Electronic patient record: Doctors consider nationwide rollout too early
The launch of the electronic patient record 3.0 in the test regions is going worse than expected. Doctors are therefore against a nationwide launch from April.
(Image: Shutterstock.com/raker)
The launch of the electronic patient record, ePA (elektronische Patientenakte) 3.0, in around 230 practices in Hamburg, Franconia and parts of North Rhine-Westphalia has met with mixed reactions. Although an ePA has now been created for all those with statutory health insurance who have not objected, it is unclear when it will be actively used.
For 71.8 percent of participating doctors, the ePA is performing worse than expected. This is the result of a survey conducted by Stiftung Gesundheit, in which 41 doctors in test practices in Franconia, Hamburg and North Rhine-Westphalia took part. According to the survey, 15.4 percent were "positively surprised".
According to the survey, doctors are particularly concerned about the software: 61% of respondents see room for improvement here before the nationwide rollout. Among other things, they criticized faulty or non-existent functions as well as the amount of time required to provide the software.
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More than half of doctors (53.7 percent) also criticize the inadequate provision of information for patients, for example from health insurers. Many patients are poorly informed and expect the practice to take care of everything.
Data security and set-up time
More than 50 percent are also concerned about the data security of the ePA. Doctors are particularly concerned about security in the event of cyber attacks and protecting the data of adolescents – including from their own parents – undergoing psychotherapeutic treatment. Setting up the software and training staff also takes time. For more than half of the doctors surveyed, this process took up to three days, in some cases even a month or longer. The average time until the practice was ready for the ePA was 8.8 days.
First IT security, then rollout
When announcing the ePA, the Federal Ministry of Health (BMG) stated that the electronic patient file would only be rolled out nationwide and filled in by doctors and pharmacists once there had been positive experiences in the test regions. In addition, the security gaps that were presented at the 38th Chaos Communication Congress should also be closed before a further rollout. However, the BMG recently brought April back into play as the start date for the nationwide rollout. According to the Ă„rzteblatt, work on the security of the ePA is almost complete.
BMG does not want to wait for "perfection"
According to the Ärzteblatt, Sebastian Zilch, sub-department head for digital care and Gematik at the BMG, also said at a meeting of the "Spitzenverband Fachärztinnen und Fachärzte Deutschlands" (Spifa) that it was not possible to wait for "perfection" and that the BMG hoped for an early start. There are also no uncertainties when it comes to data protection. Such statements and announcements have been causing uproar and contradiction among statutory health insurance physicians for weeks. Sybille Steiner, Chairwoman of the National Association of Statutory Health Insurance Physicians, called the current tests a "warm-up" phase. The Federal Association of German Pharmacists (ABDA) also recently called for security gaps to be closed and outstanding technical problems to be solved before a nationwide rollout.
Around five hospitals use ePA
The German Hospital Association (DKG) also considers the nationwide rollout in April to be impossible. According to the DKG, only a few hospitals – two to five – have been able to test the ePA. "The technical preparations for connecting the ePA to the hospital information systems are more complex than the BMG and Gematik expected. Hospitals are confronted with different challenges here than, for example, doctors' practices – such as a more complex server infrastructure and interface configuration," a DKG spokesperson told heise online.
Bavarian Association of Statutory Health Insurance Physicians calls for "real load tests"
"Real load tests during ongoing patient operations with significantly more than the 300 practices integrated to date are not yet possible due to the often inadequate hardware and software architecture," according to the Association of Statutory Health Insurance Physicians in Bavaria. The information policy of the health insurance companies shows "massive deficits","especially with regard to the individual possibilities for objection and restriction of the ePA". The KVB is therefore appealing to the BMG to postpone the nationwide rollout of the ePA.
Further rollout plan not yet determined
The test phase of the electronic patient file is currently still being evaluated, as the BMG informed heise online on request. "The feedback from users has been positive [...]. Facilities have already been able to upload and download documents and use the electronic medication list (eML)," Gematik said in response to a query. "For example, one facility participating in the pilot has already been able to avoid interactions with the eML". It also refers to experience reports in the form of videos that have been uploaded to the Gematik website.
When asked about the current number of ePAs created, as the Gematik dashboard no longer shows the current figures, Gematik spoke of "more than 70 million". However, the number fluctuates slightly due to "births, deaths and appeals to the health insurance companies".
(mack)
