E-patient record: Health insurance doctors request more time for testing phase

Before a nationwide rollout of the electronic patient recorde (elektronische Patientenakte, ePA 3.0), doctors are calling for more time for functional and load tests. Although an electronic patient file has now been created for all those with statutory health insurance unless they have objected, it is not yet certain that the ePA will work in doctors' everyday work. The pilot phase was supposed to start on January 15, but delays have prevented it from starting properly. This is why the Associations of Statutory Health Insurance Physicians in Bavaria, Hamburg, North Rhine and Westphalia-Lippe are calling on the Federal Ministry of Health to "extend the timetable for the rollout of the ePA", according to a joint press release.

Test phase not running in practice

According to the press release, there are reports from around 300 test practices in Franconia, Hamburg and parts of North Rhine-Westphalia that there is currently a "lack of technical requirements or complications" that "prevent effective testing of the ePA". The letter from the Associations of Statutory Health Insurance Physicians (Kassenärztliche Vereinigungen, KV) comes in response to a letter from the Federal Ministry of Health to the shareholders of Gematik, according to which a new start date for the nationwide rollout is possible from April.

The KVs are therefore appealing to the Federal Minister of Health, Karl Lauterbach, to provide sufficient capacity for the tests. Although the KVs see potential in a "data-secure and data protection-compliant electronic patient file", the "basic prerequisite [...] is a mature, error-free and highly secure file" that doctors and psychotherapists can use easily. "A hasty roll-out of the ePA will lead to frustration in practices and, due to unfulfilled expectations, to annoyance among the insured. In the worst-case scenario, practices and patients will unanimously reject the ePA," said the KV Bayern board members.

For Caroline Roos, deputy chairwoman of the KV Hamburg, it is incomprehensible that a rollout from April is even being considered. Errors and security deficits must first be rectified. "It is absolutely necessary to extend the test phase and expand the testing to other participants and test scenarios [...]. Software manufacturers, medical practices and all other institutions involved should be given the necessary preparation time for this," demands Roos.

Test criteria unclear

It is still unclear what criteria will be used for the nationwide rollout. Dr. Frank Bergmann, Chairman of the KV Nordrhein, also misses these: "We are missing a catalog of acceptance criteria agreed with the panel doctors' association, which the systems must meet and prove as part of the tests. The last five weeks have been sobering and have unfortunately focused exclusively on purely technical feasibility." There have been no real test results for the use of the ePA in practice. Last week, the National Association of Statutory Health Insurance Physicians (KBV), among others, expressed relief that the BMG's planned launch dates had at least been pushed back slightly. Nevertheless, the KBV also pointed out that the ePA should only be launched after a successful test phase for doctors throughout Germany.

"At the start of the pilot phase, only a few of the participating practices in Westphalia-Lippe were able to fill in the electronic patient file. The reasons for this were complex. For example, there were challenges in accessing the corresponding file systems," says Dr. Volker Schrage, Deputy Chairman of the KVWL Executive Board. Currently, the electronic medication list is also not working properly in all cases. "In some cases, the data is not transferred at all or only incompletely. The increased need for consultation in the doctor-patient relationship should also not be underestimated," warns Schrage. So far, a third of the pilot practices in Westphalia-Lippe have not been able to test the ePA because the necessary ePA module is missing. As soon as the ePA plans became known, representatives of health IT had already commented that the BMG's plans were very ambitious.

(mack)