Users continue to struggle with the electronic patient record

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Almost all statutory health insurance members have had an electronic patient record (elektronische Patientenakte, ePA) created by their health insurance fund since January 2025 – a total of around 70 million out of approximately 75 million insured individuals. Since October 2025, practices and hospitals have been obliged to upload data such as findings or laboratory values. Most of those dealing with the ePA are still dissatisfied or even frustrated.

Doctors are obliged to fill the patient record, but many are not convinced yet. According to dpa, the chairman of the German Association of General Practitioners, Markus Beier, describes the current ePA as "limited in practical usability." Currently, it is primarily "an unsorted PDF collection that practices can hardly use in everyday life." Doctors in hospitals report similar issues.

A full-text search, long demanded by doctors, which is supposed to be implemented this year, is still missing for searching within the ePA. Furthermore, the telematics infrastructure, the "health data highway," is repeatedly subject to disruptions and outages. Most practices already have the necessary technical prerequisites, but it often fails in the exchange of documents, for example with hospitals or care facilities.

ePA "The be-all and end-all"

Federal Minister of Health Nina Warken wants to significantly advance the ePA and recently presented an updated digital strategy. Like her predecessor Karl Lauterbach, Warken is also focusing on AI functions. According to Gematik figures, 4.7 million insured individuals have so far set up a Health ID, which is required to access services such as the ePA, the TI messenger, or the e-prescription.

Future applications are also intended to offer added value for people without a long medical history, such as the digital vaccination overview or greater integration of health insurance fund content. When presenting the updated digitalization strategy last week, Warken emphasized that the electronic patient record is intended to be the central instrument of a digital healthcare system. Digital initial assessment, referrals, and appointment scheduling will then be interconnected. Access to care will be via general practitioner practices, the telephone number 116 117, or digital applications. The basis will be a standardized initial assessment procedure stored in the ePA.

TI to become more stable

In addition, the telematics infrastructure (TI) is to become more stable. The minister announced a reduction in complexity and more override rights for Gematik to prevent system failures like those with the e-prescription in the future. Consumer advocates warn that insured people without an ePA should not face disadvantages when appointments are made.

Financing also remains a central problem. Digitization not only incurs investment costs but also ongoing expenses for maintenance, IT security, training, and operation. Representatives of hospitals and the KBV are calling for long-term secured financing models. Without permanently secured operating expenses, implementation in everyday practice threatens to stagnate.

Criticism from consumer advocates

Ramona Pop, board member of the Federation of German Consumer Organisations (vzbv), criticizes that the ePA has "not yet arrived in everyday life." Key functions such as digital vaccination or bonus booklets are still missing. The launch so far falls short of expectations. A third sees no personal benefit. The majority also wishes for better authorization management. With the old ePA 2.6 – before version 3.0 – insured individuals could precisely determine who could see which data. This option was abolished with the "ePA for everyone."

(mack)