Challenges Persist in the Rollout of Electronic Patient Records

The implementation of electronic patient records (ePA) in Germany is facing significant challenges as it transitions to mandatory use. Starting October 1, all healthcare providers are required to store medical documents, including test results, X-rays, vaccination records, and medication plans, within the ePA system.

Despite the potential benefits of the ePA, which aims to streamline communication among healthcare providers and minimize redundant medical examinations, the adoption rate remains low. As of late July, the Techniker Krankenkasse reported that while 11 million electronic files have been created, only about 750,000 insured individuals actively utilized the system.

A major concern is that over half of the insured population feels inadequately informed about the ePA. Although theoretically, more than 70 million individuals have access to an ePA, only around three million have acquired the necessary health ID to access their records. Furthermore, the requirement for a modern smartphone or desktop application poses barriers for those who may not have the means or desire to use such technology.

Patients are also faced with a complex process for activating their ePA accounts, which includes several methods such as using their health ID or the electronic ID feature of their national ID card. Unfortunately, only 22% of the population utilizes this electronic ID, complicating the activation process further.

Issues extend to the completeness of the ePA itself. Patients have the right to restrict access to their medical data, which can lead to incomplete records and increase the risk of medical errors. Additionally, patients can opt out of having certain documents included in their ePA, which undermines the system's effectiveness. The vision of creating one of the largest medical data repositories globally appears distant under these circumstances.

Technical issues also persist, with only 80% of medical practices equipped with the necessary software to utilize the ePA. The German Medical Association recently indicated that a substantial number of hospitals do not expect to fully implement the ePA until next year.

The integration of the ePA with pharmacies is also cumbersome. Pharmacists must obtain temporary access to patients' medication lists by using a reader device, which grants them access for a limited period. This system is intended to help identify potential drug interactions and prevent duplicate prescriptions, particularly for patients with chronic conditions.

In light of these ongoing difficulties, it appears that financial penalties for non-compliance may not be enforced until early 2026. These penalties could involve reduced payment for telematics infrastructure or even exclusion from billing with statutory health insurances for those practices that continue to refuse to implement the ePA.