What are the core electronic tasks

Electronic health card (eGK)

What can the new health card do?

Emergency data stored on the eGK can save lives, a medication plan can prevent life-threatening interactions. And with the electronic patient record (EPR), patients are better informed about their diagnoses and therapies. The aim is to improve the quality of medical care and to strengthen the role of patients.

The eGK applications have been introduced gradually since autumn 2020. Currently, the insured's administrative data, e. B. Name, date of birth and address as well as information on health insurance, such as the health insurance number and the insured status (member, family member or pensioner) are saved. The eGK contains a photo. There are only exceptions for children and young people up to the age of 15 and for insured persons who cannot participate in the creation of the photo, such as B. immobile patients in need of care. The photo helps to avoid mix-ups and to curb the improper use of services. The back of the eGK can be used by the health insurance companies for the "European health insurance card" and enables unbureaucratic treatment within Europe. The validity date on the back of the "European Health Insurance Card" only refers to this and not to the eGK itself.

Please only ever use the eGK that your health insurance company last sent you. Older cards are invalid after the new cards have been delivered and can no longer be used.

Current policyholder master data prevent misuse

The first online application of the eGK is the online comparison and online update of the insured person's master data stored on the health card with the current data of the insured person available from the health insurance company. In the event of a change that the insured has already reported to their health insurance, the eGK can B. a change of address, can be updated automatically at the push of a button the next time you visit a doctor. The health insurance companies save money because they do not have to issue new cards. At the same time, cards that are invalid or that have been reported as lost or stolen can be identified better than before when using statutory health insurance services. Abuse to the detriment of the insured community can thus be further reduced. Current policyholder master data also help doctors and their staff to update patient files.

With the emergency data, practitioners have all important information at a glance

With the emergency data of a patient, doctors have all relevant data, such as B. allergies or significant previous illnesses. Insured persons can have this information saved as emergency data on the health card if they so wish. The contact details of a relative to be notified in an emergency can also be stored in the emergency data set if desired. In an emergency, this data can then be read out by doctors or emergency paramedics without the patient having to enter a PIN. Insured persons can also make their emergency data available to their practitioner as part of standard care.

More medication safety through the medication plan

Too many people in Germany still die from undesirable interactions. Therefore, it was regulated by law that insured persons who take three or more prescribed drugs are entitled to a medication plan in paper form.

The self-administration partners in the statutory health insurance have specified the regulation in such a way that only those drugs are relevant that are taken over a period of at least 28 days. With the medication plan that is given to the patient, the treating doctors can see which medication he is currently taking. In this way, dangerous interactions can be avoided. Elderly and chronically ill people in particular benefit from the medication plan. This is created by the doctors who have to inform the insured about their entitlement to a medication plan. Pharmacists are involved from the start and are obliged to update the medication at the request of the insured person if the medication changes. Just like the emergency data, it has also been possible to save the medication plan on the eGK since August 2020 in the appropriately equipped medical practices and pharmacies.

Electronic patient files for more patient sovereignty

Since January 1, 2021, the health insurances have been obliged to provide their insured persons with an ePA in several stages. First of all, the insured person's data can be extracted from existing applications and documentation, such as B. emergency data, medication plan or doctor's letters are provided in such an EPR for the insured. Insured persons can use it to inform their practitioners about these important health data in order to improve the quality of medical treatment.

In an EPI, insured persons can also store their own data, such as a diary of blood sugar measurements. You can also view your data independently outside the doctor's office. The inspection can be carried out using a suitable mobile device such as B. a smartphone. This means that patients are much more precisely and comprehensively informed about diagnosis and therapy and can make decisions about their health better than before. This is the best prerequisite for a successful therapy.

Important detailed regulations for the introduction of the EPR, such as data protection-compliant access management, claims of the insured, obligations of doctors, questions of financing, use for research, involvement of nursing staff as well as requirements from the coalition agreement - such as the option of digitally sending the vaccination certificate, maternity record and examination booklet save and manage the dental bonus booklet digitally - were legally regulated and specified with the Patient Data Protection Act - PDSG, which came into force on October 20, 2020.

