The German health messenger will be expanded in 2026 to include direct cash register communication and mandatory ECC encryption to create a secure, networked system.
Germany’s digital health chat, the TI Messenger, will enter a new phase in 2026. After the introduction for doctors and patients, direct communication with health insurance companies and a massive security upgrade will now follow. The goal: A closed, secure network for everyone involved.
The one from the gematik Messenger developed is intended to replace fax and telephone in practices and clinics. As part of the electronic patient record (ePA), it enables encrypted communication based on the Matrix protocol. Since mid-2025, patients have been able to chat with their doctors via their health insurance app. Now the system is growing up.
Direct line to the health insurance companies from March
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The next big step is imminent: direct and secure communication between insured persons and their health insurance company via TI Messenger. Several large health insurance companies are planning to implement this service March 2026 around to go live.
This means that applications, documents and service requests can now be processed directly in the familiar ePA app environment. An end to the back and forth between telephone, mail and various online portals? Hope is great. This expansion from the clinical to the administrative area is a core part of the vision for a digitally connected healthcare system.
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Many clinics and practices are converting their telematics infrastructure to ECC – but technical changes alone do not protect against targeted attacks or human errors. The free e-book report “Cyber Security Awareness Trends” explains in a practical way which protective measures (including access controls, phishing checks and update processes) you should implement immediately after the ECC migration in order to really protect patient data. The report takes BSI recommendations and common messaging protocols such as Matrix into account. Download the free cyber security report now
Security backbone receives major upgrade
But new functions require more security. Since then 1 January 2026 A critical, network-wide retrofit is therefore mandatory: the switch to Elliptic Curve Cryptography (ECC). This encryption technology, recommended by the Federal Office for Information Security (BSI), is intended to make the entire system more resilient against future cyber threats.
The change affects every component of the telematics infrastructure – from the practice connectors to the healthcare professional cards (eHBA) to the primary systems. A necessary step in the background, because as data volumes grow, the security basis must remain state-of-the-art.
Competition between providers stimulates the market
The progress builds on a series of provider approvals in 2024 and 2025. The market for Gematik-certified messenger services has grown. After Famedly (Spring 2024) providers like came Akquinet (October 2024) and CompuGroup Medical (CGM) (January 2025).
This multi-provider strategy from gematik is intended to promote competition and innovation. At the same time, open standards guarantee that all certified messengers can communicate seamlessly with each other. Pilot projects, for example in Soest, have shown that as soon as the messenger is implemented, it is actively used by practices and pharmacies to coordinate e-prescriptions and medication plans. Since January 2026, professional versions such as “tim+” Pro from Arvato Systems have also been coming onto the market, which are specifically tailored to the workflow needs of hospitals.
The Roadmap: Messenger will become ubiquitous
The gradual introduction of the TI Messenger is a cornerstone of the German digital health strategy. If 2025 was the year of patient integration, 2026 should be the year of deeper integration.
The gematik roadmap envisages further development: work on the specification for TI-Messenger Pro 1.1 is scheduled to begin at the end of February 2026, with a release planned for May 2026. There is also a “TI-Messenger Connect“version is planned. It is intended to make the secure messaging functions usable outside of the main ePA app – a possible integration into other health apps is now within reach.
But hurdles remain. Acceptance in medical practices is only growing slowly. The full benefit of the network only unfolds with a critical mass of active users. Advanced features such as voice and video calls are also still pending. Their technical foundations through the Matrix Foundation are not expected until later in 2026. Nevertheless, the combined steps in functionality and security show clear momentum for building a truly connected digital health network.
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PS: Practice owners and hospital IT who, in addition to ECC updates, primarily want to reduce susceptibility to phishing and incorrect connector configurations, will find concrete checklists, awareness measures and priority lists for small to medium-sized facilities in the guide. The compact guide shows how you can combine training, technical measures and control processes so that TI Messenger and ePA apps can be used safely in everyday life – even with a limited budget. Request an e-book on cyber security awareness now
