Electronic patient record: What to expect from the nationwide launch

After an initial test phase in around 300 practices in Hamburg, Franconia and North Rhine-Westphalia, the electronic patient file (ePA) is set to go live on the 29th, as Health Minister Karl Lauterbach believes it is safe, despite expert opinions to the contrary. At least the major software providers are ready for the launch, as the Ärztenachrichtendienst (Aend) has found out. However, it may still take some time before all practices and pharmacies are equipped with the ePA modules, corresponding updates are installed and doctors and practice staff have familiarized themselves with the new processes. The parties involved had pointed this out.

The health insurance funds have created the ePA files for all insured persons who have not objected. "After successful testing, the ePA for all will be available for use by practices, hospitals and pharmacies nationwide from April 29, 2025," according to the Federal Ministry of Health. Anyone who wants to test their ePA app, or the front end for insured persons, will need a health ID, which can be created using an ID card or electronic health card. In addition to the ePA app, some providers also require an app for the health ID. Insured persons can also use the app to object to the regular posting of billing data by the health insurance companies, for example.

Occasionally there are disruptions, which can be due to various factors, such as a malfunction in the HealthIDs. In some cases, information is provided in the Gematik WhatsApp channel or in the TI disruption portal. It is possible that problems will become more visible with the further rollout of the ePA, as was the case with the e-prescription, for example. Especially at the beginning of the further rollout, it is likely that only a few insured persons will encounter doctors who can upload documents to the ePA or process them. It will also take some time before pharmacies are able to access the ePA and data from the electronic medication list.

According to the German Association for Health IT (bvitg), there are "isolated technical problems, which are mostly due to the network architecture and system configuration of the facilities". Although the use of the ePA will be mandatory for doctors from October 1, sanctions are currently planned for early 2026. "The gradual and initially voluntary introduction is the right way to enable practices that are ePA-ready to get started," says Dr. Sibylle Steiner, board member of the National Association of Statutory Health Insurance Physicians.

"Many of the test practices have only been able to work with the ePA, i.e. view and fill it in, since March. Experience with its performance and usability in everyday practice is therefore too limited. However, we need this information in order to be able to reliably assess whether the ePA can be used in healthcare, especially as the test practices keep reporting technical problems," said Dr. Karl-Georg Pochhammer, Deputy Chairman of the Board of the National Association of Statutory Health Insurance Dentists at the beginning of April.

Major manufacturers ready

The practice management systems "Turbomed", "Medistar", "Albis", "M1 Pro" and "Data Vital" from Compugroup Medical (CGM) were ready for use on the launch date, reported the Aend. In most cases, a software update has already been rolled out. The ePA module for Duria, which has already been rolled out but deactivated, will also be reactivated in good time with an update. According to information from Aend, the ePA module is also permanently integrated in other practice management systems, such as T2Med or Tomedo. Gematik's TI score currently no longer shows the status of the ePA modules.

According to Managing Director Jens Naumann, the tests on Medatixx products were "stable and beneficial". He recommends actively testing the ePA now. There is currently no more information on ePA in Gematik's TI score (as of April 25, 2025, 11:49 a.m.). However, it is unclear whether all practice management systems currently available on the market – especially the less common systems – will have the ePA modules in the future. More than a year ago, Health Minister Karl Lauterbach said that doctors would have to change their PVS for a functioning ePA.

Nationwide launch premature

"The nationwide launch of the ePA is premature because the technical security gaps have not been credibly and verifiably eliminated. For patients, a launch without mandatory participation for medical facilities is initially intransparent: they cannot know whether the respective practice can already access the ePA," explains Manuel Hofmann from Deutsche Aidshilfe. However, with the electronic medication lists and billing data automatically loaded into the ePA, "sensitive diagnoses are potentially already visible", says Hofmann. Among other things, Aidshilfe provides information about this on its website.

"In general, we at Deutsche Aidshilfe will continue to monitor the introduction process closely," says Hofmann. Pediatricians had also warned in advance that information in the ePA could potentially endanger the welfare of children. A new guideline was therefore recently published to ensure better protection. The Lower Saxony Medical Association had also recently spoken out against the opt-out solution for children.

(mack)