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The e-prescription was introduced in Austria in 2022 and digitizes the prescription process in the healthcare system. The introduction of the e-prescription poses special challenges and risks, which are examined in the article from various perspectives. The e-prescription replaces the previous paper prescription and is intended to increase efficiency and improve data quality. The prescription process is carried out electronically from the prescription to the billing, with the relevant information being stored in the administrative system. The e-prescription can be redeemed using an e-card or QR code, and reimbursement is done exclusively electronically. The e-prescription enables the electronic prescribing of medications in Austria. The pharmacy electronically records the data and forwards it to the social insurance companies on a daily basis. However, there are certain areas where the e-prescription cannot be used, such as for long-term anesthetics. The system currently only applies to medications reimbursed by the social insurance companies. Data protection plays an important role in the digitization of the healthcare system, and appropriate technical and organizational measures must be taken to ensure an adequate level of protection. A risk analysis shows that the electronic prescription (e-prescription) provides effective security measures against dangers such as unauthorized access or forgery. As part of the Health Telematics Act, a closed network has been established to ensure the confidentiality and integrity of personal data. The e-prescription is considered more forgery-proof than the traditional paper prescription and can only be redeemed once. To prevent abuse, information about the patient and the issuer must be included, and the prescription must be electronically signed. Although there were initially difficulties, around 1.2 million e-prescriptions have already been issued and the system is largely implemented. The e-prescription is an important step towards digital health management, but further modernizations are still required. The Vienna Medical Chamber provides information on the topic of e-prescriptions on its website. There is also an FAQ document that answers questions about the e-prescription. There is excitement about the new e-prescription, as reported on orf.at. The electronic health record ELGA also provides information on digitization in healthcare. [Extracted from the article]

The electronic health record (ELGA) in Austria allows doctors to access their patients' health data and link information with other providers. However, doctors are not legally obligated to collect ELGA health data, and the question of access to the record and the liability consequences of such a breach of duty must be answered according to general professional and civil law principles. The article discusses whether doctors are obligated to access the electronic health record (ELGA). It emphasizes that doctors must not unconditionally rely on the medical accuracy of patient statements and that it is necessary to professionally interpret the patient's information and ask targeted questions. The doctor's liability may be considered if they do not take into account available information. [Extracted from the article]

Background: The socioeconomic status is often an important confounder in the context of epidemiological studies. However, this information is typically not included in studies based on claims data, possibly due to a lack of knowledge regarding the completeness and validity of the available information. Objectives: Our aim was to assess and evaluate the socioeconomic status in the German Pharmacoepidemiological Research Database (GePaRD). Methodology: First, an algorithm was developed to assign an educational status to individuals insured in 2017 in order to estimate the socioeconomic status at the individual level. For comparison, the socioeconomic status was estimated based on the place of residence. For plausibility, we examined whether the known association between the presence of obesity and the socioeconomic status could be reproduced. Results: Based on different age groups it was possible to dichotomously estimate the socioeconomic status for 86–93% of those under 60 years of age and for 67% of the 60- to 69-year-olds. For individuals 70 years and older, the proportion of missing values was very high. In all subgroups, the prevalence of obesity was higher among persons of lower socioeconomic status than among persons of higher socioeconomic status. The estimation based on the place of residence produced plausible results, but with smaller differences by socioeconomic status. Discussion and conclusion: Overall, the study results suggest that in terms of plausibility and completeness the information available in GePaRD is well suited for estimating the individual socioeconomic status for age groups up to 69 years. [ABSTRACT FROM AUTHOR]

The article focuses on Covid-19 pandemic pushed the need for analysis right at the top of the agenda at the touch of a button and access to data on one's own health. It mentions uniform exchange format for electronic health records are implemented in Europe and actions for exchange about rare diseases, infectious diseases and efficacy studies. It also mentions extramural and intramural applications area, data from so-called wearables such as fitness trackers, watches, blood pressure monitors.

The article reports that the parties involved are arguing about the obligation to prove the entitlement to use services by means of an electronic health card (eGK). Topics include considered that the defendants Health insurance class 2 with statutory insurance refused to provide a photo for the eGK and applied for a paper-based insurance certificate to be issued.

