (ABDA) is currently working on a uniform app that can be downloaded. According to the ABDA, 12,000 of some 15,000 pharmacy owners have already registered for it. 

But the paper form will not be abolished immediately.

“Having a smartphone must not be a prerequisite for obtaining medication,” said ABDA Vice President Mathias Arnold.

To cut down on bureaucracy, it should also be possible in future to prescribe other medical equipment such as hearing aids electronically.

Electronic sick note

The move to embrace the digital world continues with the arrival of the electronic certificate of incapacity to work (eAU) or sick notes.

This would be “a blessing” for the health insurance providers, the GKV-Spitzenverband (statutory health insurance association) says.

“This would finally put an end to all the paper,” the association said. Every year, some 77 million paper sick notes are issued nationwide – and three times – one for the cash register, one for the employer and one for the employee.

The Appointment Service and Pensions Act (TSVG), which came into force in May, stipulates that from 2021 doctors will only be able to submit certificates digitally to the health insurance companies.

Meanwhile, another law passed to limit bureaucracy says that companies should request the data of their sick employees from the health insurance companies electronically. Pilot projects for the eAU are already underway at various health insurance providers.

READ ALSO: How Germany plans to ditch paper sick notes for digital ones

Electronic patient records

From 2021 those with with statutory health insurance will be able to receive their electronic patient records (ePA) from their health insurance provider if they want it. The file will contain findings, diagnoses, vaccinations and doctor’s letters.

The patient can decide who gets access to the data, what information is stored, and decide what to delete from it.

However patient advocates have raised some concerns over data protection.

READ ALSO: German health care – everything you need to know

Before the electronic files becomes reality, Health Minister Spahn must address some of these issues.

Greens politician Klein-Schmeink says that all this “may still take some time”.

More than 70 million people rely on Germany’s statutory insurance system, representing 90 percent of the population.