Q&A: What to know about the roll out of Germany's electronic patient file
Germany's new electronic patient file (
Elektronische Patientenakte
) has been made available throughout the country from Tuesday.
Written as ePA for short, the electronic patient file is basically a digital database designed to allow doctors to access patient records and share them with others involved in a patient's care (other doctors, pharmacists, health insurance companies etc.)
From Tuesday the software is being rolled out nationwide, but it will still take some weeks or months before the ePA is accessible in all of Germany's clinics. Participation in the digital system will be legally mandated for all medical offices from October.
What's in my ePA?
According to
DPA
, a patient's initial file will include include records of prescriptions for medications they take. Over time more content will be added, including records of medical treatments, vaccination history, medication plans, X-rays and other images from medical checks or screenings, etc.
The idea is that over time, your ePA accumulates records and effectively allows your doctor to review your medical history during treatments.
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Who can see my medical information?
With the ePA in place, when you visit a medical practice and they scan your health insurance card, doctors there will normally be able to access your electronic records for 90 days.
Patients can review their own records in an ePA app provided by their health insurance provider (
Krankenkasse
).
In the same app, patients will be able to adjust some settings around who can access their records and for how long. For example, you can extend or shorten the length of time a doctor can review your records.
Additionally, during a medical consultation, patients may decide if a finding should be included in their file. For sensitive data, patients must be informed of their right to have it withheld.
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Do I need to opt-out?
The ePA is set to be an opt-out system, meaning all patients in Germany will automatically have their file saved in the system unless they explicitly withdraw their consent.
Former Health Minister Karl Lauterbach, who brought forward the electronic patient file initiative, says that patients' data will be stored on secure servers and that foreseeable security issues have been worked out during the ePA's testing period.
But anyone who objects to their information being stored in this way can opt out of the ePA system completely.
A family doctor loads documents into an electronic patient record 'ePA' in his practice. Photo: picture alliance/dpa | Daniel Karmann
Most critics of the electronic filing system have highlighted the risk of sensitive health data being leaked in the event of hacks. Some organisations have voiced concerns about the potential misuse of data when medical records are compiled and shared.
If you do want to opt out of the ePA, you should consider how it may affect the quality of medical care you can get in specific situations.
For a standard visit to the doctor, the difference could be simply that you need to answer more questions about your medical history. But in an emergency situation, for example, without access to your ePA medical personnel could be missing vital information about medications you're taking.
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How do I opt-out?
If you do want to opt out of the electronic patient file, you can do so at any time and have your digital medical records completely wiped.
Health insurance providers should allow you to opt out of the ePA system on their website or in their patient apps. You may have also received a letter in the mail with instructions for doing so.
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If all else fails, try calling your health insurance provider for more information, or sending them a letter.
If you send a letter, be sure to include your full name, your health insurance number (
Versicherungsnummer
), and your date of birth.
You'll also want to write a line clearly stating that you object to the creation of an electronic patient record by them. In German, you could write:
"Ich widerspreche der Erstellung einer elektronischen Patientenakte durch die [Name der Krankenkasse]."
You will need to sign the bottom of the letter and include the date and location as well.
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