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HEALTH

Health care in Germany: Here’s what’s changing for patients in 2021

From a stricter measles vaccination requirement to digitalisation of doctors' appointments and prescriptions, here's what you can expect from January 2021 onwards.

Health care in Germany: Here's what's changing for patients in 2021
A stethoscope at a Ger Alias (url - SEO) Title size Teaser From a stricter measles vaccination requirement to digitalisation of doctors' appointments and prescriptions, here's what you can expect fr

More health care staff

There’s no doubt that the coronavirus crisis put a lot of strain on Germany’s health care system – and its workers – in 2020. But to try to prevent personal shortages in 2021, Health Minister Jens Spahn announced that Germany would hire 20,000 new health workers in retirement and care homes.

Additional employees will also be hired at health offices and as birth assistants at hospitals, said Spahn, without giving a specific number. 

READ ALSO: Explained: How Germany plans to fight its drastic shortage of care workers

Electronic documents easier to access

Since January 1st, people with statutory health insurance have been able to voluntarily use an electronic patient record (ePA), which is provided by their health insurer. 

This means that, with the patient's consent, medical history, treatments, medication administered and previous illnesses can be stored electronically, so that other treating doctors and hospitals can also access this information if necessary and get a quicker (and better) picture of the patient's condition.

The aim is to optimise health care, but also to avoid unnecessary multiple examinations. Patients themselves can specify who is allowed to view the data. For privately insured patients, the electronic patient file will not be available until January 2022.

QR Code prescriptions

From July 1st, patients will receive their prescription from their doctor via QR code and app and thus transmit it to the pharmacy. The pharmacy can then inform the patient whether the preparation is in stock or when it will be ready for collection. 

This model is to be mandatory for people with statutory health insurance as early as 2022, replacing the paper prescription.

Sick notes submitted electronically to health insurance

A paper 'Krankenschein'. Photo: DPA

Until now, employees had to submit their sick note (Krankenschein) to the insurer themselves when they called in sick. at work

As of January, this can be done electronically: the doctor will then send the so-called eAU (electronic certificate of incapacity for work) directly to the insurer. However, the patient will still receive a paper certificate which they can pass on to their employer.

From 2022, the employer will also be able to retrieve the sickness notification directly from the health insurance company.

READ ALSO: How Germany plans to ditch paper sick notes for digital ones

Higher threshold for private insurance

Due to the increase in wages in 2020, the “assessment threshold” (what income is needed to qualify) for private health insurance will also rise in 2021. Now anyone earning more than €64,350 gross per year – as opposed to the prior €62,550 – will qualify.

Longer deadlines for treatment

Previously, if a doctor prescribed physiotherapy, occupational therapy or another type of therapy, it had to be started 14 days after the date of issue of at the latest. According to the new version of the Therapeutic Products Directive, patients now have more time for this – namely up to 28 days after the date of issue – in order for the statutory health insurance to pick up the costs..

Stricter mandatory measles vaccination

Previously children who started at a Kita or school before March 1st 2020 were required to provide proof of a measles vaccine – but now the requirement is being extended to all school-age children, and staff of schools and Kitas, regardless of when they started.

Anyone who disregards the rule can expect a fine of up to €2,500.

READ ALSO: Measles vaccination to become mandatory in Germany

A child being vaccinated against measles in Hanover. Photo: DPA

Easier change of health insurance fund from 2021 possible

Until now, people with statutory health insurance have only been able to change health insurers after a minimum contract period of 18 months. This is changing in the new year: The minimum term will then only be twelve months.

The termination procedure has also been simplified: in future, it will be sufficient to submit a declaration of enrolment in the new insurance company, which will then serve as a termination of the previous one. The employee will only be informed informally about the change.

Better protection against ultrasound damage

Ultrasound examinations during pregnancy that are not medically justified and not part of the benefits catalogue (Leistungskatalog) of the statutory health insurance will be banned as of January 1st.

A new regulation in the Radiation Protection Act is intended to protect embryos from an unnecessary, excessive dose of radiation.

The high ultrasound intensities required for imaging are said to be associated with a possible risk to the unborn child, especially since much more sound energy is absorbed at the skeletal level as bone formation begins.

The ban includes Doppler, duplex, 3D or 4D procedures, commonly called “Babyfernsehen” (“Baby-TV”) “Babykino” oder “Baby-Viewing”. Many practices offer such examinations as self-pay services (IGeL).

READ ALSO: From Kindergeld to tax benefits: What changes for families in Germany in 2021
 

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HEALTH

EXPLAINED: How Germany wants to contain the monkeypox virus

Health experts recently raised the alarm about cases of a rare virus in Europe. Here's what Germany is doing to limit the spread of monkeypox and what to do if you suspect you have it.

EXPLAINED: How Germany wants to contain the monkeypox virus

What is monkeypox and how is it transmitted?

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) that causes small lesions on the skin, headaches and fever. It’s similar to chickenpox or smallpox, though the illness tends to be less severe than smallpox.

