Nino Mangiapane, Federal Ministry of Health

We are in the situation in Germany with regard to the objective of our project that i will be able to speak not only about technology, but also a survey of the German health system, because inclusion of stakeholders is important for us.

The objectives are to boost quality, enhance efficacy of national insurance, avoid follow-up costs, avoid adverse effects, avoid submission of false claims, reduce admin expenses by structured use of IT in medical care.

The current situtation is that we have lots of IT but traditionally these technologies have been used to document services and calculate fees for providers and payers and the systems are largely unable to communicate with each other, there are about 200 different systems in use already.

The health sector is of course extremely complex with very large numbers of players - linking and networking all of these players is the task we’ve set ourselves. We’ve tried to change things before, but no-one was interested so we passed legislation in 2003 to unify the Health Telematics Framework - we’re introducing electronic health cards with mandatory parts (admin data, finance status, prescriptions) and discretionary data. There was a political insistence on the participation of insured persons and data security. This is not a state-run project but the framework is set by the state and run by healthcare stakeholders - statutory and private insurers (50%) and Health Care providers (50%) So decisions need to be taken by them to define the necessary specifications. The health card is the physical manifestation and key to the dedicated technical infrastructure. We have focused strongly on security features. We are now releasing a range of features - the electronic health card, health professional card, card terminals, connectors to the telematic platform network infrastructure etc.

And all of these go through rigorous testing and consultation before release and implementation which is phased and implemented offline before online. Field testing is starting already across different regions and movement towards roll-out is progressing well. It’s been a long journey and many obstacles had to be overcome but these are essential technological platforms that will enable the communication we’ve heard so much about already today.