The electronic patient file - the guide for your practice

If you as a doctor want to know which medication a patient is taking or what pre-existing conditions are present, you reach for the patient file as a matter of course. In many practices, this document is still managed and archived in paper form. But by 2021, this is no longer in keeping with the times. Legislators have therefore introduced the electronic patient file, which will gradually replace the conventional physical file.

What is the electronic patient record?

Since January 1, 2021, people with statutory health insurance have the right to an electronic patient record - or ePA for short. This digital patient file is provided by the respective health insurer as an app and may therefore differ somewhat in appearance depending on the provider. The app can be installed by the insured on an end device such as a smartphone or tablet. From 2022, it should also be possible to use the ePA via the desktop. The digital record is of course voluntary for the patient.

The advantage of the ePA for patients is that they can take more responsibility for their own health data. They can decide for themselves which data to share with which doctors - and which not. The ePA is not yet available for people insured by private health insurers. But that is set to change in 2022.  

What data can be stored in the ePA?

Essentially the same information can be collected in the electronic medical record as in the traditional physical medical record, for example. For example:

• Diagnoses
• Medication Plans
• Treatments
• Therapy measures
• Doctor's letters
• Laboratory results

Patients can also add their own data (e.g. from fitness trackers). Emergency data records can also be created in which, for example, allergies or other intolerances are entered.

The ePA is to be gradually expanded according to the will of the legislator. From 2022, for example, it should be possible to add maternity and vaccination records and, for example, dental bonus booklets. The aim is for all important health data to be available in one place. 

Doctors must meet these technical requirements

In order for practices to be able to use the new electronic patient record and read it out depending on the patient's release, there are some technical requirements. To be able to use the ePA - and the applications that will follow - your practice needs to be connected to the telematics infrastructure (TI). All components must be approved by Gematik (National Agency for Digital Medicine).

Practices that want to connect to the telematics infrastructure for the first time need these components:

In addition, the practice management system (PVS) must be adapted. If you make house calls, you should get a mobile card terminal. These also work in offline mode. However, data cannot be updated with the mobile card terminal. The conventional card terminal with connection to the connector is still required for this.

And what does the electronic patient file cost?

So a few technical conversions and investments are necessary. But don't worry: All costs are reimbursed by the associations of statutory health insurance physicians.

The TI start-up flat rate for VPN access, installation, PVS customization and time is 900 euros. In addition, the following costs are covered for the initial equipment:  

• Maintenance of components per quarter: 248 euros
• One connector (for up to three physicians in the practice): 1,549 euros
• Mobile card terminal: 350 euros

For electronic medical records, these costs are additionally reimbursed:

• Adaptation of the PVS for the ePA: 150 euros
• Update for the ePA connector: 400 euros
• Operating cost surcharge for ePA per quarter: 4.50 euros

For more information on the financing of the telematics infrastructure and related components, contact the National Association of Statutory Health Insurance Physicians.

The electronic patient file has these advantages for physicians

In return for this technical effort, the electronic patient record offers some advantages for physicians. One important point that definitely speaks for the electronic patient record is that health data can be shared more easily with other medical professionals. Data is updated at the touch of a button. Synchronization takes place in real time. For example, unnecessary examinations can be avoided. It also significantly reduces the risk of contraindications. Damage to the patient's health can therefore be prevented more effectively.

And the ePA also has a major advantage in terms of the time factor, because: On average, German doctors only have about 7.5 minutes per patient. So if data can be recorded and viewed more quickly, the time saved can be used to treat the patient.

Is the electronic patient file DSGVO-compliant?

Many doctors are concerned about data security. After all, information about patients is particularly sensitive data. For this reason, the information in the electronic patient file is specially protected and stored in encrypted form on German servers.

Before the respective health insurance company is even allowed to offer an ePA, it must also first go through an elaborate certification process, which is carried out by Gematik. Only when the National Agency for Digital Medicine has completed its assessment can the health insurance company officially offer the electronic patient record.

So, as you can see, legislators are aware that health data deserves special protection and appropriate measures have been introduced. Nevertheless, data protectionists criticize the fact that in the introductory phase of the ePA (i.e., 2021), patients will not yet be able to control which data a doctor is allowed to view and which not. That will not be possible until 2022. In addition, older people without a mobile device or Internet connection could be disadvantaged. This is because the ePA is currently only available as an app on a smartphone or tablet.

Is it mandatory for practices to set up ePA?

Since July 1, 2021, physicians and psychotherapists have to fulfill the technical requirements to be able to read and adapt the ePA. Some physicians have complained that the timetable for all these technical requirements and implementations is too tight.

Stages of ePA implementation

Overall, the ePA has been or will be introduced in different stages. Namely:

Stage 1: Test phase

On January 1, 2021, the test phase for the electronic patient record began. From this date, the statutory health insurers had to make the ePA available to their insured persons. In the first quarter of 2021, the digital record was tested in around 200 medical practices and hospitals.

Stage2: Roll-out

As of April 1, 2021, doctors' offices and the like should be taking care of the connection to the new electronic patient file or the telematics infrastructure.

Stage 3: Widespread use of the ePA

From July 1, 2021, it should be possible for doctors' offices to read out and fill in the electronic patient file. However, the Association of Statutory Health Insurance Physicians complains that not all technical requirements had been met by the time the ePA was officially launched. In hospitals, the electronic patient record must be ready for use by January 1, 2022 at the latest.

Nelly promotes the development of electronic patient records

If you use the electronic patient file as a doctor, you can fill it in even more easily with Nelly. This is because all documents are already made available digitally in the software, making it easier to transfer them to the patient file. This saves you time and effort with Nelly and optimally supports the digital patient file, which will become standard in modern medical practices in the coming years. Create a digital workflow in your practice now. We will advise you on your individual case free of charge and without obligation!

Contact Nelly now!

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