Karl's new electronic health record: The Health Minister's story time

Shortly before the launch of the "electronic patient record for all" (elektronische Patientenakte für alle, ePA 3.9), Federal Health Minister Karl Lauterbach tried to demonstrate the advantages of an electronic patient file to a patient in front of members of the press. Did he really succeed? Not likely. During the demonstration, the doctor was filmed reading the data measured with an analog blood pressure cuff and entering it into a practice management system. However, there is no sign of the new electronic patient file and it will also be difficult to find in the test regions at the moment.

An opinion by Marie-Claire Koch

Marie-Claire Koch has been working as an editor at heise online since 2021 and now writes primarily about digital health.

According to Lauterbach, the new patient file is intended to empower the insured. At the same time, he is disempowering the insured by automatically imposing the ePA on them without any objection. A responsible patient could have opted for an electronic health record themselves, but this decision was taken away from them. Instead, the Federal Ministry of Health emphasizes that it is possible to use the ePA without an app, so it is best to ask your doctor or pharmacist. To actually be able to "actively" use the ePA themselves, insured persons must register and download the app from their health insurance provider. If the app is up and running one day, it will most likely not be able to do any more than the previous app.

There have been warnings for a long time

Lauterbach wants to be celebrated for the ePA, even more so than for the e-prescription and the electronic certificate of incapacity for work. True to the motto "whatever the cost" or "after me, the deluge" – but it doesn't matter. After all, healthcare digitization has not yet swallowed up billions and policyholders are not currently receiving any information letters from their health insurance companies about the highest premium increases to date – Irony off. The industry was quick enough to point out that the implementation time is too short and that the ePA will not be a finished product when it is launched.

How long will he be able to celebrate before the masquerade is blown, and the fairy tales are told? Unclear. Like so many things. In particular, the benefits of the ePA – at least in the first year – and also the benefits of ePA data for research."The data will never be analyzed by companies, but by scientists," Lauterbach promises. Another one of many promises that the minister cannot keep. And as a privately insured person, he doesn't care because so far, the transfer of data for research purposes is only planned for people with statutory health insurance.

Trust put at risk

He repeatedly emphasizes how important trust is for the plans surrounding the ePA. But there are dangers lurking in several places. The health insurance companies are still boasting that the objection rate has so far been below expectations, while at the same time many insured persons do not feel sufficiently informed and probably won't be anymore. Once trust has been lost, it is difficult to regain it. Everyone agrees on that. Nevertheless, trust is being put at risk, despite all the warnings from security experts and data protectionists. Instead of involving them more, they were disenfranchised. Action is only taken after the security gaps have been demonstrated.

In order not to jeopardize his goals, the minister appeases. Lauterbach's premature promise of absolute security was naive and was quickly withdrawn. Meanwhile, Lauterbach has also realized that there is no such thing as 100% safety. The Federal Ministry of Health should be doing everything it can to protect our most sensitive data in the best possible way, instead of making untenable promises. Instead, we can look forward to what lies ahead.

(mack)