“Extremely worrying” – This is what lies behind the controversial deal of the Techniker Krankenkasse | EUROtoday

In the Techniker Krankenkasse (TK) promoting, on-line drugs looks as if a medical novel. “At 8 a.m. sharp, the computer boots up, the headset is put on, and the two spotlights are aimed at the man in front of the white screen,” says the TK web site about a physician from the TK medical middle. TK policyholders can contact them 24 hours a day by video, phone, or chat to make clear medical issues.

But the digital idyll of the devotedly ready physician appears to be below menace. The operator of the digital TK medical middle is to vary at the start of December. Instead of the present operator, the corporate Ife Gesundheit primarily based in Nehmten in Schleswig-Holstein, which might be solely recognized to specialists, the corporate TeleClinic is to take over this service.

The group to which this distant drugs supplier belongs might be additionally recognized to many non-experts: the mail-order pharmacy DocMorris with headquarters in Frauenfeld in Switzerland.

Remote medical remedy has lengthy been customary for many medical health insurance firms. The proportion of on-line examinations continues to be low at round one p.c of all physician's visits. However, given overcrowded physician's places of work and the more and more sparse provision of care in rural areas, trade observers see nice development potential on this sector.

However, TK's new alternative of associate may result in conflicts. The Swiss on-line pharmacy is just not significantly common amongst German pharmacists. The North Rhine Chamber of Pharmacists, for instance, describes the type of cooperation as “extremely questionable”.

The Chamber observes “with some concern” that “telemedicine providers and foreign drug shippers have de facto the same parent company in terms of ownership structure.” “The reliable separation between doctor and pharmacy is at risk here,” says the North Rhine Chamber of Pharmacists. Data safety officers additionally level to potential conflicts that would probably come up from the precise design of the net service.

The undeniable fact that criticism of the cooperation between TK and DocMorris has not been louder to date might be just because virtually no one is aware of about it. TK has revealed the results of the tender on its tender portal.

TK itself sees no issues with the cooperation. TeleClinic “met the required criteria better in terms of quality and economy” than different opponents “and was therefore awarded the contract”. TK additionally sees no issues with information safety.

Not all telecommunications cooperations went easily

The medical health insurance firm states that TeleClinic shops “all personal data in encrypted form on servers” situated in Germany. This complies with TK’s contractual necessities.

TeleClinic additionally emphasizes that the information of German policyholders is just not transmitted to DocMorris or to Switzerland. “TeleClinic processes all user data in encrypted form in German data centers,” the corporate says. DocMorris says that “at no time will there be an exchange of user data” between TeleClinic and DocMorris.

However, not all of TK's collaborations with digital service suppliers have gone easily. In the previous, for instance, TK cooperated with the corporate Ada Health, which had developed an app for clarifying signs. The program was thought of one of the vital common well being apps.

In 2019, nevertheless, allegations have been made that Ada Health had handed on person information to Facebook, for instance, with out their consent. TK ended the cooperation at the moment.

When requested, TK said that the “data protection issues that arose at the time” had not affected TK. Ada Health left a corresponding request unanswered.

Berlin-based lawyer and information safety skilled Jan Mönikes sees no downside in precept with information switch throughout TeleClinic's on-line consultations, although the proprietor relies in Switzerland. “There is no form of data flow that is more strictly regulated by authorities than that of health data. The fact that TeleClinic's owner is based in Switzerland does not change the situation, as the country is viewed by the EU as having an adequate level of data protection” and subsequently information “can flow freely across this border”.

The TK contradicts the issues

Mönikes, nevertheless, raises questions concerning the particular design of the digital providing for TK policyholders. “If TeleClinic were to offer a preset button after the digital consultation, for example, that allows policyholders to redeem a prescription directly at DocMorris, this would set off alarm bells for competitors. This could raise similar legal questions to those of operating system manufacturers who pre-install a specific web browser and thus restrict fair competition,” says Mönikes.

The information safety lawyer additionally factors out that potential cross-subsidization must be taken into consideration. “If TeleClinic was awarded the contract by TK because they offer cheaper prices than competitors, but make up for these losses with income from DocMorris, this could also distort the market,” says Mönikes.

TK contradicts these issues. TeleClinic contractually assured TK that it will act independently of its guardian firm. “It is contractually obliged to refrain from doing anything that could give the impression that it is being influenced by the pharmaceutical industry or individual companies in the pharmaceutical industry when providing its services. TK therefore has no reason to believe that there would be a conflict of interest,” mentioned TK.

TeleClinic pronounces that e-prescriptions from telemedical remedies might be redeemed “in all pharmacies.” In addition to complying with authorized necessities, TeleClinic has “also contractually committed itself to independence from TK.”

The assurances of the contract companions are however met with scepticism in pharmacy circles. This can be because of a non-final ruling by the Munich Regional Court in May. The courtroom prohibited TeleClinic from receiving sufferers from DocMorris web sites in sure instances. The North Rhine Chamber of Pharmacists introduced the case.

TK states that it has “extensively examined the ruling from a legal perspective” and has come to the conclusion that there was “no reason to exclude” TeleClinic from the tendering course of. TeleClinic states that the ruling “particularly deals with the advertising of an asynchronous treatment path for erectile dysfunction” which “is not part of TK's services and therefore has no impact on the cooperation”.

The North Rhine Chamber of Pharmacists, which initiated the proceedings in opposition to DocMorris, doesn’t consider DocMorris's assurances. “Breaking the law is part of DocMorris' DNA,” the Chamber mentioned.

Andreas Macho writes for WELT primarily about prescribed drugs and the development trade.