Health Minister Karl Lauterbach wants to enforce the electronic patient file (ePA) for everyone. If you don’t want that, you have to actively disagree. With the change of strategy, he finally wants to digitize the healthcare system.

In principle, every person with statutory health insurance in Germany should receive the ePA.

The Federal Ministry of Health announced this recently Twitter. Accordingly, Gematik was commissioned to prepare the opt-out rule for the electronic patient file.

Insured persons must actively object to electronic patient files

The electronic patient file actually started in 2021 as the core of Lauterbach’s digital agenda. However, the system has not really got going yet.

Previously, those with statutory health insurance had to actively opt for the ePA. Lauterbach is now changing the strategy: all patients should receive the digital file automatically.

People who prefer not to do so will have to actively opt out of the electronic file in the future. Compared to the Handelsblatt Lauterbach said that use is still voluntary. However, it should become the norm.

We will present a corresponding draft law for this fundamental decision in the near future.

Federal Data Protection Commissioner criticizes ePA

The Gematik should be responsible for the implementation. First, the company should check the technical and organizational requirements. After that, she should finally implement the new strategy.

The process should be completed by 2024. However, there is still a long way to go until then. Because not everyone is as convinced of the opt-out procedure as Lauterbach.

The Federal Data Protection Commissioner, Ulrich Kelber, has been particularly critical of this in the past. According to Kelber, the legislator does not pay sufficient attention to “collision” with the EU General Data Protection Regulation (GDPR) with regard to the electronic patient file.

Patients are also critical

And patients are also critical of the electronic patient file. The first responded with outrage on Twitter:

Electronic patient records digitize patient information

In the future, the electronic patient file should provide information about which medication patients are taking, what previous illnesses they have, what their blood values ​​are, or which tests were carried out in advance.

In this way, patient information should be accessible in a bundled form. In addition, the Federal Ministry of Health wants to prevent unnecessary or double examinations and missing details on the medical history. In addition, time can be saved during the treatment.

We can only make medicine better and more efficient if we use digitization.

Electronic patient file in four decision stages

The implementation of the ePa is to take place in four stages.

In the first stage, patients automatically receive an ePA. Secondly, doctors should then fill the digital file with information. In the third stage, the treating physicians can view the file. Finally, the personal health data can be donated anonymously for research purposes.

Lauterbach hopes that the last stage in particular will bring great added value for medicine. In order for meaningful medical research and preventive care models to be possible through modern approaches such as the use of artificial intelligence, the pool of data must be as large and complete as possible.

The stage at which patients can ultimately object to the ePA has not yet been conclusively determined.

Only 0.75 percent currently use the ePA

Statutory health insurance companies have had to offer electronic patient records since 2021. According to Gematik, however, only 556,000 of the 74 million people with statutory health insurance in Germany currently use the digital file. One reason for this is data protection concerns.

The head of Techniker-Krankenkasse, Jens Baas, welcomes Lauterbach’s move. It is correct that the implementation of the opt-out procedure has the highest priority, he told the Handelsblatt.

The pandemic has shown how important the availability and networking of health data is.” That is why it is important to start designing the opt-out – “so that we don’t lose any time.

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