Electronic patient record
Maximilian Reindl studied chemistry and biochemistry at the LMU in Munich and has been a member of the editorial team since December 2020. He will familiarize himself with medical, scientific and health policy topics for you in order to make them understandable and comprehensible.
More posts by Maximilian Reindl All content is checked by medical journalists.Whether medication, X-rays or previous illnesses: the electronic patient file contains all the important information about your medical history. You can view this yourself at any time. Above all, treating doctors and pharmacists can also access this data with your consent. In this way, the emergency doctor knows immediately which blood group you need. Despite all the advantages, the question remains how well the sensitive medical data can be protected. Read here what the electronic patient record is all about.
What is the electronic health record?
The electronic patient record contains all important medical data: for example previous illnesses, x-rays, prescribed medication and vaccinations. The digital storage enables you to view your health data yourself at any time, but also your general practitioner, specialists, care facilities and pharmacists.
The big advantage: Information that is important for your treatment can be taken into account and double examinations are avoided. You decide for yourself whether such a digital medical record is created.
What are the advantages of the electronic health record?
By bringing together the most important patient data, your treating physicians have all the relevant medical information at their fingertips. Your doctor can make the right decisions quickly.
For example, he can recognize and avoid possible dangers of drug intolerance. This is particularly important in emergency situations - especially if there are previous illnesses - for example diabetes, kidney failure or heart disease. The wrong medication can have serious consequences for your health.
The electronic patient record also replaces the previously usual doctor's letter. It minimizes the risk of missing information or making mistakes when changing doctor or referring to another specialist.
Your doctor can evaluate your entire medical history to find an appropriate therapy. The electronic patient file also simplifies the issuing of prescriptions.
Which data are saved?
According to the National Association of Statutory Health Insurance Physicians (KBV), the following data will be stored in the electronic patient file from 01.01.2021:
- Findings
- Diagnoses
- Therapeutic measures
- Treatment reports
- Vaccinations
Building on this, the electronic patient record is to be expanded step by step. Among other things, electronic medication plans, electronic doctor's letters, emergency data sets and electronic pain diaries are planned.
Who has access to my electronic patient record?
Access to the electronic patient file of an insured person is only granted to authorized specialists. Access to the data should only be possible in direct doctor-patient contact - for example with specialists, the family doctor or in the case of an e-prescription from a pharmacy - provided that you grant the necessary authorizations.
It is important that health insurance companies cannot view your electronic patient file. Conclusions that could affect your insurance status or benefits are excluded.
You decide for yourself which documents and data are saved for how long. However, an extended access management for the introduction date from 01.01.2021 is still in the development phase.
Extended access management means that you as the user can manage the documents in your electronic patient record independently. This means that you can decide for yourself which doctor you want to allow access to which document. This so-called document-specific control of your treatment documents will only be available from 2022.
How is the data protected?
Medical data are considered to be highly sensitive. The security of your data has therefore taken on a high priority in the development of the electronic patient record. The requirements placed on the technology as well as the authorization and encryption concepts to protect your data from access by third parties are correspondingly high.
The technical infrastructure is called telematics infrastructure (TI). The TI is a closed, encrypted network that manages all relevant patient data and access rights. Gematik GmbH was commissioned to set up and develop TI in Germany.
Although this company is privately run, it is financed by the National Association of Statutory Health Insurance Funds as a payer. So from the members of the statutory health insurance. The main shareholder is the Federal Ministry of Health (BMG), followed by the German Medical Association (BÄK) and other organizations of the German health system.
Authorized authorization is checked by an e-health card terminal (two-key principle) - for example, doctors authenticate themselves with their electronic health professional card (eHBA). The quality of the encryption methods used is regularly checked by the Federal Office for Information Security (BSI).
What do the critics say?
Critical voices refer to the issue of data security.Sensitive data that is merged and stored by a single provider could become targets of cyberattacks and represent a possible security risk. Critics also discuss the so-called TI connectors that doctors or clinics need to get access to health data as possible Vulnerabilities.
Critics also complain that when the electronic patient record is introduced, insured persons cannot yet decide which individual documents they want to make available to which doctor.
According to the Netzpolitik.org platform, information on mental health or, for example, an abortion, would also be available to doctors from other disciplines - such as a dentist. This could contradict the principles of necessity and purpose limitation.
However, the document-specific control announced for 2022 is intended to dispel these concerns under data protection law.
Will the electronic patient record become mandatory?
No. The use of the electronic patient record remains voluntary for every insured person. Providers are the respective statutory health insurances. They are obliged to provide their insured with an electronic patient file by January 2021 at the latest. Some of the private health insurance companies also want to offer their policyholders an electronic health record.
How do I apply for the electronic patient record?
As a rule, you need registered access to the online area of your health insurance company, the app provided by your health insurance company (Google Play / Apple Store) and your electronic health card (eGK).
The eGK is your current health insurance card with a photo. It is equipped with a chip that already saves your master data - i.e. name, date of birth and address as well as information about health insurance.
You can find out from your health insurance company how the application for and registration of the electronic patient file is regulated in detail.
You can access your own data using special apps for smartphones or tablets (ePA app). These are developed by your health insurance company and made available in the app stores. Access via a desktop PC is currently not available.
The ePA apps for smartphones and tablets use two-factor authentication (2FA). This is a form of proof of identity that checks your legitimacy via two different channels. It's similar to online banking: online access from your bank and an associated TAN number.
Anonymous data for research
From 2023, insured persons will have the option of making data from their electronic patient files available to medical research. This data donation is voluntary and anonymous.
Conclusions about your person are excluded. Your individual medical history remains anonymous. However, with your data donation you are making an important contribution to improving care and prevention in the German health sector.
This so-called voluntary secondary use of your data enables, among other things:
- Clarification of the smallest side effects of a drug or treatment, as larger patient groups can be examined (> 100,000 participants)
- An improved diagnosis of rare diseases
- Faster assessment and increased security when developing new treatment options (e.g. personalized medicine)
- Early containment of pandemics
- Targeted prevention measures
Can I use the electronic patient record without a smartphone?
You can only access your own electronic patient record using your own smartphone or tablet. This excludes some of the insured in Germany, as not every insured person has such a device.
However, you can have your electronic patient file processed directly by your doctor from July 2021. With your electronic health card and a PIN (provided by your health insurance company), the doctor's practice can manage your electronic patient file via its practice management system (PVS).
