The electronic patient record currently provides little benefit for insured individuals. That is the assessment of the Federal Association of Consumer Centers (vzbv) almost a year after the nationwide launch. “The electronic patient record is not currently living up to its potential,” said Ramona Pop, a board member of vzbv, on Wednesday. According to a survey by the association, only 14 percent of insured people actively use the digital record, i.e., log in via an app or on a computer. A survey by the Redaktionsnetzwerk Deutschland in January among health insurers yielded even lower figures: only 3.6 percent of those with statutory health insurance actively use the record.
The electronic patient record (ePA) was launched just under a year ago for all statutory insured who did not object. Medical facilities such as doctor’s practices and hospitals must store, among other things, findings, diagnoses and prescribed medications in it so that other treating clinicians and the patients themselves can access it.
The ePA is part of a comprehensive digitization of the health system. The current and previous federal governments hope that the system will become more efficient, for example by avoiding duplicate examinations. Data protection officers and IT experts had early raised concerns that there were gaps in security and protection of personal health data.
The vzbv sees the ePA as fundamentally positive. “It has the potential to make health care for patients safer, more efficient and more transparent,” Pop said. But it is failing in implementation: initially there were security vulnerabilities that delayed the launch. Pop describes the insurers’ information policy as “more than inadequate.” And finally, a complicated registration process must be completed for someone to access the record as a patient.
Insured Persons Want More Flexibility
The association has asked insured people in two surveys what improvements they would like. At the top: precise control over which practice, clinic or other treating professional can see which of the stored data. Currently there is an all-or-nothing principle: for example, it cannot be set that the general practitioner may see the cardiologist’s report, but the dentist and the orthopedist cannot. In addition, insured people want digital examination records, such as the vaccination passport. And notes on possible interactions between medications.
“The ePA must deliver everyday practical benefits for insured individuals,” demands Pop. A flaw in the concept is also that each health insurer designs its own ePA. That makes it harder for family members to help each other with technical problems when they are with different insurers.
The ePA is currently not failing due to the practices, but due to the inadequate implementation and the fault-prone technology
Markus Beier, General Practitioners Association
The General Practitioners Association also offers a critical assessment: in the infrastructure there are frequent outages and disruptions. “The ePA is currently not failing due to the practices, but due to the inadequate implementation and the fault-prone technology,” said Markus Beier, national chairman of the German General Practitioners Association, to the Funke media group.
Health Minister Nina Warken (CDU) recently explained how she plans to further develop the ePA. Greater control for insured individuals over their own data did not feature. Instead, she plans more networking. In the future, ePA data should potentially be linked with data from care, accident or pension insurance. Additionally, a research pseudonym should be created. A large mass of health data, including from the ePA, should then be available pseudonymized for scientific and industrial research. Unlike anonymization, pseudonymization allows conclusions to be drawn about individuals.
