What happens next with the electronic patient file

Contents

By the end of the week, the health insurance companies should have created an electronic patient record (EPR) for all those with statutory health insurance who have not objected. According to Gematik's TI dashboard, the number of ePAs created on February 8 was 70,499,929; one day later it was 70,489,531. For the tenth of February, the number of ePAs created was 70,486,940. Gematik, which is responsible for the digitization of the healthcare system, explains why around 12,000 files have suddenly disappeared.

The number of objections is growing

According to a Gematik spokesperson, there may still be “minor data adjustments on the part of the file system manufacturers”. There are adjustments due to objections, for example. At Techniker Krankenkasse, for example, the objection rate is 7 percent, at all AOK health insurance companies together the objection rate is 3.8 percent, at Barmer it is 5.3 percent. The Federal Ministry of Health had expected an objection rate of 20 percent.

File situation well advanced

“Overall, the creation of files is well advanced, so that the total number of files should no longer increase significantly,” said the Gematik spokesperson. As almost all files have now been created, Health Minister Karl Lauterbach told the Tagesspiegel that digitization in the healthcare sector is making “giant strides”, while various media headlines claim that the launch of the ePA has been postponed.

The fact that the electronic patient file will not be rolled out nationwide for the time being has been clear at least since the presentation of security vulnerabilities at the 38th Chaos Communication Congress. However, experts had already criticized the immaturity of the necessary software in advance. Shortly before the launch of the ePA announced by Lauterbach, the Federal Association of Health IT had also pointed out various problems with the completion of the software. The ePA version 3.1 is not due to be released in mid-July, but rather the interim version 3.0.5, according to the Deutsche Apotheker Zeitung.

Vaccination documentation and more

There are various hopes associated with the ePA. For example, the Federal Government's Expert Council is calling for “population-wide recording of vaccinations using the electronic patient file, which should result in a uniform central data structure throughout Germany”. This can be seen in the latest statement “Health and resilience” (PDF). In other countries, such as Austria, the “electronic vaccination record (also e-vaccination record) […] is to replace the classic paper vaccination record in the next few years”, and there is no option to object to this. The data is already entered in a central vaccination register there, which was introduced after the coronavirus crisis.

In this country, the ePA is starting with the electronic medication list, which will be followed by the electronic medication plan – which will be curated by doctors, for example –. Theoretically, the vaccination record is already stored in the electronic patient file, but doctors are not usually able to make any entries there yet.

Data in high demand

While the ePA is still bobbing along currently, interested parties are already coming forward for the data treasures of the future. In a recent election campaign speech, CDU politician Friedrich Merz spoke of reduced health insurance premiums for all those who make the data on their “electronic health card” available, by which he probably meant the data in the electronic patient file. The police are also interested in the health data, and there is as yet no ban on the confiscation of ePA data, as demanded by data protectionists.

According to lawyer and data protection expert Jan Kuhlmann, who has worked as an IT developer for a health insurance company and is co-chairman of “Patientenrechte und Datenschutz e.V.”, the data in the electronic patient file is not secure. “In the future, the medical data of all 72 million people with statutory health insurance will not be stored 'on the card', but will be stored centrally in plain text in the cloud on servers operated by IBM and Bitmarck/Rise,” explains Kuhlmann. “Decentralized data storage, as recommended by former Federal Data Protection Commissioner Prof. Kelber, would be much more secure,” Kuhlmann continues.

(mack)