Die regelmäßige Überprüfung von Referenzintervallen aus Daten des Laborinformationssystems ist eine wichtige Aufgabe im Routinelabor. Am Beispiel von Parametern des kleinen Blutbilds werden zwei weitgehend automatisierbare, indirekte Verfahren verglichen, wobei der Fokus auf Senioren liegt. Sie liefern trotz unterschiedlicher Algorithmen sehr ähnliche Ergebnisse, die aber von den Literaturangaben teilweise deutlich abweichen. Die Übernahme in die Stammdaten des jeweiligen Analyten darf nicht dem Computer überlassen werden. [ABSTRACT FROM AUTHOR]

Digitization is increasingly covering more and more sectors, including medicine. To ensure medical operation 365 × 24 hours, progressively more human and financial resources are necessary. The transformation of patient histories from paper into electronic patient records focused initially on documentation. Today, hospital information systems are increasingly used as a platform for the communication of all professionals involved in the patient process - in Switzerland, however, so far without providing patients direct access to their data. Digititizing processes intend to increase efficiency, but also to enhance clinical and administrative decision support and quality assurance. The introduction of the electronic patient record in Switzerland in 2020 is expected to provide cross-company, more complete documentation of patient care. Multimorbid patients, often treated in different institutions and by different specialists, should benefit from this in particular. Advances in artificial intelligence offer new opportunities in medicine. Challenges include ensuring reliable data protection, and better interoperability of the systems involved. Semantically structured, machine-readable data exchange is a necessity for both networked services and internationally competitive research. [ABSTRACT FROM AUTHOR]

In the last ten years, a national IT infrastructure with an electronic health record (ELGA) has been established in Austria. In 2016, e-medication was successfully put into operation as an ELGA service. This paper summarizes the most important steps in the development of the project and presents essential results and lessons learned. The main challenges were the overlapping planning, testing, usability of the software products, and the coordination of the rollout. [ABSTRACT FROM AUTHOR]

Background: Improper information transmission can lead to compromised patient safety and quality of life when patients are transferred from one setting to another. Electronic instruments may improve this situation, however, they are rarely used. Objective: The aim of this study therefore was to investigate the technical and organizational feasibility, usability, usefulness and completeness of an electronic instrument that is based on the German HL7 CDA standard for eNursing Summaries. Materials and methods: To this end, a test health telematics infrastructure, which included the German electronic health card, was established and nursing summary application was developed that allowed summary documents to be communicated between a hospital and a nursing home. The users were asked to evaluate the usability of the nursing summary application as well as to compare the usefulness and completeness of electronically and paper transmitted information. Results: This study demonstrated the feasibility of implementing an electronic nursing summary application that was based on the German HL7 CDA standard eNursing Summary and that was integrated in a test health telematics infrastructure. It could also be shown that the users rated this application as usable and that electronically supported patient transfers were superior to paper based ones. The use of the German electronic health card was regarded as a barrier by the users. Discussion: This study emphasizes the feasibility, relevance and barriers of electronically supported transfers of patients with nursing needs. Nurses working in hospitals and long-term care can integrate an application based on the HL7 CDA Standard ePfgebericht into their working processes and get better and more complete information. To ensure continuity of care in a sustainable manner in the future, the German HL7 CDA based eNursing Summary standard should become part of the German telematics infrastructure. [ABSTRACT FROM AUTHOR]

The electronic health record (EHR) is a topic of high political relevancy particularly with regards to the launch of the ‘electronic patient's dossier' 2017. To investigate the current use of EHR under Swiss general practitioners, we analyzed data from the Work Force Study 2015 with respect to use of electronic, paper and mixed (electronic as well as paper) medical history patient administration. 39% of the participants used EHR, 34% paper and 27% mixed health records. The use of EHR was significantly larger in German-speaking Switzerland (44% ) as compared with French (30% ) and Italian speaking parts (12% ). Especially younger physicians and group practices preferred EHR. EHR users reported a higher number of hours spent for research and further training. The results are discussed with respect to the challenges on general practitioners' provision posed by the demographic change. [ABSTRACT FROM AUTHOR]

