What is the ePa (electronic patient record)?

As of January 1, 2021, the introduction of the electronic patient record began. Since that time, one often hears or reads about the so-called ePa. But what it is and what purpose it is supposed to serve is still not very clear to many.

Until now, in the best case, the family doctor collected all findings of a patient. This means that he referred the patient to the respective specialists as needed and received the findings from them regarding the examinations conducted there. The same applied to reports from hospital stays. In some cases, the reports were directly given to the patients with the instruction to submit them to the family doctor; often, the reports were also sent directly. This resulted in a more or less complete collection in the patient file maintained by the family doctor.

Findings required for specialist treatment, a hospital stay, or rehabilitation, etc., had to be requested from the family doctor. However, in the case of an emergency treatment, these findings were often missing, along with important information.

Among other things, this situation is what the electronic patient record aims to resolve. Because now all findings of a patient can be collected here. They are available at any time in the free app or on the health card. Additionally, a so-called emergency data set (NFD) can be stored in the ePa, which contains all relevant information in case of an emergency, such as diagnoses, allergies, the current medication plan, pregnancy, etc. The person to be notified in case of an emergency can also be noted here.

The ePa is intended to be a record managed by the patient. Access to the ePa can be requested from the health insurance companies. Subsequently, the free app provided by the health insurance companies is downloaded by the patient onto their smartphone or tablet and used there. This means that only the patient themselves decides whether and how they want to use the ePa, which data is stored in it, and who has access to which data.

They can also decide which documents should possibly be deleted or who should have their access to the data revoked. In the long term, findings, etc., should be archived here for a lifetime. Thus, there should only be one ePa for each patient.

Since July 2021, the health insurance card can also "host" the ePa. This option is aimed at patients who cannot manage their ePa in an app themselves. Specifically, storing the emergency data set (NFD) on the health card is an important improvement over the previous handling. It saves valuable time and provides emergency responders with important information about the patient's medical history and current medication in case of an emergency.

To access the ePa on the health card, the health insurance company issues a PIN. The findings are stored directly on the health card by the doctor or service provider. The NFD is also stored on the card by the doctor.

Service providers include not only doctors but also therapists, pharmacies, or other persons/institutions involved in the treatment. However, no data is automatically transferred here either; rather, the desired files must be consciously copied to the health card or the ePa available there. The originals remain with the respective doctor, therapist, etc.

Access to the data can be restricted. Currently, this is a major point of criticism: It is not possible to finely adjust who can see which document. Either all documents are made available to a doctor or none at all. Despite this situation, the ePa was launched in January 2021. A "fine-tuning" of the releases was supposed to be possible starting in 2022.

In general, however, only those who have been authorized by the patient have access to the ePa.

Neither the operators of the ePa nor the health insurance company can access the collected data. A special feature is the NFD: In an emergency, doctors, emergency responders, and other individuals with an electronic health professional ID can access it without the patient's consent (who may not be able to provide it in an emergency). Every access to it is recorded on the health card and is thus traceable afterwards.

The protection of data is taken very seriously: The servers for the ePa are located in Germany. Thus, the ePa is subject to European data protection regulations. Extensive certification processes must also be completed before the provider can make the ePa available.

However, due to various problems with the provision of the ePa until 2024, it is now planned to be set up for everyone starting in 2025. An opt-out regulation is planned for this, meaning that every insured person should receive an electronic patient record unless they actively object.

What should be stored in the electronic patient record (ePa)?

As mentioned above, the ePa is intended to accompany us for a lifetime. Starting with the U-examinations for children and adolescents, vaccinations, allergies, blood type, it can also store, for example, the maternity record, the dental bonus booklet, and of course all other findings. But also services provided by the health insurance that have been utilized, data on health applications, as well as nursing care, even the electronic sick leave certificate and electronic prescriptions to document the medication history, should be included in the ePa. You can then also store your PDF evaluation from BloodPressureDB in your ePa.

The entire range of possibilities is not yet available but is to be rolled out gradually, i.e., supplemented.

Overall, the electronic patient record (ePa) is a very sensible innovation. However, it also places the patient as a partner in their own medical care under obligation. Because the best record is of no use if it is not maintained. Thus, it is also the patient's responsibility to keep it up to date and, if necessary, to release the findings that are of interest to the respective doctor.

Data protection for the ePa is also repeatedly discussed. These are sensitive data that are stored and should not fall into unauthorized hands. To ensure the ePa is secure, everything possible is being done, as mentioned above.

Sources:

By Sabine Croci. This article is medically reviewed. Last updated (06/2024).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.

Our offering meets the afgis transparency criteria. The afgis logo stands for high-quality health information on the internet.

What is the ePa (electronic patient record)?

What should be stored in the electronic patient record (ePa)?

Sources:

Register: