Electronic patient file also to be introduced for the German Armed Forces

Soldiers in the German Armed Forces will soon also receive an electronic patient file (ePABw), or an equivalent to the electronic patient file. The ePABw is aimed at soldiers, who will in future be able to decide for themselves which data is stored there. According to a spokesperson for the Bundeswehr support area, the soldier will retain data sovereignty.

There are also no plans for the data to be forwarded to the Health Research Data Center. “There are no plans to pass on the health data of military personnel to external recipients,” it says. A tender for procurement is to be issued this year. The ePABw is also to be approved by Gematik, as reported in Ärzteblatt 2021.

The challenge of the health insurance number

According to the spokesperson, identification for the ePABw via the health insurance number (KVNR) is currently still a challenge. “However, since the Bundeswehr has not yet appeared as a classic health insurer, some internal Bundeswehr process adjustments are required. Soldiers receive so-called free military medical care, which is usually provided by the facilities of the Bundeswehr Central Medical Service,” said the spokesperson. This free military medical care is known as Heilfürsorge and is a special form of health care for soldiers that differs from statutory health insurance. This is why a KVNR has not been necessary up to now, but it will be available for soldiers in the future.

There is also an electronic Bundeswehr health record (eGABw), which is to be used purely internally in future “to ensure optimal medical care at all times and at every Bundeswehr location”. There is another difference in terms of data sovereignty: “The data sovereignty of all health data collected by military and civilian healthcare providers on members of the German Armed Forces lies with the employer via the eGABw,” explains the spokesperson.

The 2022 Annual Report of the Parliamentary Commissioner for the Armed Forces, published in August 2023, revealed that the introduction of a digital health record is still at the project stage and is associated with considerable difficulties. Soldiers criticized, among other things, that the health record led to significant additional work, which the Ministry of Defence confirmed at the time. Things are better in Israel, where health data is analyzed using data mining “to identify health patterns, trends, and developments at an early stage and react accordingly”. Reminders would also be sent for check-ups and appointments could be arranged via app.

No data extraction for privately insured people either

The health insurance number is also a hurdle for privately insured people. It is not only required to create and use the services of the telematics infrastructure, such as the electronic patient file, but is also a prerequisite for entering data in the implant register. However, the active participation of insured people is required for the creation of the KVNR. This is why the Association of Private Health Insurers has been calling for years for a legal regulation to generate a KVNR for the insured person automatically and without the need for consent.

There are also no plans for private health insurers to transfer data to the Health Research Data Center. For those with statutory health insurance, the deadline was actually set for July 1, but was postponed again, as technical improvements still need to be made to the ePA and the Health Research Data Center.

(mack)