After years of tugging, the digitization of the health care system in Germany should pick up speed with broad-based applications for everyone. Federal Minister Karl Lauterbach is today presenting plans for a new start for electronic patient files, which are rarely used as a voluntary service.
As the SPD politician has announced, they should become binding for everyone by the end of 2024 - unless you expressly reject it. The changeover planned by the traffic light coalition is intended to bring about a breakthrough for digital applications. E-prescriptions should also make headway. In addition, more data evaluations for research should be possible.
Dahmen: "Digital patient files can save lives"
The Greens health expert Janosch Dahmen told the German Press Agency: "As in so many areas, Germany has missed digitization in the health system for years." In doing so, it contributes to faster, more efficient and better care. "The digital patient file can save lives because it provides doctors with all the important information about a patient immediately." It must therefore become the standard. The fact that so far less than one percent of the population has an e-patient file is completely insufficient. "Other countries are miles ahead of us."
The e-files introduced as a voluntary service in 2021 are intended to store findings, X-rays and lists of medications, for example, and thus also avoid unnecessary multiple examinations. So far, however, only a fraction of the 74 million people with statutory health insurance have used the offer. There are delays in networking the practices, and disputes about data protection smolder on several issues. In the coalition agreement, the SPD, Greens and FDP have therefore agreed to apply the "opt-out" principle - i.e. that everyone automatically receives an e-file and one has to actively object instead of actively applying for an e-file as before.
As efficient and user-friendly as possible
Green expert Dahmen said it was good that the minister was now speeding up. The objection solution is "a proportionate way" in view of the high benefit for the supply. Data protection and health protection should not be played off against each other. "Patients should be able to decide flexibly about the use of the file." For example, they could only make individual findings visible to certain doctors. In addition, the digital file should be as efficient and user-friendly as possible from the outset. "There is still room for improvement," explained Dahmen.
"For the patient or doctor, the patient file must be as easy to use as a search engine," said the Green politician. It would be very cumbersome for everyday practice if only long documents could be uploaded at first. A quick overview of the patient information and a uniform and structured data format are needed. The FDP specialist politician Christine Aschenberg-Dugnus said that the advantage of the e-file is not only that patients can see all the findings. Other players in the healthcare system could also get an idea of a patient's state of health with just a few clicks.
Focus also on electronic prescriptions
The federal government has already issued a target for the plans in its more comprehensive digital strategy: In 2025, it wants to be measured by whether at least 80 percent of those with statutory health insurance have an electronic patient file. Finally momentum should also be gained with electronic prescriptions, the introduction of which on a larger scale continues to falter - in the only pilot region in Germany in Westphalia-Lippe further steps were put on hold last autumn for the time being.
Green expert Dahmen emphasized: "We need a national health data room in which the data from decentralized sources systematically converge in real time." Public sector investments must be made in a digital infrastructure that combines data protection, IT security and practicability. This also requires a big throw. Half-baked solutions could cost acceptance by patients and doctors - and ultimately lives.
Lauterbach is also concerned with opening up more opportunities for research. The systematic evaluation of large amounts of digital data can significantly accelerate knowledge. A role model for this is Israel, which began digitization more than 25 years ago.
Federal Ministry of Health on e-patient files Coalition agreement, e-patient files p. 83 Digital strategy of the federal government, including on e-patient files