gematik

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gematik GmbH

logo
legal form GmbH
founding January 11, 2005
Seat Berlin , Germany
management Markus Leyck Dieken, managing director
Number of employees approx. 300 (June 2018)
Branch Healthcare
Website www.gematik.de

Logo until 2019

The gematik GmbH (previously gematik - Society for telematics applications of the health card mbH ) was founded in January 2005 by the umbrella organizations of the German healthcare to under a legal mandate the introduction, maintenance and development of the electronic health card (health card) and its infrastructure drive in Germany, coordinate and ensure the interoperability of the components involved.

The shareholders of Gematik are the Federal Ministry of Health (BMG), the Federal Medical Association (BÄK), the Federal Dental Association (BZÄK), the German Pharmacists Association (DAV), the German Hospital Society (DKG), the Central Association of Statutory Health Insurance (GKV-SV), the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Dentists (KZBV).

The BMG owns 51 percent of shares . The National Association of Statutory Health Insurance Funds, which holds 24.5 percent, finances the work of gematik 100 percent with an amount of EUR 1.00 per member of the statutory health insurance . In addition, the Federal Ministry of Health has adjusted this amount in accordance with the financial requirements (funding requirements) of the Gematik and taking into account the economic efficiency through the statutory ordinance in each case in recent years. The remaining 24.5 percent of the business shares are distributed among the top organizations of the service providers.

Since July 1, 2015, Alexander Beyer has been managing director of gematik GmbH. The lawyer previously headed the legal department there for ten years. His successor as sole managing director was the former pharmaceutical manager Markus Leyck Dieken on July 1, 2019.

Legal basis

The foundation, existence and purpose of gematik are based on legal principles, which are anchored in Section 291b of the Social Code Book V. The tasks to be performed by the gematik are also described there, essentially:

  • Technical specification of the required data formats, services and components for the telematics infrastructure
  • Test and approval of the services and components (provision or delivery is carried out by the industry)
  • Operation of part of the telematics infrastructure

The " E-Health Act " of 2015 laid the foundation for the introduction of an electronic patient record and an electronic patient box (ePF). This should enable legally insured persons and service providers to have constant access to treatment data across all institutions, as well as to self-saved measured values, electronic doctor's letters , treatment reports and medication plans .

The society for telematics applications of the health card mbH (gematik) was obliged according to § 291a paragraph 5c of the fifth book of the social security code (SGB V) to develop technical and organizational procedures for a cross-case and cross-institutional documentation by the end of 2018.

Shareholder

The shareholders of gematik are the Federal Ministry of Health and the leading organizations in the German health care system, which are divided into the two groups of service providers ( doctors , dentists , psychotherapists , pharmacists , hospitals , midwives , physiotherapists , emergency services, etc.) and cost carriers ( health insurers ; private health insurers have not had any shares in the company since 2012 . In detail, the organizations of the service providers are:

The payers are also mainly involved through their umbrella association:

Other bodies

The legal basis of gematik requires the establishment of an advisory board that advises the company on technical matters. The composition of the advisory board is also specified in Section 291b SGB V and includes:

Organizations or federal authorities can appoint further representatives to the advisory board. Use is made of this. The respective composition of the advisory board can be found on the gematik website. The advisory board should the shareholders' meeting to present issues of fundamental importance to employment and must be heard before just such decisions.

In addition to the advisory board, there is a technical committee made up of representatives of the shareholders, which advises gematik on specific technical issues.

Cost structure

Gematik estimated the total cost of the project at 14 billion euros. There was no cost-benefit analysis of the eHC project until 2013 .

The state secretary in the Federal Ministry of Health , Ulrike Flach , who was in office until 2013 , confirmed that the project had already cost 1.5 billion euros in 2009. Until the beginning of 2013, only gematik's internal expenditures amounted to 630 million euros, now more than 700 million euros.

The second generation of the eHC must be issued by 2018, it will cost around ten times as much as the first generation eHC. The statutory coffers then reckon with renewed costs of 1 billion euros.

Criticism of the composition of gematik

  • Until 2019, the composition of gematik, each consisting of 50% health insurance representatives and service providers (including doctors, pharmacists), was criticized because it made decision-making difficult even in the smallest technical details. "The Society for Telematics Applications of the Health Card, or Gematik for short, had to collect project specifications in the course of its almost five years of existence. Responsible for this are primarily its shareholders, the associations of health insurance companies, doctors, hospitals and pharmacists - the so-called self-administration. The lobby groups make the Gematik almost incapable of making decisions because they cannot agree on key issues. "
  • "The decision-making procedures of the joint self-administration are too cumbersome for such a large-scale project, the mutual blockade is all too often rewarded." That said Susanne Mauersberg from the Federal Consumer Agency .
  • Since the federal election in 2009, the shareholders have been considering restructuring gematik. The aim was a new distribution of tasks for the applications with clearly defined implementation responsibilities. So z. B. Medical representatives were responsible for the timely introduction of a secure doctor-to-doctor communication ( doctor's letter ) or for the application of emergency data , health insurance companies for updating the insured person's master data and pharmacists for the planned e-prescription . "Those involved can no longer blame Gematik. There are project managers who are personally responsible." That's what Pablo Mentzinis from Bitkom said.
  • Since the German Medical Association (BÄK), as a Gematik partner, was committed to the company's purpose (the introduction of the health card), the 113th German Medical Association in 2010 voted again against the project. Lower Saxony's representative, Axel Brunngraber, announced further measures of the medical self-administration : "We have created important bulwarks in recent years and stopped the project for years, and we will continue to do so" .

Change of the majority

In January 2019, the German Minister of Health, Jens Spahn, proposed changing the law to allocate 51 percent of the shares to the federal government and thus control the gematik company, in order, among other things, to accelerate the introduction of electronic patient files. Resolutions should also be passed by a simple majority in order to accelerate the development and introduction of the secure health data network. The changes came into force with the Appointment Service Act on May 11, 2019. Before that, the National Association of Statutory Health Insurance Funds held 50 percent of the voting rights in gematik. The other half was with the associations of doctors, dentists, hospitals and pharmacists. Your shares have now shrunk accordingly.

Web links

Individual evidence

  1. ↑ gematik - homepage - society for telematics applications of the health card mbH . gematik.de. Retrieved June 10, 2010.
  2. ↑ Benjamin Rohrer: Spiegel: New Gematik boss should earn at least 300,000 euros. In: Deutsche Apotheker-Zeitung of June 21, 2019.
  3. ↑ § 291b SGB V
  4. ↑ "Statement from participants of the German Medical Association 2014 on the status report of the German Medical Association on the cooperation with gematik" , June 19, 2014.
  5. ↑ a b c kma-online.de: kma Online - News - Technology - Welcome to the Past ( Memento from January 25, 2014 in the Internet Archive ) , accessed on June 10, 2010.
  6. ↑ Deutsches Ärzteblatt : Telemedicine and telematics infrastructure: In the stands .
  7. ↑ Spahn disempowered health insurers and doctors in digitization , Handelsblatt , January 31, 2019. Retrieved on February 1, 2019.
  8. ↑ Appointment Service and Supply Act. Retrieved May 20, 2019 .