Saturday, February 24, 2024

Problems in medical practices: NFC health cards paralyze card readers


Klaus M. was very happy when he received a new health card from his health insurance company. Thanks to the built-in NFC antenna, it should make check-in at the practice even easier and reduce waiting times. When he got to his family doctor, he was shocked: his card terminal was still not able to read his contactless card. When he put his card in the slot and wanted to enter his PIN, all he saw on the screen was a cryptic error message. “Oh shit, not again!” the receptionist blurted out. “This may take a while now.” “Why?” “The whole system has crashed. First we have to start all over again. Sit in the waiting room for a moment and we’ll call you.”

Such scenes are unfortunately not isolated cases. For about six months, doctors have been complaining that their EDP system crashes when some patients insert their electronic health cards (eGKs). The bug was initially difficult to isolate. Those affected are card terminals of the company Worldline Healthcare (formerly Ingenico) of the type ORGA 6141 online.

The card reader was released in 2017 and is currently in more than 90 percent of the more than 130,000 practices and clinics that are connected to the Telematics Infrastructure (IT). However, the development of the hardware was practically frozen in 2017 when the device was tested and approved by Gematik, which is responsible for IT (Gematik V.3.7.2, HW Vers. 1.2 certificate). The use of eGK cards with NFC (Near Field Communication) was not planned at the time, it only followed three years later.

Since 2020 only, Gematik requires additional tests for new terminals to determine if they are protected against electrostatic discharge (ESD). However, ORGA terminals already approved have not had to go through this new test. Current Gematik approvals for an ORGA 6141 online only relate to new firmware versions of the hardware which has not changed for five years.

  • More than 100,000 online ORGA 6141 card readers have problems with the new health cards.
  • Cards with galvanically coupled NFC antennas from Giesecke+Devrient are affected.
  • The cards have a higher power requirement and can be electrostatically charged and charged using radio waves.

In the winter of 2021, terminal accidents increased. The first entry on the Gematik specialist portal about the problems dates from December 3, 2021 at 3:45 p.m. At the time, Gematik was suspicious of the new G 2.1 health cards, but was still groping in the dark as to the cause. Shortly before Christmas, on December 22, 2021 at 8:30 am, the message followed that the manufacturer was providing a new firmware (V3.8.1). This could not solve the problem, but only reboot the system automatically. On January 14, 2022, at 4:45 p.m., Gematik reported that electrostatic discharge impulses when inserting an eGK G 2.1 electronic health card would cause the EDP to crash.

The culprits are the floor covering, dry winter air and plastic sleeves, which would electrostatically charge the insured and the card. To remedy this, Gematik recommended a week later the use of ESD mats, on which the cards must be placed before being inserted.

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Ebenezer Robbins
Ebenezer Robbins
Introvert. Beer guru. Communicator. Travel fanatic. Web advocate. Certified alcohol geek. Tv buff. Subtly charming internet aficionado.

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