Foto einer schwangeren Frau, die auf einer Couch liegt und gerade von einer Hebamme untersucht wird

Why Digitisation Gives Midwives More Time to Focus on the Essentials

Mountains of paperwork, appointments missed by parents and the error-prone passing on of documents in the event of arrangements for substitution: until now, this has been everyday life for both employed and freelance midwives. Digital networking in the telematics infrastructure (TI) will make the work of midwives much easier in future.

Achieving the Best for Pregnant Women and Mothers


With the electronic patient record (EPR), the TI has created a place where information on pregnant women, mothers and their offspring can be accessed directly with just a few clicks. For example, it includes the electronic maternity pass (eMutterpass), which not only optimises prenatal care but also makes collaboration with doctors' surgeries, pharmacies and clinics more straightforward. All health data, findings and so on are fully documented online. Appointments can be conveniently managed. The child examination booklet is now available digitally as an EPR component as well. This also makes life easier for freelancers, as there are no complicated handovers in the event that a substitute is necessary.

The advantages of the telematics infrastructure and its applications are obvious: Midwives can spend less time on bureaucracy and more time caring for their patients. So it is already worthwhile to connect to the TI with the electronic health professional card (EHPC) and the practice ID card (SMC-B). You can order both cards from D-Trust GmbH, a company of the Bundesdruckerei Group – as can the majority of doctors and pharmacists who are already connected to the TI.

How TI Applications Make Life Easier for Midwives

The electronic patient record (EPR) makes the work of midwives much easier. For example, the electronic maternity pass (eMutterpass) and the electronic child examination booklet (ECE booklet) will be integrated into the EPR. These digital applications can be used with the electronic health professional card (EHPC).

Easier Care for Expectant Mothers Thanks to the EHPC

If a midwife assumes the responsibility of caring for a pregnant woman, the midwife will receive access to her eMaternity record. The midwife uses the EHPC for authentication and can then view all entries in the eMutterpass, such as those made by the gynaecologist, and can also store her/his own findings there.

Well-Informed Postpartum Care Thanks to the EHPC

During the postpartum phase, the midwife is granted access to the EPR, the electronic maternity record and the electronic child examination booklet by the new mother. In order to access these digital applications, the midwife authenticates herself vis-à-vis the telematics infrastructure with the EHPC. 

TI: Overview of Applications and How they are connected

The electronic patient record (EPR) is the centerpiece of the telematics infrastructure. Insured persons can get it in the form of a free app from their health insurance provider. In future, midwives will be able to view all relevant information on pregnant women, mothers and their offspring in the EPR thanks to the electronic maternity record and the electronic child examination booklet – provided that the patients give their consent. Information is never lost even when a patient switches to a different health insurance provider. Starting at the end of 2024, “EPR for all” will be introduced and automatically made available to all insured persons.

The electronic maternity record, which is stored in the electronic patient record, offers patients and their midwives online access to their health data at any time. Midwives also benefit from fast and uncomplicated collaboration with doctors, clinics and pharmacies. The healthcare staff involved in prenatal care can document and manage doctor’s visits, findings, medical appointments and all other health data in the electronic maternity record. In future, therefore, midwives will already have all the relevant information at their disposal during their initial consultation with a pregnant woman. Bothersome, time-consuming telephone enquiries to attending physicians will be a thing of the past.

In future, the same content will be found here as in the printed version of the child examination booklet. In the electronic child examination booklet (ECE booklet), parents receive digital reminders about upcoming mandatory screening appointments well in advance. In addition, the results of the screenings are entered into the electronic patient record in a standardised and structured manner.

KIM enables secure and direct communication between all participating professional groups in the telematics infrastructure. KIM users can send and exchange doctors’ letters, treatment and cost plans, findings, X-ray images, laboratory data, invoices and sick notes by e-mail in a secure environment.

The electronic medication plan contains information on the medications used to treat patients and is stored on the health card. All authorised service providers in the telematics infrastructure can view the medication plan quickly at any time. The complete documentation of prescribed medication serves the purpose of drug therapy safety, more specifically in terms of contraindications and medication errors. In future, the EMP is to become part of the electronic patient record (EPR).

TIM supplements KIM by providing secure, mobile, ad-hoc communication. Regardless whether queries about prescribed medication, information on laboratory results or call-back requests are involved, TIM will soon enable all healthcare professions throughout Germany to communicate with each other in real time via text message. This will save valuable time on all sides.

Emergency data is information about the patient that may be helpful for treatment in an emergency situation. For example, this may be due to pregnancy, previous illnesses, intolerances, operations, or allergies. The emergency data also includes diagnoses, medications and contact details for doctors, midwives, or relatives who need to be informed in an emergency. Patients can store personal documents such as an organ donor card, a healthcare proxy or a living will. The patient alone decides whether to create an emergency data record and which information is to be included.

Accessing the telematics infrastructure and thus the electronic patient record requires two cards, an electronic health card terminal and a connector. With the electronic health professional card (EHPC), midwives personally identify themselves in the TI as a member of their professional group. The most important component of the EHPC is a qualified electronic signature (QES). It replaces the handwritten signature in the telematics infrastructure. Each one of the various applications in the TI must be signed with the QES when completed. The purpose of the second card, SMC-B, is to identify the accessing practice. The electronic health professions register (EHPR) is responsible for issuing both ID cards. Midwives can order the cards from D-Trust once the EHPR has been approved.

To ensure that everyone who is part of the healthcare system can connect to the TI, most of the costs involved are refinanced by the National Association of Statutory Health Insurance Funds. This includes both the costs for the technical equipment (card reader and connector) and the ongoing operating costs for the EHPC and SMC-B.

Applying for an EHPC and Ordering It Online from D-Trust

Midwives receive their electronic health professional card from the newly created electronic health professional register (EHPR). The task of the EHPR is to verify the applicant’s professional licence. This also requires reliable identification of the applicant. Once your professional licence has been confirmed, you will receive a process number from the EHPR for the order.

The EHPC is ordered from D-Trust using its own eHealth portal. After entering the transaction number, you will receive a pre-filled application. All you have to do is complete the application, print it out and send it in. You must also provide valid identification, for example using the PostIdent procedure. Once valid identification and the signed application documents have been submitted, the EHPC can be produced and then, once approved, sent out by the EHPR.

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