For many people, health records are one of those things: there is the index card at the family doctor. And one more in each additional practice. X-rays and vaccination records are already in drawers somewhere. From Friday on, a new voluntary offer will start to more than 22 million insured persons, such documents and a lot more digitally and stored in a bundle: in electronic patient files (EPR), which can be accessed via smartphone. In a test phase, Health Minister Jens Spahn’s (CDU) flagship project should first get under way in a controlled manner. Because networking with the practices is not easy. There is official criticism of data protection.

Why a digital patient file at all? After years of tussling about more functions for the electronic health card, Spahn finally wants to advance digitization. And the e-file is a central element that is supposed to make things easier for patients and doctors. For example, to avoid unnecessary multiple examinations because you do not have data on the medication taken or previous treatments at the appointment in the practice. The EPR should gradually be able to do more. In addition to medical reports, x-rays and blood values, the vaccination card, the maternity record, the yellow examination booklet for children and the tooth bonus booklet should be from 2021 be available digitally. What they want to save and what not is up to the patients themselves to decide.

(Image: SOMKID THONGDEE / Shutterstock.com)

In the new year, many areas of the healthcare sector will switch to digital services. After the just started electronic patient record, electronic prescriptions are to follow in the summer and electronic sick notes in the fall.

How exactly does it start? The introduction should also run gradually – because this is a major technical project. At the beginning of the year, all insured persons are now entitled to receive an ePA app from the fund. For the time being, you can fill them with content yourself. And non-digital documents initially have to be scanned in using a mobile phone or tablet. There is also an area with information on insured persons from the respective health insurers, for example with reminder functions or a kind of receipt for billed services. Doctors should feed another area with medical data. In the first quarter 200, the networking in live operation will initially only be available with selected practices in Berlin and the region with statutory health insurance Westfalen-Lippe.

What do the doctors say? According to and then more practices should join – doctors do not expect a digital revolution directly. “If the technology is up and running smoothly, the EPR certainly has the potential to be a useful addition to everyday treatment,” says the head of the National Association of Statutory Health Insurance Physicians, Andreas Gassen. But the expectations shouldn’t be too great. Insured persons would have to actively activate documents. “This will be a hurdle for many older patients.” For practices, the EPR does not replace medical documentation and communication between doctors. At the beginning of the year, there was also a lack of suitable connection devices for the protected information superhighway in the healthcare sector. By July 1st, all 200 000 Practices for the EPR should be technically networked.

What do health insurers and consumer advocates say? Statutory health insurances (GKV) are based a wide use of the new possibilities. “The electronic patient record is a milestone on the way to using digitization for better care,” says the head of the National Association of Statutory Health Insurance Funds, Doris Pfeiffer. You hope that there will be a lot of interest among the insured. Consumer advice centers also see great opportunities to digitally improve care and gear it more closely to patient needs. But that must be open to everyone, even without a mobile device. That is why you recently advertised terminals in cash registers. From July 2021 it should now be possible to have e-files filled in medical practices – with a new PIN number and the electronic health card.

What about data protection? Spahn promises “highest standards”. The top data protection officer Ulrich Kelber gave the e-file a warning about the first stage. An initially “slimmed-down” version of the access rights is under criticism. In this way, patients can determine which data should be included in the e-file and which doctor can see them. More detailed access, depending on the doctor, only for individual documents is only just beginning 2022. That forced “all or nothing”, complained Kelber – the dentist could see the psychiatrist’s findings. The cash registers agreed with the data protection officer on an “extensive information text”, as it is called by the umbrella association. Everyone who wants an ePA can get it.

The security of eHealth was also an issue in c’t 1 / 2021. The focus shows how easy it was to manipulate sealed card terminals in medical practices, which are supposed to be used for security checks of electronic patient files. In addition, the c’t editors 000 checked health insurance apps and, in addition to questionable code Quality also discovered problems with the transport encryption and data protection.

(ktn)