2024-10-29 15:45:00
What is the electronic medical record?
The electronic medical record (Patient electronic medical record or e-PA in German) will serve as a digital repository of patient health information. It will include, for example, details on mediation plans, laboratory results, dental care and vaccinations and should accompany patients throughout their lives. Doctors can add details to the file and patients can also upload documents.
In 2021, e-files were introduced as an optional offering, but of the 74 million people with public health insurance, only about 1% signed up. The government’s aim is for 80% of legally insured patients to have ePA by moving to the “opt-out” principle.
Currently, important data is spread across servers at practices and hospitals where patients have been treated in the past, which can cause problems and delays when changing practices or switching providers.
When will it be available and for whom?
From January 15, 2025, health insurance companies must provide an electronic file to everyone who has public health insurance in Germany, except those who have opted out. Around 90% of the German population is covered by public health insurance. People with private health insurance can only get e-PA if their insurer provides it to them.
According to citizens’ rights groups, the file together with the documents and data it contains are stored centrally on servers in Germany and encrypted, resulting in high data security.
A doctor’s waiting room in Germany. Photo: Picture Alliance / dpa | Daniele Karmann
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How does it work?
Patients have access to the electronic dossier via an app of their health insurance company and can control which documents can be viewed there. According to the Ministry of Health and health insurance companies, patients can block documents and delete them, or even cancel the entire file at any time.
In addition to uploading laboratory results, patients can also create their own diaries, for example with blood pressure measurements.
During the visit to the doctor, the healthcare professional will be able to insert the patient’s health insurance card into the reader and, via the office computer, add data on ongoing treatments.
The Ministry of Health states that no one can read the contents of the electronic medical record except the insured patient and those who have been authorized by him to access it (for example a doctor). Exactly what is stored there is decided by the insured person himself in consultation with his doctor.
Health insurance companies also charge for the services they have been invoiced for. This way you can know when a doctor was visited, what diagnosis was made or what medications were prescribed and when.
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Why is it launched?
It’s all part of Germany’s plans to be more digital friendly. THE digital health law it was approved by the Bundestag at the end of 2023 and also included the introduction of electronic prescriptions at the beginning of this year.
The government says the electronic file is also about safer and more streamlined healthcare so doctors can see what drugs patients are taking if, for example, they switch to a new practice.
It could also be useful in an emergency. Doctors will be able to better recognize pre-existing conditions in the patient’s electronic record and rule out interactions during medication administration if they can see what other medicines the patient takes regularly.
How do you decide what can be seen in the electronic file if you have privacy concerns?
As mentioned above, patients should be able to decide for themselves which document is visible and to whom.
This can be adjusted via the confidentiality levels that patients can mark in the app. For example, a document in the e-file is marked as visible to everyone who has access to it by inserting the chip card, or is visible only to certain doctors. Documents can also be marked as locked so only the patient can see them.
“You can view, insert, delete or hide content at any time, grant or limit access rights and raise objections,” says the German Consumer Advice Center.
What if I don’t want an electronic file?
If you don’t want the electronic file you must actively object to your health insurance company, in this case it won’t even be prepared. However, it should also be possible to delete a file once configured if you change your mind.
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