Pharmacy staff voice concerns over glitches in the electronic prescription service
The e-prescription system in Germany, set to become mandatory from January 2024, is currently facing significant reliability issues, with frequent disruptions and outages affecting the telematics infrastructure. These interruptions have caused operational challenges for pharmacies and potentially risked patient health.
Pharmacists and their associations have publicly expressed concerns about the system's instability. Thomas Preis, the head of the German pharmacists’ association, described the e-prescription system as extremely unreliable, with multiple days of outages or significant disruptions affecting tens of thousands of patients in just a few weeks. Between May and June 2025 alone, outages were reported on over half of the working days.
The main problems reported include periodic complete or partial system outages of the telematics infrastructure (TI), problems with third-party service providers contributing to system outages, and a lack of flexibility for pharmacies during downtime.
Gematik, the federal digital agency responsible for this infrastructure, has admitted that there have been components and services affected by disruptions in recent times. The organization is continuously working to further improve the reliability and stability of the e-prescription system.
Several proposed solutions have been discussed, including urgent and continuous improvements to the system’s technical stability and reliability, calls for Gematik to provide more operational flexibility for pharmacies during technical failures, and legal and political pressure to hold service providers accountable. There is also ongoing dialogue between stakeholders to strengthen the telematics infrastructure and improve crisis management processes.
Eugen Brysch, a board member of the German Foundation for Patient Protection, has requested a "daily e-prescription radar" to inform doctors about the system’s functionality. He has also demanded that Health Minister Nina Warken (CDU) instruct Gematik to submit a monthly disruption report.
Despite the challenges, the goal of the mandatory e-prescription system is to provide more convenience and reduce the number of trips to the doctor's office. Follow-up prescriptions can be issued without another patient visit with the e-prescription system. Manual signatures and trips can also be eliminated. However, those who wish can still receive the prescription as a paper printout.
Stable and secure operation is the top priority for Gematik. The head of the Federal Association of Pharmacists, Thomas Preis, has stated that the e-prescription system is outpacing Deutsche Bahn in terms of unreliability. He believes that digitization of the healthcare system is inevitable, but the current unreliability of the e-prescription system is unacceptable. The German Foundation for Patient Protection has demanded an early warning system for disruptions in the e-prescription system to ensure patient care remains uninterrupted during inevitable downtimes.
- The e-prescription system's instability, as described by Thomas Preis, has led to frequent outages that affect tens of thousands of patients, causing operational challenges for pharmacies and potentially risking patient health, especially during critical medical-conditions.
- Amidst the continuous calls for improvements in the e-prescription system's technical stability and reliability, Eugen Brysch, a board member of the German Foundation for Patient Protection, has requested a "daily e-prescription radar" and a monthly disruption report from the responsible digital agency, Gematik, to ensure seamless health-and-wellness care during downtimes and improve transparency regarding system issues.
