MEDIFACT

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MEDIFACT is the central, data-driven intelligence of the Unified Health Insurance. Calling it “all-knowing” would be an exaggeration – but MEDIFACT is designed to become more precise exactly where bureaucracy, media discontinuities and error-prone processes make today’s system expensive.

As a powerful large-scale computing system operating on a secure, state-run infrastructure, MEDIFACT becomes the true heavy lifter of the Unified Health Insurance: it processes tens of thousands of transactions in parallel and in real time – cleanly, transparently and without fatigue.

MEDIFACT works with medically relevant information: patient data, images, findings and conversation records – where legally permitted and where it truly matters for treatment, quality and remuneration.

Systems such as “ChatGPT” can handle published knowledge very well (and have been a great help to me here), but they have no access to individual patient data in medical records. MEDIFACT, by contrast, is based on structured, verifiable data from everyday medical practice and can derive the decisions required in the healthcare system.

Regarding digitalisation: I view the further development of the Electronic Patient Dossier (EPD) critically. In my view, there is a risk that part of the objectives may once again fail in practice – similar to earlier approaches surrounding the law on patient records.

MEDIFACT is continuously supplied with relevant data, images and conversation records from new staff trackers. The information originates from direct exchanges with service providers, medical professionals and entries in the patient dossier. On this basis, MEDIFACT can make precise and reliable decisions.

MEDIFACT largely relieves service providers of time-consuming documentation work, thereby creating valuable capacity. This time can be invested in direct patient care and training. As a result, the medical and nursing services expand, with unchanged staffing levels, by multiples.

The consumer affairs programme “Kassensturz” vividly demonstrated on 16 September 2025 the consequences of excessive documentation requirements: enormous volumes of writing – and at the same time alarming deficits in training.

The main tasks of MEDIFACT

• Assignment of case numbers (clear allocation of all processes).
• Transcription and evaluation of remuneration requests:
  service providers no longer submit invoices to the Unified Health Insurance, but instead tracker data, audio recordings, images and medication consumption. MEDIFACT calculates the services and initiates the remuneration.
• Patient information:
  reports from service providers are additionally translated into easily understandable language.
  Confidential conversation content that is not relevant for handling is removed.
  Patients receive an SMS or e-mail inviting them to review and confirm or comment on their request.
• Documentation: creation of the correct entries for the patient dossier.
• Staff evaluation: recording qualifications and experience of staff and determining the remuneration paid by the Unified Health Insurance to service providers for their work.
• Flat rates: use of hospital beds, operating theatres, intensive care beds, recovery rooms, expensive equipment, etc. MEDIFACT calculates remuneration individually, fairly and transparently.

MEDIFACT can do much more – click here.

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