The symptoms of the disease caused by the virus are generally mild and clear up in 2-4 weeks without treatment, but can occasionally result in more serious illness if the patient has a weaker immune system.

The disease is called monkeypox because it was first discovered in macaques – a type of monkey – in a Denmark laboratory in 1958. Around 12 years later, the first human cases were discovered in the Democratic Republic of Congo in West Africa.

Scientists believe that, rather than monkeys, the disease could have been transmitted to humans through close contact with rats or other rodents in sub-Saharan Africa. 

Since then, the disease has spread to other countries but has generally been contained within the West African region. In the past few weeks, however, cases have emerged in Europe and North America.  

Why are people concerned about it in Germany?

After the first case was discovered in the UK at the beginning of May, experts assumed that the virus was likely to be present in other European countries.

This prognosis turned out to be accurate, and Germany reported its first case of the virus on May 20th. Since then, six cases in total have been discovered in the Bundesrepublik, including one in Munich and three in Berlin. A further patient with the virus is currently being treated in isolation at Freiburg University Hospital, while authorities have reported evidence of infections in Saxony-Anhalt as well. 

The Health Ministry and Robert Koch Institute (RKI) have said they expect more cases to emerge as time goes on.

“We are in the early stages of this outbreak,” Lothar Wieler, the head of the RKI, said on Tuesday. 

Much is still unknown, he said, but the situation is being closely monitored. Samples from many more people are being analysed, and authorities are also looking for contacts of people with a proven infection. 

READ ALSO: 

Is this another Covid pandemic? 

Thankfully, no. So far, around 250 cases of the virus have been reported to the World Health Organisation (WHO) in 16 countries worldwide. Though this figure is worrying, the WHO has said that the risk to the general public is still very low.

Speaking to journalists on the sidelines of German Doctors’ Day in Bremen, Health Minister Karl Lauterbach (SPD) emphasised that the developments should be taken seriously. But, he said, the difference between Covid-19 and monkeypox are vast.

“What we are currently experiencing with monkeypox is not the beginning of a new pandemic,” he told DPA. Since the pathogen is well known to health experts, countries are well-equipped to bring the situation under control with good contact tracing and caution, he added.

Lothar Wieler and Karl Lauterbach

Lothar Wieler, the head of the Robert Koch Institute (RKI) and Health Minister Karl Lauterbach (SPD) speak at a press conference about monkeypox on Tuesday, May 24th. Photo: picture alliance/dpa | Sina Schuldt

One major difference between Covid-19 and monkeypox is the way it is transmitted.

According to experts, monkeypox is much harder to transmit to another person than the coronavirus. While Covid-19 can be passed on through airborne droplets and particles, monkeypox infections generally occur after sustained and close physical contact with an infected person or animal.

Of the recent cases that have become known to the RKI, most had been infected at large events “that were connected with sexual activities”, Wieler explained.

What should people do if they suspect they have monkeypox?

On Tuesday, the RKI issued recommendations that anyone who suspects they have monkeypox should self-isolate for 21 days.

If people notice small, red lesions appearing on their skin, they should contact their doctor or local health authority, who may require tests to be carried out and will likely ask for information about contacts. 

The contacts of infected people should also isolate for 21 days, the RKI said.

Generally, monkeypox is most identifiable through changes to the skin. The illness starts with red lesions, which pass through different stages and eventually crust over after the incubation phase of the virus is complete. 

Other symptoms of the disease include headaches, fever, chills, muscular aches and exhaustion. 

Experts also say that prevention is better than cure. Richard Pebody, head of the pathogens team at WHO Europe, recommends regular hand-washing, good hygiene and safe sex as practices to prevent the spread of the illness. 

What is the Health Ministry doing to contain the virus? 

Germany wants to control the spread of monkeypox by tracing contacts and quickly isolating infected people. 

Speaking in Bremen on Tuesday, Lauterbach said that the situation required a “tough response” and that the spread of disease could be contained if outbreaks were caught early. 

Now that the RKI has formulated isolation guidelines for both contacts and infected people, these will are set to be passed onto the 16 German states in the form of a recommendation.

The states will then be responsible for implementing and enforcing the rules.

Woman self-isolates with monkeypox

A woman self-isolates at home. The RKI recommends 21 says of isolation for people with monkeypox. Photo: picture alliance/dpa | Sebastian Gollnow

In addition, health experts are currently investigating whether existing vaccines should be rolled out to certain segments of the population.

This is a view supported by Klaus Rheinhardt, the head of the German Medical Association. Rheinhardt said on Tuesday that he thought vulnerable groups should be inoculated with the smallpox vaccine, which is believed to be highly effective against monkeypox.

This could include people with illnesses that weaken their immune system. Experts believe that the majority of people who died after a monkeypox infection in West Africa were HIV patients. 

Germany currently has around 100 million doses of smallpox vaccines in storage. Smallpox vaccination was compulsory in West Germany until 1975 and in East Germany until 1982, but the vaccination campaigns were phased out shortly before the eradication of the virus. 

READ ALSO: Monkeypox: German health expert calls for isolation measures

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