Electronic patient file: Doctors don't want to be left alone with it
From January 2025, electronic patient records are to be automatically available to everyone. However, doctors fear a bumpy start in the middle of the flu season
(Image: Tero Vesalainen/Shutterstock.com)
Since 2021, anyone can register for an electronic patient record. As around 1.3 million people have done this so far, it is set to come automatically in February 2025 for everyone who does not object. Initially, the "ePA for all" will be available with just a few functions. Anyone who already has an ePA can simply continue to use it. Doctors generally welcome the plan: according to the GP association, a "well-implemented ePA" could "noticeably improve" care.
The coronavirus crisis has shown "how much Germany has to catch up in terms of digitalization and how important digital data exchange is in healthcare," Dr Gerald Gaß, Chairman of the German Hospital Federation (DKG), also told heise online. Telemedicine specialists recently expressed their desire for a functioning platform for the exchange of information. Currently, many hospitals and medical practices use different systems that are not interoperable or lack the necessary functions.
Doctors fear that the nationwide launch of electronic patient records will involve additional work and initial disruptions, as was the case with e-prescriptions. According to Gaß, "previous attempts have shown how cumbersome and often dysfunctional digitalization is in Germany. E-prescriptions or digital reporting procedures in hospitals have often initially led to more rather than less work for employees." There are also security concerns regarding the ePA; for hospitals in particular, the ePA has so far been associated with more risks than benefits.
Concerns about chaos with electronic patient files
As findings cannot be storedin the ePA as structured data but as PDF documents, the GP association fears a chaotic start. A search function demanded by doctors is also not available, meaning that each PDF has to be opened individually. This is particularly problematic for patients with a large number of findings. The Ärztezeitung quotes Dr. Leonor Heinz, Head of the Coordination Office of the Initiative of German Research Practice Networks, as saying that practice teams cannot be expected to open individual PDFs in day-to-day care. In her opinion, the ePA should not be a "digital scroll".
"To date, the ePA is de facto hardly usable. Colleagues and insured persons have to contend with almost endless loading times and a chaotic structure of the ePA, among other things," explains Prof. Nicola Buhlinger-Göpfarth, Federal Chairwoman of the General Practitioners' Association, first to the Funke Mediengruppe. There had been three years "to eradicate teething troubles".
Do not leave doctors alone with a defective ePA
Buhlinger-Göpfarth is certain that the implementation of the ePA has been sobering and that a four-week test phase will not turn the tide. In her opinion, the responsibility for this lies not only with the Federal Ministry of Health, but also with the manufacturers and the future digital agency of the Ministry of Health, Gematik. "What must not happen under any circumstances is that practices are left alone with a non-functioning ePA for everyone in the middle of the infection season," says Buhlinger-Göpfarth. She called it "more than risky" to allow the ePA for 70 million people with statutory health insurance.
With e-prescriptions, there are occasional disruptions to individual services, and sometimes central services of the telematics infrastructure are also disrupted. In addition, the status of practice and hospital administration systems varies greatly, as can also be seen from Gematik's TI score. Some do not appear to have implemented a connection to the ePA, while others do not. Doctors should therefore consider changing their practice management system if they want a functioning e PA.
According to Sebastien Zilch, sub-department head for Gematik, e-health and telematics infrastructure at the BMG, the BMG has "put instruments in place to tighten the thumbscrews". This is reported in the Ärztezeitung. Only recently, the National Association of Statutory Health Insurance Physicians published framework agreements on behalf of the BMG that manufacturers can conclude with the KBV. However, this is only the beginning.
(mack)
