"ePA for everyone": Chairman of the GP association warns of chaos at the start
Statutorily insured patients are to receive the electronic patient file automatically. However, there is a risk of a chaotic start, doctors are concerned.
Dr. Marcus Beier, Co-Chairman of the General Practitioners' Association, calls for a functioning electronic patient file.
(Image: HÄV / Marco Urban)
The electronic patient record (elektronische Patientenakte, ePA) is set to become the centrepiece of the digitalization of the healthcare system. However, the GP association warns against a chaotic launch of the ePA in the middle of the infection season. The association passed a resolution stating, among other things: "A successful launch of the ePA in 2025 is only possible if the technical, content-related and organizational requirements are created in good time".
The motion "Ensuring a successful launch of the electronic patient file (ePA) in 2025" was submitted by Kristina Spöhrer from the digitalization committee of the Association of Statutory Health Insurance Physicians in Lower Saxony. The ePA is to be officially launched automatically throughout Germany in mid-February 2025 for all those who do not object.
To exploit the potential of the ePA, the Federal Ministry of Health, the future Digital Agency for Health and the health insurance companies in particular must fulfill their obligations. This includes, for example, informing citizens about how it works. However, doctors would not be able to fulfill this task during the infection season. In addition, the ePA should be technically mature and implemented accordingly in the practice management systems (PVS), according to the resolution.
Chaos start pre-programmed?
According to the co-chairman of the GP association, Dr. Markus Beier, "the status of implementation is extremely sobering. Everything currently indicates that the PVS providers will de facto not be ready for the ePA launch. Their failure would cause a chaotic start – in the middle of the infection season, when our practices are already completely overloaded."
In the past, there has also been criticism that doctors will initially have to work primarily with PDF documents without a search function. Doctors are therefore worried about a "digital scroll". Until there is a full-text search, "it must be ensured that the metadata fields of the PDF/A documents to be uploaded can be filled in easily, automatically and unambiguously in the PVS systems", the resolution states. Doctors also recently criticized the conversion of PDF documents to PDF/A.
Unrealistic promises
Doctors are particularly critical of the unrealistic promises made by health insurance companies to their policyholders, and warn of the consequences that the launch of ePA 3.0 and the associated nationwide distribution could have for doctors. "A large proportion of the more than 70 million people with statutory health insurance will be standing outside our doors asking what to do now," says Beier.
Although the electronic patient file has been available since 2021, only around 1.5 million people have registered for an ePA. It is unclear how many will actually use the EPR. So far, the options are limited. Professional groups also regularly criticize that not enough consideration has been given to the patient file and other services such as e-prescriptions. Criticism has come from hospitals and the care sector, for example. In addition, there are still unanswered questions, for example regarding the transfer of research data. The aim is to create a unique and secure research data space in Germany and increase the interest of pharmaceutical companies in investing in Germany.
Documents and images can currently be uploaded, but only up to 25 MB per file. Doctor's letters, medical reports and medication information can be stored in the ePA. Some insured persons can also make their entry in the organ donor register via the ePA. However, there is criticism of the inability to store large files such as MRI images, as well as the short test phase and regular disruptions to services relating to the telematics infrastructure – the "data highway" of the healthcare system.
(mack)