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Author: Cornelia Wels-Maug
Hot on the heels of further delays to the introduction of the electronic health card, comes news of much higher costs than previously expected. An independent cost-benefit analysis produced by Booz Allen Hamilton and commissioned by Gematik, the company in charge of the implementation and the running of the project, concluded that costs are likely to be around €3.9bn rather than €1.4bn previously expected, and could be as high as €7bn. And this sum doesn't include the €585m cost of issuing of the cards.
Taking into account the five-year introduction phase, overall cost is estimated at €5.2bn, which will exceed expected savings of €4.4bn by €800m.
Comment: Gematik's management board is still digesting Booz Allen Hamilton's analysis and is not ready to comment on its results. However, it is certain that the e-health card will go ahead, since its introduction is integral to the German code of social law.
However, the question arises: why is Gematik commissioning a cost-benefit analysis now, in the middle of the project? Before the project began, an initial study determined costs of around 1.4bn versus annual savings of €1.7bn, which sounded promising.
The German government's plans are regarded as the most ambitious telematics project in Europe currently under way. Though other countries such as the UK, France, and Italy are engaged in related projects, their scale in terms of functionality and number of users are smaller. The high complexity of the e-health card, involving 80 million insured citizens, 123,000 general practitioners, 65,000 dentists, 2,200 hospitals, 21,000 pharmacies and 270 health insurance companies, makes it a very large challenge. And the communication, or rather the lack of it, between the involved parties is causing delays in the execution of the project.
We are still a couple of years away before all 80 million insurants are due to have their e-health cards. Gematik has been issuing specifications of the necessary equipment and is testing its market suitability. No tests with patient have started yet, but they will begin in two states this autumn and will be extended to six other sates in 2007. In every step of this long-drawn process, specifications will be altered and adapted to arising problems.
This is a prestigious undertaking for the German government. Its success is not only important for its own standing, but would act as a showpiece for the German IT industry and help it win similar projects in other countries which are currently looking at introducing such a system. Every time one breaks new ground, unforeseen difficulties can arise. But given the many challenges that this project has had to face so far, this news will give more ammunition to its critics.
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