Austria's Health System Faces Chaos After Fax Ban
Since the beginning of the year, Austria's healthcare system has been thrown into disarray following a ban on fax communications by medical professionals. This regulation, implemented for data protection reasons, has resulted in significant delays for patients as medical documents are now being transported via USB drives and CD-ROMs, often using taxis or even ambulances.
The prohibition on faxing has severely disrupted communication among hospitals, private practitioners, and insurance providers. Reports indicate that some healthcare facilities have resorted to using faxes as a temporary solution when their new communication systems fail.
Andreas Krauter from the Austrian Health Insurance Fund (ÖGK) acknowledged that the fax was the preferred method of communication across many sectors of the healthcare system, including hospitals, private practices, and social insurance institutions. Although the ÖGK has introduced a web-based system as a substitute for faxing, it has encountered compatibility issues with most commonly used IT systems in Austria. This alternative operates on cloud servers based in Germany and has been criticized for its complexity and lack of user-friendliness.
Healthcare professionals have expressed frustration over the new system's usability, with some stating it is nearly impossible for hospital staff to navigate. A recent study assessing the transition from paper to a digital system in a surgical department in Graz found that while doctors spent more time with patients, nursing staff became bogged down with electronic documentation, leading to decreased patient interaction.
The new system requires users to generate a ticket online, after which they receive an email link allowing them to upload documents. However, data uploaded is set to be automatically deleted after 90 days, raising concerns about record-keeping and accessibility.
In light of these challenges, the Austrian Medical Chamber proposed a new method for transmitting medical findings, termed 'directed finding transmission,' which would function similarly to email but with added data protection measures. This proposal would restrict communication to registered medical service providers.
The ÖGK has shown a cautious openness towards this new approach, emphasizing the need for thorough evaluation and discussion before implementation.
The fax ban was anticipated, having initially been postponed during the COVID-19 pandemic. However, the ensuing complications have caught many by surprise, with warnings from healthcare providers going largely unheeded.
Additionally, the Austrian Court of Auditors has criticized the implementation of electronic health records, known as ELGA, highlighting that meaningful usage of its core application, 'eBefund,' requires comprehensive data entry by healthcare providers. Despite the rollout of ELGA eight years ago, by the end of 2023, only hospitals were consistently recording electronic findings.
Currently, there is no centralized storage or searchable database for patient data, which is spread across multiple storage areas without a clear system for private practices or structured formats for specialist findings. The integration of radiological and laboratory data from private practices is not yet in place but is expected to be addressed by mid-2025. Recommendations from the Court of Auditors stress the importance of organizing data in a structured and easily searchable manner.
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