The electronic patient record (ePA) will be introduced for all legally insured people from 2025 – unless they object to it. Consumer advocate Sabine explains what the ePA is supposed to achieve, how to use it and how secure the sensitive health data is.
Findings, surgical reports, doctor’s letters – people with a longer medical history in particular often carry a large number of documents from practice to practice. In the future, the electronic patient record (ePA) will free both patients and doctors’ practices from this paper chaos.
From the beginning of 2025, statutory health insurance companies will automatically set up an ePA for all insured persons – unless they object to the creation. Here we answer the most important questions:
1. What exactly is the electronic patient record?
The electronic patient file is a virtual file folder in which we patients’ health data will be stored in the future,” explains Sabine Wolter from the North Rhine-Westphalia Consumer Center. For example, doctor’s letters, laboratory results and hospital discharge reports can be stored centrally. In the future, the dental bonus booklet or the vaccination certificate will also be stored there digitally.
When you first look at the ePA you will notice that it is initially empty. Starting in early 2025, doctors will be required to enter current treatment documents in the file, but they will not upload older findings or documents subsequently.
However, insured people can add these documents themselves or ask their health insurance company for support: From 2025, they can apply for the digitization of up to ten older medical documents twice within 24 months. The health insurance company takes on this task, as the consumer advice center explains.
“Over the years, the ePA fills up – at a certain point, as a patient, you have an overview of all your health data,” says Wolter. However, the use of the ePA remains voluntary – even in the long term.
2. When does the electronic patient record start?
In 2025, statutory health insurance companies will automatically set up an ePA for all insured persons who have not objected. “This happens automatically,” explains Sabine Wolter. A first important date is January 15, 2025: At this point, the ePA will initially be introduced in selected model regions for those with statutory health insurance – including Hamburg, Franconia and parts of North Rhine-Westphalia.
If everything goes according to plan, all other legally insured people should receive their ePA a month later. However, the exact timing may vary depending on the health insurance company.
“Then the doctors are also obliged to fill out the ePA,” Wolter continued. “But there can also be delays because the practices first have to upgrade their management software.”
3. What advantages should I have as a patient?
Better overview of the medical history: When did the laparoscopy take place? How long have I been using these eye drops? Questions like this can quickly cause uncertainty when talking to a doctor. “Many people have difficulty describing their entire medical history or don’t know the technical terms,” explains Sabine Wolter. The ePA is intended to make changing doctors easier because the new practice can directly access the stored data.
Access to documents: Having all medical records in one place can be a huge relief. According to Wolter, people repeatedly contact the consumer advice center to report problems because practices refuse to hand over their documents.
Better treatment in an emergency: What previous illnesses are present? Which studies have already been carried out? The ePA can provide answers to such questions. This pays off, especially in an emergency, emphasizes the consumer advocate. Anyone who carries the electronic health card with them will have access to the ePA in the emergency room at the latest – and thus to important information for treatment.
4. How do I get access to my ePA?
By reading the electronic health card, the doctor’s office, the physiotherapist or the medical supply store has access to the data that is in the electronic patient file and that is visible to them.
But how do you get your ePA yourself? “If you want to use the full options, you need the ePA app from your health insurance company,” says Sabine Wolter. You can find out exactly what it is called from a list from Gematik, the national agency for digital medicine.
Alternatively, the possibility should also be created to access the ePA via a browser application on the PC.
What is needed for access:
- Electronic health card with NFC function: “You can recognize it because there is a small radio wave symbol on the card,” says Wolter.
- PIN: Insured persons must request this from their health insurance company – you can do this in advance. “You don’t just get it sent to you by post, you have to authenticate yourself,” says Wolter. The Postident procedure is common, in which you authenticate yourself at the local post office with your ID card.
- End device: The mobile operating systems Android 10 or iOS 16 should be at least on the smartphone. “With a PC you need a card reader with security level two,” says Wolter.
This process does not seem easy to everyone: “Activating the app requires tolerance for frustration,” writes the magazine “Finanztest” (issue 1/2025). Anyone who needs support can get it from their health insurance company: With the rollout of the ePA, the health insurance companies are obliged to set up ombudsman offices to provide support with the setup.
Once the app is up and running, you can view the documents in the ePA. To log in to the app, you then have to hold the electronic health card up to your smartphone or PC card reader.
6. What actually applies to children?
Children also receive an ePA – provided their parents do not object. “A baby born in March will have an ePA set up when his statutory family insurance begins. This is then managed by the parents,” explains Sabine Wolter. Management by parents applies until the child is 16 years old. The child can then decide independently about how to use their ePA.
7. How do I object?
The use of the ePA remains voluntary. Anyone who does not want an ePA to be set up for him or her should object in good time. The exact process will be explained by the respective health insurance company.
Even if the ePA has already been created, it can be deleted if desired. If you regret your decision later, that’s no problem either: “You can also ask the health insurance company to create a new ePA later,” says Sabine Wolter.
8. Is my data safe?
“The level of protection is already very high,” emphasizes Sabine Wolter. “After all, the data is not sent by email, but rather via the special telematics infrastructure, a closed data system in the healthcare system.”
Only doctors and patients have access to the contents of the ePA – and only after appropriate identification. However, as with all digital applications, “everything on the internet is never 100% secure,” warns Wolter.
By the way: According to Gematik, the health insurance companies themselves do not have access to the ePA. Only patients and authorized healthcare professionals can view the stored data.
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