Electronic patient file: This is how the storage of your medical data works

Plans for an electronic patient record have been around for more than 20 years and have been available on a voluntary basis since 2021. So far, the e-file (ePA) has only been used little. This is now changing: from Wednesday, the act will be gradually introduced across the board. What the “ePA for all” is about.

A patient’s entire medical history can be viewed in the file at the touch of a button – from treatments and operations to preventive examinations, X-rays and prescribed medications. The big advantage: Doctors treating new patients could immediately see what has been done so far, where the risks lie and additional precautions make sense.

When prescribing medication, they could also identify whether there is a risk of undesirable interactions with other medications. Even in emergencies, treating doctors can quickly find out about the situation – even if the person affected may not be responsive.

Since the beginning of 2021, insured people have been able to use the electronic patient file on a voluntary basis through offers from their health insurance companies. According to Federal Health Minister Karl Lauterbach (SPD), only less than one percent of the approximately 73 million people with statutory health insurance have done so so far. The reason is complicated registration procedures and sometimes immature apps for use.

Instead of having to actively apply for the e-file, those with statutory health insurance will receive it automatically from January 15th. This should only be avoided if you expressly object (opt-out). Lauterbach assumes that not many insured persons will reject the e-file. Less than one percent of those insured at AOK object.

The health insurance companies are obliged to inform their members about the options for objection. Most insured people have therefore received mail from their health insurance company in the last few months. Insured persons can usually object to the creation using an online form or by mail to their health insurance fund. The National Association of Statutory Health Insurance Physicians points out that the objection is also possible retrospectively: the health insurance companies are then “obliged to delete the ePA including all data”.

With the provision of electronic patient files on January 15th, practices, clinics and pharmacies in three model regions – Hamburg, Franconia and North Rhine-Westphalia – will start using the ePA. After successful testing, it will be used nationwide – according to the Ministry of Health, this will be the case “after around four weeks at the earliest”.

You could still benefit from the advantages of electronic patient records, even if you cannot access the data via the app from anywhere. Because it would be available in the doctor’s office. In addition, the e-file can also be used via a desktop computer, viewed in selected pharmacies or by authorized persons – for example a family member.

The law obliges doctors to include medication data, diagnostic reports, doctor’s letters and discharge letters in the electronic file as standard. If you wish, you can also add further information, including information from previous treatments. The medication list is filled automatically via the electronic prescription. Patients can also add documents themselves.

Insured persons can limit access to data both in terms of time and content. This is also possible for individual practices, hospitals or pharmacies. According to the National Association of Statutory Health Insurance Physicians, it is possible, for example, to grant the family doctor unlimited access, but the radiologist only for one day. Certain documents can also be hidden or permanently deleted by the insured.

According to the Ministry of Health, the data is stored on secure servers and encrypted in the ePA. However, the Federal Association of Consumer Organizations (vzbv) remains concerned about possible security gaps that the Chaos Computer Club had reported on. However, according to the ministry, they should be fixed by the start of the patient file.

Yes. One goal of the reform is to give pharmaceutical research in Germany a boost by making patient data available on a large scale. However, the data is given pseudonyms and can no longer be directly assigned to people. Users of the ePA can also object to the use of data for research purposes at any time.