In some regions, the electronic patient file (EPA) is already everyday in medical practices. Little by little she should come all over in Germany. At the beginning of the second quarter, which has now started in April, the Federal Ministry of Health plans should start. There is no precise date yet. What does patients come up? And what experiences a family doctor in Nuremberg has it gained?
How does the nationwide expansion run?
Since January 15, 70 million of the 74 million legally insured persons throughout Germany have received an EPA from their health insurance. The interaction with practices and clinics is initially only tested in three regions. “The Germany-wide roll-out is imminent,” says the executive health minister Karl Lauterbach (SPD). He assumes “that we can enter a high -run phase outside the model regions in the coming weeks”. Then there is a next, wider -tied stage of the test – for doctors at first voluntarily.
Roll out for the nationwide: “Safety always goes.” And: “We will only introduce the next stage when we have thoroughly tested the level before.” E-files were already introduced as a selectable offer that you had to take actively, but they were hardly used. Therefore, the traffic light coalition turned the principle with a law: Now everyone is getting an e-file unless you actively contradict.
What information is saved in the EPA?
The electronic patient file should accompany insured persons for a lifetime. In the digital memory, for example, doctor’s letters, findings, laboratory values and prescribed medication are to be collected. Access are given practices, clinics and pharmacies when the insured are in their health insurance card in their reader. This is regularly limited to 90 days.
The insured persons can revoke access rights via the smartphone app of your health insurance company or determine which doctors should get insight for how long. In this way, you can also upload documents to the e-file, for example self-led blood pressure diaries or important diagnoses from the past.
How does the EPA work in practice?
300 practices, pharmacies and clinics in the three model regions of Hamburg and the surrounding area, Franconia and parts of North Rhine-Westphalia are already testing the EPA in everyday life. Among them is the practice of the Nuremberg family doctor Nicolas Kahl. “It doesn’t work yet, but it is running stable,” he says.
The file is initially empty and is filled with documents during treatment. Currently, Kahl and its practice team can upload PDF files from EKG or lung function tests to the EPA. In addition, all e-recipes he exhibits are automatically saved there.
Since the start of the pilot phase, access to the E -files has increased significantly according to the majority of the federal digital agency Gematik – to more than 276,000 last week. Medicial lists have been called up almost 69,000 times. According to the ministry, 3.5 million e-recipes are routinely included in e-files.
What criticism is there?
The Association of Statutory Health Insurance Physicians (KV) in the model regions still consider it too early for a nationwide start. “A large part of the practices have the corresponding EPA module, but the practical teams continue to report technical problems and challenges in integration into practical processes,” says KV Westfalen-Lippe. In some cases, it cannot be accessed on e-files, or there are long loading times. The KV in Bavaria also sees no progress in problem solving. The acceptance of doctors and insured could suffer if the EPA starts too early.
What advantages does the EPA offer?
Experts are convinced that the electronic patient file can improve treatment. As a result, he can see the findings from other doctors and no longer has to run after it, says family doctor Nicolas Kahl. This saves time and prevent double treatments. “It helps us if we don’t know a patient well and he cannot provide any information about his medication.” For example, this could help prevent dangerous interactions between medication.
“It will be worthwhile in perspective,” Kahl is certain. However, this will take months, if not years. Because there are only findings and medication in the e-files that were placed or prescribed after they started. If patients want to deposit older diagnoses or regulations, they have to upload them themselves. A maximum of ten documents are possible annually, says Kahl.
What is the acceptance?
According to the Federal Association, around 4 percent of the 27.49 million insured persons from the EPA have contradicted the AOK. It is 7 percent of the 11.9 million insured with the Techniker Krankenkasse. In the practice of Nicolas Kahl, too, only a few patients have expressed reservations. “In the single-digit percentage range,” says the 37-year-old.
His experience: Anyone who rejects the e-file is often afraid that the data could get into the wrong hands. “Some don’t want me to see that they were with another doctor.” For most patients, however, the EPA is not an issue at all, he found. “They don’t have on the screen that they have one.”
How safe are the health data in the EPA?
Computer specialists and various organizations from the healthcare system warned of security gaps before starting in the model regions, which could give unauthorized access to all e-files. Lauterbach emphasized that it was possible to solve security problems for mass access that the Chaos Computer Club had worked out.
Expert Bianca Kastl and Martin Tschirsich from the Chaos Computer Club had uncovered them. From Kastl’s view, these continue despite updates. “The promised updates are only the attempt to limit the damage in one of the many of us demonstrated attacks,” she said. “Electronic patient files can still be attacked with little effort.”
© dpa-infocom, dpa: 250409-930-427813/1