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<p>Digital referral and prenotification systems are gaining importance in emergency medical service (EMS) coordination, as the legally compliant selection of the “nearest appropriate” facility increasingly depends on a&#xa0;dynamic resource environment. In Germany’s federally organized emergency care system, the operationalization of “appropriateness” remains insufficiently specified in many state regulations. In practice, a&#xa0;distinction has therefore emerged between fundamental appropriateness (structural qualification) and current appropriateness (time-dependent admission and resource availability). Using the example of IVENA eHealth (IVENA: <i>interdisziplinärer Versorgungsnachweis</i>), this paper demonstrates how both dimensions can be operationalized technically: through configurable referral targets and resource logics, real-time representation of temporary restrictions, and standardized prenotification with role-based visibility for hospitals, EMS units, and—depending on regional governance—for dispatch centers. Patient allocation codes (PZC/RMI) are described as the semantic core of the system; their harmonization is prerequisite for interoperability and secondary data use. In addition, system-generated data are discussed as instruments for surveillance, operational quality management, and health services research, as well as for application in major incidents (e.g., mass casualty incidents, pandemics). Overall, digital referral systems should be understood less as IT projects and more as governance and steering instruments designed to enhance transparency, resilience, and patient safety at the interface between prehospital care, dispatch centers, and hospitals.</p>

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Digitale Steuerung von Akut- und Notfallpatienten

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Christoph Hoepfner,
  • Michael Städtler,
  • Viktoria Bogner-Flatz

摘要

Digital referral and prenotification systems are gaining importance in emergency medical service (EMS) coordination, as the legally compliant selection of the “nearest appropriate” facility increasingly depends on a dynamic resource environment. In Germany’s federally organized emergency care system, the operationalization of “appropriateness” remains insufficiently specified in many state regulations. In practice, a distinction has therefore emerged between fundamental appropriateness (structural qualification) and current appropriateness (time-dependent admission and resource availability). Using the example of IVENA eHealth (IVENA: interdisziplinärer Versorgungsnachweis), this paper demonstrates how both dimensions can be operationalized technically: through configurable referral targets and resource logics, real-time representation of temporary restrictions, and standardized prenotification with role-based visibility for hospitals, EMS units, and—depending on regional governance—for dispatch centers. Patient allocation codes (PZC/RMI) are described as the semantic core of the system; their harmonization is prerequisite for interoperability and secondary data use. In addition, system-generated data are discussed as instruments for surveillance, operational quality management, and health services research, as well as for application in major incidents (e.g., mass casualty incidents, pandemics). Overall, digital referral systems should be understood less as IT projects and more as governance and steering instruments designed to enhance transparency, resilience, and patient safety at the interface between prehospital care, dispatch centers, and hospitals.