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HEALTH

The new rules on digital prescriptions in Germany

When you visit the doctor in Germany, you should now receive a digital prescription rather than the previous pink slip.

An 86-year-old Berlin resident inserting his health insurance card into a reader to get a prescription alongside German Health Minister Karl Lauterbach.
An 86-year-old Berlin resident inserting his health insurance card into a reader to get a prescription alongside German Health Minister Karl Lauterbach. Photo: picture alliance/dpa/Reuters/Pool | Annegret Hilse

What’s happening?

From the start of the year, a major change came into force in the organisation of healthcare in Germany.

That’s because e-prescriptions (known as an ‘e-Rezept’ in Germany) became mandatory, meaning you should no longer get a pink paper slip from a doctor in order to pick up medicine from the pharmacy. 

People insured in Germany should be able to redeem the prescription with their electronic health card (eGK), via the E-Rezept-App or with a paper printout. 

It’s part of Health Minister Karl Lauterbach’s plans to digitalise healthcare in Germany.

READ ALSO: How Germany wants to roll out e-prescriptions and digital patient records

How exactly does it all work?

Good question. 

There are a few ways that you should be able to get your prescription from the doctor. One way is that electronic prescriptions can be issued and used by inserting a health insurance card into a card reader. 

So your medicines can be loaded onto the card at your doctor and you take the card to a pharmacy where they can see which items have been prescribed for you. No PIN is required to use it.

Since July 1st last year, this health insurance card system has been in place in some pharmacies and doctor’s surgeries, but it has been rolled out extensively.

The process works by storing the data on a central server and then giving the pharmacies permission to retrieve the data when the patient comes in.

According to the German government, an e-prescription can also be managed with a smartphone via a secure e-prescription app and sent to your chosen pharmacy.

To use the secure e-prescription app, patients need an NFC-enabled electronic health card and their PIN, which they receive from their health insurance provider. E-prescriptions can then be digitally assigned to a pharmacy using the app or presented at a pharmacy (with the prescription code).

An e-prescription code can also be handed out as a paper printout at the doctor’s office and you can take that to a pharmacy.

E-receipt

A person puts their health insurance card in a card reader during a presentation of the new e-receipt in Berlin on Wednesday. Photo: picture alliance/dpa/Reuters/Pool | Annegret Hilse

Does it work?

In theory, it should. But a member of The Local team had problems accessing a digital prescription, which was recently issued. Unfortunately, the pharmacies said they could not see the prescription uploaded to the health insurance card and the issue had to be resolved with the doctor’s office. 

So it seems that there are some teething problems. 

In this case, can I still get a printed prescription?

Yes, as we mentioned above, patients can get a printout of the e-prescription with a code at the doctor’s office. This can be scanned at the pharmacy who can then give you the medication prescribed.

However, the aim – at least from the government’s communication – is to move towards a digital system so it will be encouraged to avoid the paper route if possible. 

READ ALSO: What to know about Germany’s new digital healthcare law

Anything else I should know?

According to the German government’s Health Ministry, you won’t need to go to the doctor’s office if you need a follow-up prescription so that should save time. 

Aside from prescriptions that used to come on pink slips, prescriptions that came on green and blue slips can also be issued digitally if the system is set up to do so in the doctor’s practice. 

What happens if my doctor cannot issue me an e-prescription?

Since January 1st, doctors have been obliged to issue prescriptions for those with statutory health insurance in electronic form.

If they can’t do that, there are no consequences for patients. But the new digital law means there is a penalty for doctors. Doctors who do not support the e-prescription model will likely be subject to a fee reduction of one percent, according to the German government. 

READ ALSO: 7 things to know about visiting a doctor in Germany

Member comments

  1. Can you advise on how it will work for those of us without a German health insurance card. I have an international insurance (acts like “private”) which reimbursed me for my medical expenses including prescriptions.

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For members

HEALTH

KEY POINTS: How could Germany solve its worsening GP crisis?

Patients around Germany are struggling to find doctor's appointments - and experts warn the problem could get worse. Here's what the government wants to do about it.

KEY POINTS: How could Germany solve its worsening GP crisis?

