The electronic health card has become a synonym for the digital transformation of the German healthcare system. It envisions nothing less than a nationwide infrastructure for a growing number of applications that would replace existing communication processes by secure, digital pathways. Yet, despite governmental backing and funding, first applications have yet to materialize.
Within this chapter we suggest the notion of “installed base of opposition” as an explanation for the difficulties plaguing German ehealth initiatives. We use the example of a specific initiative on medication management for polypharmacy patients. By tracing the associated discourse over the last 10 years, we delineate the opposition that eventually led to the termination of the initiative. We conclude that the slow and cumbersome progress of infrastructure development in the German healthcare sector can be explained by the existence of a multi-faceted installed base of opposition.
Copyright 2017, The Author(s).