Abstinence after stationary qualified withdrawal treatment for alcohol dependent patients Objective: The aim of the study was to determine the relapse rate after a qualified withdrawal treatment (QE), developed in interdisciplinary collaboration, for alcohol dependent patients and to identify risk factors for a relapse. Methods: In this naturalistic study, all patients were invited to a clinical interview at the beginning and the end of the therapy as well as one year after completion of the treatment. In addition, the electronic health records (EPA) were searched for relevant variables predicting relapse. Results: The percentage of premature termination of the treatment (6.67 %) was low. The relapse rate (reference time window of two years after the qualified withdrawal treatment) was 56.67 %. The placement rate to long term treatment amounted to 26.67 %. Risk factors for relapse, such as the number of previous withdrawals or the duration of alcohol dependency could be identified. Moreover, especially a high psychosocial burden was a significant predictor. Conclusion: The newly developed program for a qualified withdrawal treatment yields comparable relapse rates as those found in other studies. The psychosocial situation of the alcohol dependent patient should be carefully examined in order to adapt the therapeutic strategies accordingly. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a major cause of permanent disability. Therefore, the rehabilitative approach right at the beginning of the treatment is all the more important. Consequently, well-functioning interprofessional collaboration is especially crucial in the acute phase. This study investigates which characteristics can have a positive or negative impact on interprofessional collaboration from the team members' point of view. Method: In a Swiss stroke center two focus group interviews were conducted with members of all professional groups involved in the primary treatment process. Participants received the literature-based interview guide in advance. Knowledge Maps served as instrument to visualize interview statements. The summary was based on principles of content analysis. Results: Participants estimated interprofessional collaboration as "generally well-functioning". The mutual understanding of different roles should be further developed. Structure and content of interprofessional meetings ought to be revised. Additionally, electronic medical records should be used more effectively. Conclusion: Interprofessional collaboration is a crucial factor for patients' recovery and regaining maximal independence after a stroke. The analysis of collaboration allows interventions to improve treatment results. [ABSTRACT FROM AUTHOR]

Background: Patient data management systems (PDMS) enable digital documentation on intensive care units (ICU). A commercial PDMS was implemented in a 25-bed ICU replacing paper-based patient charting. The ICU electronic patient record is completely managed inside the PDMS. It compiles data from vital signs monitors, ventilators and further medical devices and facilitates some drug dose and fluid balance calculations as well as data reuse for administrative purposes. Ventilation time and patient severity scoring as well as coding of diagnoses and procedures is supported. Billing data transferred via interface to the central billing system of the hospital. Such benefits should show in measurable parameters, such as documented ventilator time, number of coded diagnoses and procedures and others. These parameters influence reimbursement in the German DRG system. Therefore, measurable changes in cost and reimbursement data of the ICU were expected.Material and Methods: A retrospective analysis of documentation quality parameters, cost data and mortality rate of a 25-bed surgical ICU within a German university hospital 3 years before (2004-2006) and 5 years after (2007-2011) PDMS implementation. Selected parameters were documented electronically, consistently and reproducibly for the complete time span of 8 years including those years where no electronic patient recording was available. The following parameters were included: number of cleared DRG, cleared ventilator time, case mix (CM), case mix index (CMI), length of stay, number of coded diagnoses and procedures, detailed overview of a specific procedure code based on daily Apache II and TISS Core 10 scores, mortality, total ICU costs and revenues and partial profits for specific ICU procedures, such as renal replacement therapy and blood products.Results: Systematic shifts were detected over the study period, such as increasing case numbers and decreasing length of stay as well as annual fluctuations in severity of disease seen in the CM and CMI. After PDMS introduction, the total number of coded diagnoses increased but the proportion of DRG relevant diagnoses dropped significantly. The number of procedures increased (not significantly) and the number of procedures per case did not rise significantly. The procedure 8-980 showed a significant increase after PDMS introduction whereas the DRG-relevant proportion of those procedures dropped insignificantly. The number of ventilator-associated DRG cases as well as the total ventilator time increased but not significantly. Costs and revenues increased slightly but profit varied considerably from year to year in the 5 years after system implementation. A small increase was observed per case, per nursing day and per case mix point. Additional revenues for specific ICU procedures increased in the years before and dropped after PDMS implementation. There was an insignificant increase in ICU mortality rate from 7.4 % in the year 2006 (before) to 8.5 % in 2007 (after PDMS implementation). In the following years mortality dropped below the base level.Conclusion: The implementation of the PDMS showed only small effects on documentation of reimbursement-relevant parameters which were too small to set off against the total investment. The method itself, a long-term follow-up of different parameters proved successful and can be adapted by other organizations. The quality of results depends on the availability of long-term parameters in good quality. No significant influence of PDMS on mortality was found. [ABSTRACT FROM AUTHOR]

