The electronic patient record (ePA) will be available nationwide for all doctors and pharmacists starting April 29, 2025, following a successful pilot phase. Initially, the use of the ePA will be voluntary for healthcare providers, allowing them time to familiarize themselves with the system. However, the mandatory use for doctors and other healthcare providers is set to commence on October 1, 2025. Federal Health Minister Prof. Karl Lauterbach has described this rollout as a "long overdue turning point" in the digitization of the healthcare system, expressing confidence that the ePA will soon become an indispensable part of everyday medical practice in Germany.
According to Lauterbach, the ePA is expected to improve the quality of care and open up new avenues for AI-supported research. Security of health data has been a central concern during the preparation for this rollout. Florian Fuhrmann, Managing Director of gematik, emphasized that "the security of health data has top priority." The necessary security measures have been successfully implemented in coordination with the Federal Office for Information Security (BSI) ahead of the nationwide launch.
In recent months, the ePA has been tested in various model regions, including Hamburg, Franconia, and parts of North Rhine-Westphalia. Additional security precautions have been established for the national rollout, including checks of health insurance numbers and other card features. Furthermore, the number of accesses to electronic patient records will be limited based on the size of the healthcare facility.
For Lauterbach, the ePA represents a critical project alongside hospital reform during his tenure. He believes that it will revolutionize medical care by simplifying how healthcare providers access patient histories, including pre-existing conditions. However, concerns from data protection advocates have persisted. Recent criticisms have emerged, particularly regarding patient control over who can view their medical records. The Patient Protection Foundation has raised alarms that patients will not have the ability to regulate access to specific findings and prescriptions, contrary to previous assurances from Lauterbach’s ministry.
According to the gematik agency, which oversees the implementation of the ePA, access to the system will always pertain to a medical institution and the entire ePA. Documents can be individually hidden or deleted, but this means that if a patient does not want their pharmacist to know about their therapy with a psychotherapist, they must also restrict access for all other healthcare providers, such as their general practitioner or cardiologist. This raises questions about true data sovereignty for patients.
Lauterbach addressed these criticisms, stating that patients will indeed have the autonomy to decide which findings appear in their patient files. However, software expert Mark Langguth, who has been involved in developing the ePA, expressed disappointment over the limitations in patient control. He noted that a more patient-friendly solution could have been technically feasible and warned that the current approach might hinder acceptance of the digital innovation.
Despite the controversies, the outgoing health minister reported that opposition to the ePA among insured persons has been limited. "Only about five percent have opposed its use," Lauterbach stated, indicating that the majority of patients appear willing to embrace the new system. Since January 15, 2025, electronic patient records have been created for over 70 million statutory insured persons in Germany, unless they have explicitly opted out.
The ePA is designed to store a variety of medical information, including findings, laboratory values, and medication details, which will be populated primarily by the treating physicians. Patients will also have the capability to upload documents and view their data through a smartphone app provided by their health insurance.
Healthcare providers will gain access to the ePA by inserting the patient’s insurance card into a reader, a process aimed at reducing duplicate tests and preventing the prescription of medications that may interact negatively with those the patient is already taking. However, the rollout has not been without its challenges. Barbara Römer, head of the General Practitioners' Association, pointed out that her practice is not yet able to start using the ePA due to pending updates from their software provider.
Römer highlighted that the most significant advantage for patients will be having all their findings readily available without the need to carry physical folders or documents. She noted that patients should ultimately have control over which documents are uploaded to their records. However, she also recognized that the initial implementation may lead to gaps in the records, as not all historical findings will be included at the outset.
The federal government has emphasized that the ePA will empower patients by providing them with a comprehensive overview of their medical data, enabling better-informed decisions by healthcare professionals. Lauterbach is optimistic that Germany will soon have one of the most advanced infrastructures in Europe for electronic patient records and medical data management.
As the April 29 launch date approaches, the healthcare sector is bracing for the transition to digital records, with hopes that the ePA will enhance patient care and streamline the medical process. Nevertheless, the concerns regarding data access and patient control remain critical issues that will need to be addressed as the system evolves.
