Doctors criticize the too uncritical debate on e-patient files
The medical association MEDI considers the information provided to date on electronic patient files to be too uncritical.
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The electronic patient record (EPR) 3.0, which will be automatic for everyone from 2025, divides opinion. Some see this as disenfranchisement, as they will not be able to actively opt for the EPR themselves. Others criticize the limited options, while still others see an improvement in care. As with the increased use of e-prescriptions, doctors are wondering to what extent the processes in the practice will be affected. The MEDI doctors' association in Baden-WĂĽrttemberg therefore also wants to explain the risks of electronic patient records.
"We see little critical debate in the public discussions on the ePA," explains MEDI deputy chairman and GP Dr. Michael Eckstein. Together, he and orthopaedist Bernhard Schuknecht have developed a campaign to raise awareness of the EPR, which aims to make transparent "what risks the EPR entails at the present time", says Eckstein.
Open letters
In addition, the MEDI Association has written an open letter on data security in the ePA to the Commissioner for Data Protection and Information Security, Prof. Dr. Louisa Specht-Riemenschneider, and one to the Chairwoman of the National Association of Statutory Health Insurance Physicians, Dr. Sybille Steiner. They ask, for example, what will happen after the test phase if it is not successful.
The doctors emphasize that they do not want to reject or block digitalization, but rather support it. "However, we are convinced that the electronic patient file is not yet ready for the market. We see dangers in this," warns Dr. Norbert Smetak, Chairman of MEDI Baden-WĂĽrttemberg e. V.
Only recently, the General Practitioners' Association also expressed concerns, as the "nationwide rollout" coincides with the infection season, and demanded a number of prerequisites from politicians for ePA 3.0 to ensure a successful launch. Among other things, the practice management systems are not yet ready for the electronic patient file.
The MEDI also criticizes insufficient data protection. The former Federal Commissioner for Data Protection and Information Security, Prof. Ulrich Kelber, has already stated that the removal of security measures was a mistake. In his opinion, user-friendliness and IT security are possible "with a little more willpower".
Further concerns relate to plans for a European Health Data Space (EHDS). The original plan for the EHDS was that some of the data could be passed on without the possibility of objection – this has since changed. The Federal Ministry of Health plans to implement 300 research applications by 2026.
According to the Gematik specification, a "Data Submission Service" in the file system generates "unique work numbers and delivery pseudonyms in order to be able to clearly assign the pseudonymized medical data in the transmission to the Research Data Center (FDZ)" – as is also the case with various registers on the basis of the health insurance number. Insured persons can therefore also object to the data transfer in the ePA or at the ombudsman's offices of the health insurance funds – this is done via the "Consent Decision Management in the file system".
According to the Federal Ministry of Health, the FDZ does not know which data record comes from which patient when data is transferred. After Health Minister Karl Lauterbach spoke of "crawlers" at the Research Data Center for Health, there was a lot of criticism. His plan is to make Germany more attractive again as a location for pharmaceutical companies. In addition to less bureaucratic research applications, the aim is to attract data from citizens.
(mack)