Introduction: Most surgery of the lumbar spine is performed with the patient under general anesthesia (GA); however, qualitative benefits of spinal anesthesia (SA) have been reported. The goal of this study was to compare time efficiency between these two anesthesia methods in lumbar spine surgery. To test the hypothesis that the use of SA leads to significant time saving compared to GA for lumbar spine surgery, key points in the preoperative, intraoperative and postoperative anesthesiology care times were analyzed. The focus was on anesthesia time excluding surgery time. Materials and methods: Electronically based data of 473 anesthesia procedures (368 SA, 105 GA) for lumbar spine interventions performed in the prone position (i. e. decompression, discectomy and transpedicular instrumentation) were analyzed retrospectively. Patient population data including gender, age, American Society of Anesthesiologists (ASA) classification and body mass index (BMI) were analyzed. The focus was on the documented perioperative key time points which are defined as follows: (1) induction, (2) positioning (turning into prone position), (3) scrubbing and covering, (4) surgery time (knife to skin closure), (5) closing (end of surgery until leaving operating room) and (6) handing over to recovery. Differences in the amount of time for each perioperative period were calculated for SA and GA. Results: In 7 out of the 368 SA patients SA failed and had to be converted to GA. There were no significant differences in BMI, ASA prevalence and gender between SA and GA patients but SA patients were significantly older (median 61.7 ± 15.4 years) than GA patients (median 56.1 ± 14.6 years). However, SA required significantly less time for induction (SA: 17.7 ± 7.0 min, GA: 21.6 ± 7.2 min), preoperative preparation (SA: 9.7 ± 3.6 min, GA: 13.3 ± 5.4 min) and closing period (SA: 4.9 ± 1.1 min, GA: 15.3 ± 5.7 min) compared to GA. Total anesthesia time with exclusion of the surgery time revealed a significant time reduction using SA of 19 min (95 % confidence interval: range 13.6-24.4 min, median in SA: 56.7 min, median in GA: 75.7 min, p < 0.0001). Conclusions: This study showed that in lumbar spine surgery 19 min of anesthesia time can be saved using SA compared to GA which could have an impact on economic aspects. Gender, BMI and ASA had no statistically detectable influence on the choice between the two anesthesia methods. The fact that time-intensive complex instrumentation is mainly performed in younger patients may explain why GA patients were younger than SA patients. [ABSTRACT FROM AUTHOR]

The most recent data on the use of electronic medical records (EMR) in Swiss practices are from 2007. Since then, software products have evolved, The aim of our article is to update the knowledge about the current status of EMR implementation in Swiss practices and to gain information about Swiss primary healthcare providers' views of software tools providing clinical decision support. [ABSTRACT FROM AUTHOR]

The article presents a report which reveals that the life and health of people in Germany could be better be protected when possibilities of digitization responsible and scientifically reasonable in health care would be used. It mentions about the realignment of health care towards a digital and systematically learning health system. It mentions about collecting electronic patient file for more targeted research, prevention, diagnostics and therapy.

The article discusses how smart phone has fundamentally changed lives and its impacts on electronic health data dealing with how smartphone owner can swap their personal health data quickly and reliably with doctors or health insurance.