The electronic patient record (ePA/elektronische Patientenakte) will be introduced on January 15, 2025. The purpose of the electronic patient record (ePA/elektronische Patientenakte) is to function as a digital health folder for those with statutory health insurance. It stores health data such as doctor's letters, medical findings, medication plans, laboratory findings, X-rays and possibly self-entered documents. The use or non-use of the electronic patient record (ePA/elektronische Patientenakte) must officially have no negative impact on healthcare. However there are considerable doubts about it and this promise.
An electronic patient file (ePA/elektronische Patientenakte) must be created for those with statutory health insurance, unless the person objects. Electronic data capture is therefore standard for those with statutory health insurance. The electronic patient file (ePA/elektronische Patientenakte) for those with statutory health insurance is therefore optional but not voluntary. This obligation does not apply to those with private health insurance. Private health insurers can offer this, but they are not obliged to do so. [1] [2] [3]
The medical documents stored in the electronic patient file (ePA/elektronischen Patientenakte) include among other things electronic medication plans, data for checking drug therapy safety, laboratory and image findings (X-rays, CT or MRI images), treatment findings, doctor's letters or discharge letters. In the future, the electronic medication plan, the e-vaccination pass, the e-dental bonus booklet, the electronic examination booklet for children and the e-maternity pass will also be stored. These are so-called medical information objects (MIO/medizinische Informationsobjekte). [4]
The electronic patient record (ePA/elektronische Patientenakte) is touted as being designed to facilitate the exchange and access of medical documents between doctor's offices, pharmacies, clinics and patients. Its use is intended to, among other things, eliminate unnecessary duplicate examinations, make it easier to change doctors and shorten hospital stays. But this assumption ignores the fact that particularly in medicine a further ruling can be indispensable and cannot be considered useless across the board. In addition the electronic patient record (ePA/elektronische Patientenakte) is intended to enable so-called voluntary data donations for public welfare purposes.
Officially there should be no negative impact on healthcare whether or not one uses the electronic patient record (ePA/elektronische Patientenakte). But it is unclear how the above-mentioned incentives for the electronic patient record (ePA/elektronische Patientenakte) and this promise are compatible.
Access to the electronic patient file (ePA/elektronische Patientenakte) takes place using the health insurance company's special ePA app. Statutory health insurance companies are obliged to offer the electronic patient file (ePA/elektronische Patientenakte) and consequently they are also obliged to offer a corresponding ePA app. [1] [2] [3]
With the ePA app health insurance holders should be able to access the contents of the electronic patient file (ePA/elektronische Patientenakte) at any time. Documents should be able to be viewed, inserted and deleted and access rights should be able to be changed. Healthcare providers such as doctors are only allowed access if this is necessary for treatment. The service providers should also only have access for a limited time, doctors and hospitals 90 days and pharmacies 3 days. How copies will be prevented is unclear however. [1] [2] [3]
The electronic patient record (ePA/elektronische Patientenakte) inevitably requires a stable technical infrastructure. Health insurance holders need a suitable device. The health insurance companies' ePA apps must go through the gematik approval process and run on a gematik-approved telematics infrastructure (TI/Telematikinfrastruktur). [1] [2] [3]
Only statutory health insurance companies are obliged to offer an ePA app. In addition to an appropriate operating system, health insurance holders need a card reader with security class 2 or higher and their own keyboard. Health insurance holders without an ePA app can only use the electronic patient file (ePA/elektronische Patientenakte) passively and cannot make any changes. [4] [5] [6]
[Domestic Politics] Electronic Patient Record - Background 2024-11-27[Domestic Politics] Electronic Patient Record - Meaning & Risks 2024-12-04
[Domestic Politics] Electronic Patient Record - Options for Action 2024-12-11
Src:
[1] Elektronische Patientenakte (ePA): Digitale Gesundheitsakte für alle kommt 2024-07-01
https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/krankenversicherung/elektronische-patientenakte-epa-digitale-gesundheitsakte-fuer-alle-kommt-57223
[2] Sozialgesetzbuch (SGB) Fünftes Buch (V) - § 291
https://www.gesetze-im-internet.de/sgb_5/__291.html
[3] Sozialgesetzbuch (SGB) Fünftes Buch (V) - § 291a
https://www.gesetze-im-internet.de/sgb_5/__291a.html
[4] Medizinische Informationsobjekte
https://www.ina.gematik.de/themenbereiche/medizinische-informationsobjekte
[5] ePA aktuell
https://www.gematik.de/anwendungen/epa/epa-aktuell
[6] Die Telematikinfrastruktur
https://www.gematik.de/telematikinfrastruktur
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