The wide range of application possibilities of the electronic Health Card
The electronic Health Card will replace the current health insurance card in the foreseeable future. The appearance of the two cards differs in particular in two respects. On the front side of the card is a photo of the insurant to enable precise identification. The European Health Insurance Card (EHIC) on the rear side of the electronic Health Card can be used as visual ID right from the start. It replaces the "E111 Form" in the event of illness in a foreign country and entitles the insurant to unbureaucratic medical treatment abroad. But, of course, the differences are not just restricted to the appearance of the cards. In contrast to the old health insurance card, the electronic Health Card is not a memory card but a processor card, which means that it is equipped with a microprocessor like a standard computer.
Data security and the "dual-code principle"
In addition to these changes, the functional scope of the card in particular has been significantly expanded. Personal health cards can be managed directly by the insurant and be made available to the individual medical care providers as desired. A particular focus is placed on protection of personal data, as the insurants decide themselves, whether, if, and to what extent the personal medical data is made available for archiving. This also means that the patient has the right to delete saved data again as desired. The owner of the card decides who can view the data saved on the card. In this way, a general practitioner can be allowed access to data which is hidden from an orthopaedist, for example. Certain data must be authorized by the insurant with the entry of a PIN. Health data can therefore be protected and hidden prior to the card being read.
By handing over the electronic Health Card and entering the PIN, the patient consents to sharing a certain part of the data saved on the card. A code in the "duel-code principle" blocks further security levels in order to protect personal data. The law stipulates who is permitted access to the data.
Doctors, dentists or chemists, for example, are allowed access. Their health profession ID provides them with the second code required to gain access to the data on the electronic Health Card handed over voluntarily by the patient.
The different application possibilities will be made available to the insurant on a step-by-step basis. The basic configuration includes administrative data such as patient name, date of birth, health insurance company and insurance status. This data must be handed over by all patients. As with the previous system, the data is transferred to the computer for invoice purposes via a reading device. With the new system, however, the data of the insurant is not only saved on the card, but can also be compared online during a visit to the doctor. Alongside the administrative data, the electronic prescription is the second compulsory part of the electronic Health Card. In the future, doctors will save the prescribed medicine as an electronic prescription (eRezept) on the electronic Health Card. The prescription is also signed electronically via the health profession ID (HBA). In the chemist or mail-order pharmacy, the card is read via a reading device, the signature checked for validity, and the electronic prescription deleted when the medication has been issued. With the eRezept, the 700 million paper prescriptions issued each year using the previous system will be a thing of the past.
In addition to the administrative functions, the electronic Health Card can, at the wish of the patient, also save personal health data such as medication documentation, emergency data and information from the electronic patient record.