Telematics infrastructure: the digital healthcare network

The word telematics combines the terms telecommunication and informatics. It generally refers to the networking of different IT systems and the ability to link different types of information from different sources with each other. The telematics infrastructure is used in the healthcare sector to share data digitally between practices, hospitals, pharmacies and other institutions within the German healthcare service. It enables a wide variety of applications, for instance online updating of the insured person’s master data on the medical data card or the use of the electronic patient record, the electronic medication treatment plan and much more.

The ultimate goal of the telematics infrastructure is to provide better support and care for all patients through comprehensive, easily accessible information. Since this often also involves personal data and sensitive information, data protection and data security are particularly important aspects of the telematics infrastructure. It is also stipulated by law for data security to be the top priority for the telematics infrastructure.

Medical, dental and psychotherapy practices, hospitals, medical care centers (MCC), laboratories and pharmacies are connected to the telematics infrastructure as authorized health institutions. Facilities for midwives, physiotherapists, outpatient and inpatient care can also connect voluntarily. Facilities for other healthcare therapists, health trade professionals, health insurance providers, but also those of the public health service and research, to name just a few examples, will also be able to do this in the future. 

In addition to the registration, which is only possible for authorized health facilities, certain technical requirements must also be met in order to use the telematics infrastructure. Practices or other health facilities need what is known as a connector, for example – a device that is comparable to a sealed internet router but that initially only establishes the connection with the telematics infrastructure. It uses an approved VPN access service that shields all data from the general internet through encryption.

Health professionals that access data in the context of the telematics infrastructure applications or want to exchange it must show evidence that they are entitled to it with a health professional card called a Smartcard. If required, this card is inserted into an e-health card terminal connected to the telematics infrastructure through the connector. The institution card ensuring an institution’s authorized access to the telematics infrastructure is also in this e-health card terminal. 

In order to access or change certain patient data, the patient’s electronic medical data card must also be available and scanned. In purely practical terms, access is therefore only possible if the patient hands over the card for this. 

The telematics infrastructure is the basis for many new digital healthcare applications. These include applications that patients can choose, but don’t have to.

The online comparison of the insured person’s master data on the electronic medical data card has long since been used. Master data include the patient’s policy number, date of birth or address, for example. Management of the master data via the telematics infrastructure is compulsory.

Other examples of applications include the electronic issuance of prescriptions (e-prescriptions) or the optional storage of emergency data on the medical data card. Creating an electronic medication treatment plan, i.e. documentation of the prescribed medicines and their dosage, and keeping an electronic patient record are voluntary options – they are only used if insured persons want to do so and allow it.

Medical data is usually sensitive data and must therefore be especially well protected. The telematics infrastructure uses a very high encryption security standard for data exchange. Only people who are authorized and show specific identification are allowed access to the system. Many applications also require the express consent of the patients and the scanning of their personal medical data card.

In order to guarantee data protection and security for the telematics infrastructure in the long term, the Federal Office for Information Security (BSI) checks the cryptographic procedures, i.e. the encrypting procedures, regularly. They are always updated to reflect new developments.