By the year 2025 a “telematic infrastructure 2.0” should replace the networking of the healthcare system that exists today. With this TI 2.0, the Gematik project company draws the conclusions from the network failure in the year 2020. The connectors used in medical practices, hospitals and pharmacies are being replaced as “proprietary IT solutions” by open “access interfaces on the Internet”. The master data management of the insured by inserting an electronic health card is being replaced by an internet service.

“IT arena for medicine” Gematik’s groundbreaking white paper outlines the future German healthcare system as an “IT arena for medicine” in which different playing fields exist and different games are played, each with its own rules. As the designer of this IT arena, Gematik takes on other roles such as “entrance control for all parties involved” and the role of the referee who makes sure that nobody commits a foul. In addition, it develops new rules of the game and playing fields for “new disciplines”.

Aside from all the beautiful metaphors and graphics, the white paper on TI 2.0 shows that Gematik is now the consequences of the failure of the TI 1.0 in summer 2020. At that time, after a faulty certificate change 80. 000 medical practices were flown out of the telematic infrastructure. In two thirds of the practices, a software update of the connectors had to be installed manually. The entire troubleshooting took 52 days. Now the connectors are to disappear as a “proprietary IT solution” and the “universal accessibility of the services through access interfaces on the Internet” is to be replaced. This universal accessibility also means that the previous smart card solutions will disappear.

For the insured, the doctors and dentists, this means that the insured master data management via the electronic health card through an internet service of the respective health insurance companies is replaced. The electronic health professional card and the SMC cards for the identification of medical practices, hospitals and pharmacies are also to be replaced by electronic ID procedures, in which the medical associations, associations of statutory health insurance physicians and other associations provide the appropriate federated eID. If possible, a single sign-on should always be used.

Open source preferred As the Gematik explains , the redesign of the telematic infrastructure is inevitable, because a lot has happened in recent times technically. IT is thought and implemented differently today than it was ten years ago. “The basic architecture must become more technology-independent so that data silos are dissolved and mobile patient care possible. The trend is clearly towards the cloud with” unlimited resources “and economies of scale. The spread of the open source culture in society and industry has increased significantly.” Wherever possible, TI 2.0 uses open source.

(mho)