Electronic patient file 01.01.2021 - it's finally here, but what does it do and how do you get access?

They say good things come to those who wait. Does this also apply to the electronic patient record or "ePA" for short? 2021 begins with an innovative start for those with health insurance: The introduction of the ePA! The ePA is supposed to be a milestone of digitalisation in the health care system and improve the processes between the insured and the service providers. Whether the ePA can fulfil these expectations depends on the acceptance of the insured and will only become apparent in the future. Usability and data protection (there has already been criticism in this regard from the Federal Data Protection Commissioner Ulrich Kelber) will play a key role in acceptance. In today's blog article, we will therefore first address the questions of what the ePA can do and include how you can gain access to it.

a) Legal framework

The ePA is intended to promote digitisation in the health care system. By utilising the ePA, insured persons should be able to manage their health-related data electronically themselves, independent of their location. Until now, health data was decentralised to the individual service providers. Therefore, it was (and is) sometimes necessary for insured persons to request and collect their health data, such as X-rays, from the various service providers. This has sometimes cost some insured persons a lot of time and stress. Perhaps you have experienced this, too?
On the basis of the Patient Data Protection Act (PDSG), health insurance providers are now obliged to offer ePA to their insured persons as of 1 January 2021. The PDSG amended the essential provisions for the ePA in the Fifth Social Code - Statutory Health Insurance, in short, "SGB V", §§ 341 ff. SGB V, were amended.

On the websites of the health insurance companies or the website of the GKV-Spitzenverbands, you can find out whether your health insurance provider offers ePA. Whether you use the ePA is up to you. Use of the ePA is voluntary and free of charge.

b) Applications of the ePA

At the beginning of its introduction, the ePA is still in a kind of "test phase". Not all applications prescribed by law are yet available, see scope of application, § 341 Para. 2 SGB V. However, this is intended by law; various applications do not have to be available until 01.01.2022. Furthermore, not all service providers are connected to the technical infrastructure at the beginning. This, too, will only take place gradually across the board. It is therefore possible that not all of your service providers will be able to store your medically relevant data in your ePA as early as 01.01.2021.

However, with the start of the introduction on 01.01.2021, the health insurance providers are to make the following applications available to you, in particular, § 342 Para. 2 No. 1a SGB V:

• Data on findings, diagnoses, implemented and planned therapy measures, early detection examinations, treatment reports and other examination and treatment-related medical information
• Data concerning electronic medication plans
• Electronic emergency data
• Data within electronic letters between the doctors and institutions participating in the care of the insured (electronic doctor's letters)
• Health data provided by the insured persons.

From 01.01.2022, the ePA is to be supplemented by the following applications, in particular, § 342 Para. 2 No. 2a SGB V:

• Electronic dental bonus booklet
• Electronic examination booklet for children
• Electronic parent-child passport
• Electronic vaccination documentation.

In principle, the ePA should be designed in such a way that the insured persons themselves can determine which service providers have access to which medical data in the ePA. However, due to the legal requirements, this will only be possible from 01.01.2022, which has been criticised from a data protection point of view, among others, by the Federal Data Protection Commissioner Ulrich Kelber. You can read the press release on the website of the Federal Commissioner for Data Protection and Information Security. Health insurance providers are legally obliged to inform the insured of this restriction when using the ePA, § 342 para. 2 no. 1g, h SGB V.

You can obtain the ePA from your health insurance provider. They offer their respective ePA apps for download in the Google Play Store or Apple App Store. As a rule, you then have to create a user account and identify yourself; depending on your health insurance provider, this can be done by using an activation code or video identification procedure, for example. Your user account is linked to your smartphone/tablet. In addition, your health insurance provider should also offer the use of the ePA without an ePA app, e.g. if you do not have a smartphone. On request, the health insurance provider will then create an ePA for you; the service providers themselves cannot create an ePA for you. You can release the ePA for the service providers by means of the electronic health card and PIN (you will receive this from your health insurance provider).