The Gesellschaft für Telematik (gematik) is responsible for the introduction and operation of the telematics infrastructure. Ensuring data protection and data security in the telematics infrastructure is one of the core legal tasks of gematik and includes high demands on all technical components used (e.g. connector) as well as on the organizational procedures in the telematics infrastructure. The components and services of the telematics infrastructure are therefore approved by gematik. At the same time, proof of security is provided in accordance with the specifications of the Federal Office for Information Security.

What choice do insured persons have in terms of medical applications?

Each insured person decides for himself which medical applications he would like to use and who is allowed to access his data. The insured determine whether and to what extent they use an application such as the emergency data, whether they use the card to document their willingness to donate organs (information on the existence of a written declaration on organ donation and its storage location can be electronically documented on the card) or whether they use an electronic medication plan or the EPR.

In addition, patients can view or print out their data and, in the future, show or hide data for certain doctors. In addition, insured persons or an authorized representative can delete documents in the patient record. As with the health insurance card, only the administrative data of the insured (insured master data) are stored on the eGK.

How safe is my data?

With the introduction of the eGK, a secure "health network", the telematics infrastructure, was set up. Like a data superhighway, the telematics infrastructure connects those involved in the healthcare system in such a way that they can exchange the medical information that is important for treatment quickly, safely and practically. Only authorized service providers, such as doctors or dentists, can access the data with the consent of the insured person. Access to the medical data is only permitted for the purpose of supply.

The telematics infrastructure enables secure access to medical and personal data of insured persons. Such data is extremely sensitive and must be protected particularly reliably. Since no one except the insured person has the eGK key and there is no "master key", unauthorized third parties (insurance companies, authorities, companies) cannot access the insured's sensitive medical data. Abuse is a punishable offense. For reasons of traceability, accesses are saved on the card so that it is always clear who has accessed the data of the eGK.

Gematik is responsible for the introduction and operation of the telematics infrastructure. Ensuring data protection and data security in the telematics infrastructure is one of your statutory core tasks and includes high requirements for all technical components used (e.g. connector) as well as for the organizational procedures in the telematics infrastructure. The components and services of the telematics infrastructure are therefore approved by gematik. At the same time, proof of security is provided in accordance with the specifications of the Federal Office for Information Security.

In the telematics infrastructure, medical data is not only protected by modern encryption methods during transmission, but is never decrypted there. The sensitive health data are protected using modern cryptographic procedures. These procedures were developed by independent scientists and examined for their effectiveness over several years and are always adapted to the current state of technical research. These encryption methods prevent unauthorized persons from reading the data. In addition, signature processes protect the data from unauthorized changes and ensure that the authorship of data cannot be subsequently disputed. With the eGK, on ​​which the individual key of the insured person is saved, the insured person has it in their own hands to make the data readable again. The data of the eGK may only be accessed for the purpose of medical care. Only a narrow, legally defined group of people has access. This includes in particular doctors and dentists. In order to be able to access the medical data on the health card, the so-called two-key principle applies. Similar to the bank card, the insured must activate the medical data using their eGK and a personal identification number (PIN). Doctors need a second key for access, namely their health professional card and also a PIN. (Exception: outside the doctor's office, insured persons access their EPI independently, for example with their tablet or smartphone; special secure procedures are provided for this.) That means that unauthorized users would only find very strongly encrypted data that they do not decrypt and no specific data Can assign insured persons. With the eGK, the insured receive a technical means to protect themselves effectively against unauthorized access and to determine for themselves who can save, view or change which data and when.

All of these measures ensure the highest level of protection for personal medical data, so that informational self-determination is guaranteed for the patients at all times. They are constantly being technically developed by gematik.

additional Information

  • Terms and regulations

    Terms and regulations relating to the electronic health card from A for doctor's letter to V for insured master data service

  • Legal framework

    Legal framework for the introduction of the electronic health card and the development of the telematics infrastructure

May 5, 2021