Minister of Health: "Electronic patient record remains a central element"

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Digitalization is “indispensable” and, if used wisely, “a gain in every respect,” said Federal Minister of Health Nina Warken (CDU) on the occasion of the presentation of the updated digitalization strategy for healthcare and nursing on Wednesday in Berlin. A draft law is expected to be presented this quarter – unlike originally planned, in a bundled procedure instead of two separate laws.

Digitalization can “lead to more quality, to more efficiency in care,” relieve staff, and help with documentation, appointment scheduling, or overcoming language barriers, said Warken. Health insurance companies will also be able to add additional content to the electronic patient record in the future, “perhaps for vaccination certificates.”

“Make ePA attractive for everyone”

“We must make even greater use of digital possibilities. The central instrument remains the electronic patient record,” emphasized the Minister of Health. So far, the ePA has been particularly useful “for patients with a medical history, with, for example, many findings and doctor's visits.” However, the ePA should become attractive for all insured individuals. This can only be achieved “if we really integrate further applications that offer concrete added value,” such as appointment scheduling. “The ePA is then truly the central hub,” said Warken.

In the future, digital initial assessment, referrals, and appointment scheduling will converge there – a law to this effect is in progress. The system is to be set up in a “three-pronged approach”: access will be via the family doctor's practice, via 116 117, or via digital applications. However, it is crucial that a uniform initial assessment procedure is carried out in all cases, which is stored in the ePA.

Digital appointment scheduling will access a uniform appointment database. This is being developed jointly with health insurance companies, self-governing bodies, and Gematik. Practices, 116 117, and digital applications will be able to access it – technically according to the same standards.

A further focus is the use of artificial intelligence. AI should “be used where it increases the quality of treatment, relieves the burden of documentation, or supports communication,” said the minister. AI real-world laboratories are planned, where applications will be tested while ensuring data protection. Service providers are to receive more legal certainty in their use.

More oversight rights for Gematik

The technical basis – the telematics infrastructure (TI) and its components – is also to become more stable. System failures, for example with e-prescriptions, have shown that the TI is too complex, Warken admitted. “We want to achieve more stability through fewer components and thus less complexity.” Gematik is to receive “more oversight rights” for this and be able to make clearer specifications. The minister did not reveal details yet.

As ambitious as the plans are, financing remains a major hurdle. Digitalization requires not only investments in technology but also ongoing funds for operation, maintenance, IT security, and training. Although the ministry points out that investments will also bring relief in the long term, without a structurally secured operating cost model, implementation, especially in hospitals and practices, threatens to stall.

Complex processes and established structures

Different IT systems, many involved actors, and complex responsibilities make uniform implementation difficult. “Data is still too rarely captured in a structured and standardized way,” said Warken. The goal is therefore to use data more systematically and to make it compatible with the European Health Data Space. In this context, she also announced a German implementation for a patient summary record for 2027. This will make information available more quickly, for example, for emergency services.

The ministry sees the strategy as a “roadmap for the coming weeks, months, and years.” A draft law for a “Law on Digital Care and the Health Data Space” is to be presented still in the first quarter of 2026. According to Warken, digitalization is to become “no longer just a supplementary element, but an essential pillar of care.”

Uncertainties regarding financing

A central obstacle to digital transformation remains sustainable financing. Although funding programs have provided important impetus, according to those involved, long-term funds for operation, maintenance, IT security, and personnel are often lacking, as the German Hospital Association announced upon request. The National Association of Statutory Health Insurance Physicians also regularly calls for – analogous to the Hospital Future Act – a Practice Future Act for a better financial basis. Without a sustainable operating cost model, digitalization threatens to fail in the everyday reality of facilities – investments alone are therefore not sufficient if ongoing costs are not permanently secured.

(mack)