Everything about the electronic patient record (ePA)

In the coming year, every person with health insurance will receive an electronic patient file. t-online answered the most important questions.

Federal Health Minister Karl Lauterbach (SPD) is counting on rapid positive effects through the launch of electronic patient files (ePA) for all insured persons at the beginning of next year. The ePA will lead to better and less bureaucratic care, said the SPD politician in Berlin at the start of an information campaign.

According to a law passed by the traffic light coalition, all insured people received an ePA from their health insurance company at the beginning of 2025 – unless they believed it was necessary for themselves. They are intended to be a digital memory for information about medications, findings and laboratory values ​​and accompany patients throughout their lives. The e-file is scheduled to start on January 15, 2025, initially in two model regions in Franconia and Hamburg. It is expected to be available to patients, practices, clinics and pharmacies nationwide four weeks later. E-files were already introduced in 2021 as an optional offer that you have to take care of yourself. However, they have hardly been used so far.

Plans for an electronic patient record have been around for more than 20 years. Since the beginning of 2021, insured people have been able to use offers from their health insurance companies on a voluntary basis. According to Lauterbach, only one percent of insured people have done this so far.

What are the advantages and disadvantages of the ePA? t-online answered the most important questions.

Information about which medications a patient is taking, what previous illnesses they have or what examinations have already been carried out has so far been largely recorded on paper, sent via doctor’s letter and can be found in the file folders of doctors’ practices and hospitals.

These documents should now be digitally recorded and merged. This includes, among other things, findings, diagnoses, doctor’s letters and treatment reports. This gives doctors and hospitals, but also psychotherapists and physiotherapists, nursing staff, occupational and company physicians and midwives access to the data. Since 2022, the electronic vaccination certificate and the maternity certificate, the U-examination booklets for children and the electronic dental bonus booklet have been part of the ePA.

The advantages are obvious: omissions and errors in the medical field are often due to the fact that different treating people inadequately exchange information. For example, about medications that have already been prescribed and which may interact with newly prescribed medications. Greater transparency should enable better health care, including in emergencies and reduce errors in treatment.

There is no longer a need to compile a large number of doctor’s letters, surgical and laboratory reports and other documents from doctor’s offices, hospitals and other facilities.

Unnecessary double examinations or repetitions of therapy attempts that have no effect can be avoided in this way. This also makes it easier to obtain a second doctor’s opinion, as all findings are recorded centrally.

The treating doctors do not automatically have access to the stored information. This requires approval from the patient. Similar to the bank card, patients must activate their medical data – with their electronic health card and a personal identification number (PIN). And the doctors also need a second key, in addition to the medical profession card and a PIN number.

Patients should be able to decide alone which medical data they want to use and who has access to the data. The access rights granted can also be revoked at any time. It is also possible to determine who can access each stored document individually. The data is stored centrally on servers in Germany and encrypted.

Data protection officers see the danger that the data could fall into the hands of others and lead to false disadvantages, for example on the labor and insurance markets.

The Central Ethics Commission at the German Medical Association calls for appropriate transparency and supervisory structures that ensure data security and compliance with ethical standards.

Since January 1, 2021, everyone with statutory health insurance is entitled to have an ePA provided by their health insurance company. As a rule, this can be applied for in the online area of ​​the cash register. After your identity has been verified, you will then receive a PIN with your card, which you can use to log in to the health insurance company’s app. It is also possible to register for your next doctor’s visit using the card terminal in the practice.