It was a bleak prognosis from Health Minister Karl Lauterbach (SPD) when he spoke to reporters at a press conference back in March: “In the ten to fifteen years… in many areas of Germany, we won’t have enough GPs. We simply won’t be able to find a GP… because the GPs won’t be there.” 

The SPD politician was presenting his plans to reform local doctors’ practices and make the profession a more attractive option for future generations – plans that have just been voted through by the cabinet. 

Germany already has a severe shortage of GPs, Lauterbach explained, but the deficit will only increase as more qualified doctors head into retirement and too few medical students decide to become GPs.

According to the National Association of Statutory Health Insurance Physicians, 37 percent of practising GPs in Germany are currently over the age of 60. This has prompted fears that a significant proportion of doctors could soon retire, leaving a struggling system at the brink of collapse. 

With his Care Reinforcement Act, the minister hopes to create enough incentives to boost the numbers of doctors in local surgeries, stem the wave of retirements and shore up the provision of care for the wider population. 

READ ALSO: German ministers greenlight plan to improve healthcare at GPs

A paired-down version of the draft was voted through by cabinet ministers on Wednesday morning. 

These are the key proposals included in the draft – and the more controversial ones that have so far been left out. 

Better remuneration 

For GPs – as is already the case for paediatricians – the current cap on remuneration will be lifted. This guarantees that doctors in local surgeries will receive payment for additional work carried out, even if the budget is exhausted.

According to the ministry’s estimates, this is likely to result in additional costs in the ‘lower three-digit million range’ for the statutory health insurance funds.

Less bureaucracy

A cornerstone of the plan is to remove the need for unnecessary appointments, for example for repeat prescriptions and sick notes for chronically ill patients. 

A standardised ‘annual care flat rate’ for patients with chronic illnesses would mean that GPs were remunerated  for care without requiring these patients to come into the practice for in-person appointments. Instead, they could be issued with e-prescriptions and pick up their medication without needing to see a doctor. 

READ ALSO: 10 key things you need to know about healthcare in Germany

More digitalisation

Lauterbach has repeatedly emphasised the need for more digitalisation in the healthcare space, for example via e-prescriptions and digital medical records.

Practices will also be encouraged to offer online services such as telehealth in order to cut waiting times and prevent overcrowded waiting rooms. However, doctors have criticised the draft for not setting out concrete requirements. 

Digital prescription in Germany

A patient picks up a digital prescription at a pharmacy in Germany using their health insurance card. Photo: picture alliance/dpa/AKNR/IMAGO/Steffen Schellhorn | Steffen Schellhorn

Bonuses and incentives

Doctors who offer services to the wider community, for example by offering home visits and weekend appointments, will receive financial incentives to do so.

However, the specific criteria for qualifying for these bonuses has yet to be defined. 

Medical care centres

To improve access to care in communities, the government wants to make it easier for local authorities to set up so-called Medical Care Centres (MVZ), for example by assisting with security deposits. 

These centres bring together numerous doctors with an array of expertise to offer comprehensive and cooperative care to patients. The model is based on a similar scheme in the former GDR and differs from smaller, specialised practices where GPs are self-employed. 

Services for young people

According to the draft, psychological and therapeutic services for children and adolescents should be improved. This group of patients will be planned for separately to ensure adequate access to services. 

READ ALSO: How to find available therapists in Germany

Increased transparency

Patients with statutory or long-term care insurance should soon have access to a comparison portal that gives them an overview of the service offered by various insurance funds. 

For example, figures on authorisations, refusals and objections to certain health insurance benefits – but also on processing times and the quality of advice and support services – will be available to view online. 

Health Minister Karl Lauterbach

Health Minister Karl Lauterbach (SPD) explains his hospital reform plans at a press conference in Berlin. Photo: picture alliance/dpa | Jörg Carstensen

What isn’t included in the latest draft law?

In order to make progress in passing his reforms, Lauterbach removed some proposals from the draft that had faced opposition in cabinet. 

These include plans to set up ‘health kiosks’ – in other words, easily accessible advice centres for treatment and prevention in areas with a high proportion of disadvantaged households.

Lauterbach also wants to campaign to end statutory health insurance funding for homeopathic treatments. Since the treatments don’t work, he argued, the health insurance funds should not be obliged to pay for them. 

READ ALSO: Germany’s long-standing love affair with homeopathy

With reporting by DPA

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