Digitizing Local Pharmacy Care at gesund: E-Rezept, Telemedicine, and Store Integration

E-Rezept was coming, and the Gematik specs defining it kept shifting while everyone built. Thousands of independent pharmacies across Germany had no way to accept a digital prescription and no connection to telemedicine providers, while a mail-order competitor was ready for both. Every month of delay moved more prescriptions out of the neighbourhood for good. gesund.de set out to build the pharmacy-first answer, and I led the product side of that build.

The fragmentation ran in every direction. Patients had no single app to scan a prescription, pick a pharmacy and track fulfilment. Pharmacy IT was split between Warenwirtschaft, POS, wholesalers and robotics, with no shared digital layer on top. Telemedicine providers like Zava and Doctorderma had no compliant way to route a prescription to a local pharmacy at all.

Marketplace logic pulls in one direction: optimise patient convenience above everything and you end up rebuilding mail-order with extra steps. The line I held on the roadmap was a single test for every feature decision: does this bring the patient back to their local pharmacy? In practice that meant giving pharmacies control even where it cost friction. Participation was opt-in, each pharmacy set its own acceptance windows, and each decided what it took on and when. Treating pharmacies as interchangeable fulfilment nodes would have been simpler to build. It would also have handed the market to the mail-order players we were competing with.

Three priorities came out of that test: an E-Rezept flow patients could complete without help, a Cockpit pharmacies would use every day, and a telemedicine handoff that passed compliance review.

The regulatory mechanics changed mid-build. CardLink gave way to PoPP, and new NFC eGK requirements arrived. So the redemption flow was designed to swap handover methods without rebuilding the journey around them. Fallback flows got as much design attention as the happy path: partial fills, substitutions and out-of-stock, each with in-app chat to the pharmacy, because a patient whose first prescription fails rarely tries a second. Compliance sat in the foundations: DPIAs, a consent ledger, purpose limitation, encryption at rest and in transit, full audit trails.

• E-Rezept flow: QR scan, NFC eGK tap, PoPP-ready redemption; patients choose a nearby pharmacy and follow real-time status.
• Pharmacy Cockpit: orders, reservations, substitution handling, pickup and delivery management, with integrations into NOVENTI, PHOENIX, Sanacorp, and BD Rowa.
• Telemedicine Connect: consent-based routing from teleconsultation partners to any opted-in local pharmacy.
• Local value chain: same-day pickup, delivery slots, proximity matching, OTC add-ons in the same basket.

Funnel analytics tracked every step from scan to pharmacy selection to pickup, with A/B tests on pharmacy ranking, delivery defaults and chat prompts. Onboarding playbooks brought pharmacies live faster. SLO dashboards and error budgets kept the platform reliable at national scale, tied to Gematik's release cadence. €417M of Rx revenue flows through the platform today.

• Faster, simpler E-Rezept handover through PoPP and NFC eGK, with reduced abandonment across the scan and routing steps.
• A higher share of prescriptions fulfilled by local pharmacies instead of mail-order. That share was the number the roadmap was judged on.
• Pharmacies control their own workload through opt-in and acceptance windows.
• Shorter time-to-fill through inventory signals and substitution flows.