Pharmacy personnel express discontent over issues in the digital prescription platform
The electronic prescription system in Germany, designed to streamline healthcare and reduce trips to the doctor's office, has been plagued by frequent outages, causing significant disruptions for pharmacies and patients. These outages, which can last for days, affect tens of thousands of users, with the system's unreliability largely attributed to technical disruptions and instability in the underlying Telematics Infrastructure (TI).
The TI, which supports electronic prescriptions, patient records, and related digital health services, has been a source of recurring problems. Issues with external service providers managing critical TI gateways, such as the RISE gateway operated by Arvato, have led to partial or complete failures of essential services. These disruptions have been reported repeatedly since the system became mandatory in January 2024 and have intensified recently.
German pharmacists, represented by the Federal Union of German Associations of Pharmacists (ABDA), have criticised the instability, emphasising the critical role of e-prescriptions for patient health. They have demanded that the federal digital agency Gematik, responsible for the TI, urgently improve system stability and provide pharmacies more operational flexibility to supply medications during outages.
In response, Gematik has acknowledged these issues, attributing many outages to external providers rather than internal system failures. The agency has resolved certain technical glitches when reported, but ongoing challenges highlight the need for a more robust and reliable digital health infrastructure.
Efforts to improve stability include enhanced collaboration between Gematik and external TI service providers, calls for structural improvements and compensation for losses linked to outages, and increased pressure from healthcare stakeholders for system reliability, responsiveness, and contingency planning. These efforts are part of broader reforms, such as the Hospital Future Act, which mandates upgrading healthcare IT systems by 2027, aiming for a more integrated and stable digital infrastructure.
The German Foundation for Patient Protection has demanded an early warning system for disruptions in the e-prescription system, while its board member, Eugen Brysch, has called for a "daily e-prescription radar" to inform doctors of system functionality. Health Minister Nina Warken (CDU) has been urged to instruct Gematik to submit a monthly disruption report.
Despite the challenges, the e-prescription system offers benefits, such as eliminating manual signatures and trips, making it more convenient for patients. However, in case of outages, pharmacies need more flexibility to still provide care for patients. Those who wish can still receive the prescription as a paper printout.
Gematik continues to work on improving the reliability and stability of the e-prescription system. The head of the Federal Association of Pharmacists, Thomas Preis, has stated that the e-prescription system is outpacing Deutsche Bahn in terms of unreliability. Preis and Brysch, among others, believe that the current unreliability of the e-prescription system is unacceptable and that stable and secure operation should be the top priority.
- The e-prescription system in Germany, designed for health-and-wellness and medical-conditions management, has encountered frequent technical disruptions,, with the underlying Telematics Infrastructure (TI) being the primary source of these issues.
- Science and technology have played significant roles in the development and implementation of the German e-prescription system, but the system's general-news-worthy instability, especially in light of recent outages, raises concerns about its reliability and the digital health services it supports.
- As efforts continue to improve the e-prescription system's stability, advocate groups, such as the Federal Union of German Associations of Pharmacists (ABDA), and health authorities, like the German Foundation for Patient Protection, are calling for increased system responsiveness, contingency planning, and regular reporting on disruptions, thereby enhancing the system's impact on patient health and medical-conditions management.
