Germany: Healthcare system and eHealth strategy

Healthcare system

Basic data

357,000 square km
82.5m inhabitants
230 inhabitants per square km
Complex health care system federal/regional, corporal

Healthcare system

Mainly public task financed through taxes. From January 2009 the government will fix the insurance contribution for all insured persons. Newly introduced private part also for legal health insurance members. Free access to most health services.

Healthcare organisation

Two levels:
  1. state (federal level, regional level with 16 german federal states - Laender )
  2. corporal level (e.g. health insurance companies).

Healthcare insurance system

200 legal health insurance companies with 72m members and 52 private health insurance companies with 7.1 million.

Number of general practitioners, dentists and hospitals

In Schleswig-Holstein: 89 hospitals (28 in free-non-profit, 25 in public and 36 in more private sponsorship), 53 precaution and rehabilitation hospitals
Communication between different professionals concerning the single patient
  • MediCom Net Flensburg, the network blood and the radiology network.
  • Pilots in praxis networks
  • Gematik Germany

Main realised telemedicine activities

  • Electronic patient document of identification "eHealth card Schleswig-Holstein",
    Telemedicine supply of coronal patients (TSGZ),
    Teleradiological supply of an island region.
  • Electronic patients card realised probably at the end of 2009
  • Partnership for the heart
  • Telemedicine supply of coronal patients (study with 570 patients)
  • Cooperation between Charite Berlin, ICW AG, Bosch, Barmer Ersatzkasse
  • Cooperation between BARMER Ersatzkasse and ICW AG
  • Electronic Patient Record for the insured persons from the Barmer Ersatzkasse (approx. 5.3m insured persons)

International cooperation on patient basis

Exclusively five hospitals of Schleswig-Holstein have treated by now more than 1,200 Norwegian patients through the patient bridge Norway.

eHealth strategy

Main objectives

  • Building up a telematics infrastructure (electronic patient card).

Aims

  • Communication between all professionals (hospitals, health insurers, practitioners, dentists, family doctors).
  • Cross-linking of all professionals and exchange of all relevant medical documents and data.
  • An electronic patient record with a lifelong medical history for every patient.

Main actions in milestones

Level of development 1 (obligatory for insured persons) expected from the end of 2008
  • Electronic update from the insurance data from the insured persons on the electronic patient card.
  • European Health Insurance Card on the reverse.
Level of development 2 (obligatory for insured persons) expected by the middle of 2008
  • Electronic prescriptions.
Level of development 3 (optional for the insured persons) expected by the end of 2009
  • Emergency data set.
  • Pharmaceutical documentation.
Level of development 4 (optional for insured persons) expected by the middle of 2009
  • Electronic patient receipt.
  • Electronic health record.
  • Electronic letter of referral.

Main projects

Pilot tests with 10,000 insured persons in each pilot region. Project coordination:

Links

www.gematik.de
www.die-gesundheitskarte.de
European Commission report "eHealth priorities and strategies in European countries",
see chapter Germany on page 42.

Contact

Thorsten Beck (member of the Executive Steering Committee),
E-Mail: thorsten.beck@sh.aok.de

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