What is it, can I refuse?

The electronic patient record (EHR) is intended as a practical convenience, but not everyone likes the idea. What is that? Do you need the electronic patient file and is it mandatory, or can I refuse it? We clarify…

For many, the most important information in advance: The electronic patient file is a “patient-managed file”. That means you decide whether you want it or not. You cannot be forced to have such a file created and you do not have to object to it, because it will only be created at your request.

What is the electronic patient record for?

The electronic patient file should contain all relevant information about diseases. Patient treatments and medication included. This saves you, for example, having to request copies of all files when changing doctors or consulting a specialist, or having examinations done twice over you.

After a visit to the hospital, your family doctor can see what has been done, and when you are admitted to the hospital, the doctors treating you can see what illnesses you have had, what medication you may have to take or what you are allergic to.

Can anyone see everything in my digital medical record?

The patient has full control over what goes into the file and who can see which part of it. With the combination of his insurance card and a PIN, he gives access and can even set a time limit, so that the doctor can only look at the file once.

The insured person can place documents in the electronic patient file themselves and can regulate access in such a way that only these documents can be accessed during treatment.

Health insurance companies cannot and must not view these files.

How do I control access to my patient record?

Patients control their electronic patient file either via an “ePA app” or can edit the data on their doctor’s computer.

• The app is a service provided by your health insurance company and you can either use it here find it or search for it in your app store by entering the name of your health insurance company and “ePA”.
• You then have to apply for the ePA from the health insurance company.
• You then register in the app for the electronic patient file. In order to then access the file, you can either read in the data via NFC with your mobile phone or you can use two-factor authentication.
• Then the doctor can fill your ePA with the desired data at the next visit.
• You can use the app to see the contents of the file and also determine who can access what.

How secure is the data in the ePA?

All data in your electronic medical record is encrypted and decrypted either by the protected app or an equivalent application at your doctor’s office when needed.

The data is not on your insurance card, but on a server of the company that was commissioned by the federal government to host it. Whoever finds your card does not automatically have access to your data.

Every call to your data is made via the central server, which is why these queries are precisely logged. You can see who has seen what and what data they have opened.

Incidentally, if you change health insurance, the data in the ePA can be transferred, since it is stored centrally on a server and only one type of authorization needs to be passed on.

Is an electronic patient record possible without a smartphone?

If you don’t have a smartphone, you can still use the ePA. To do this, they have to apply for it in writing or by telephone from their health insurance company and fill out and sign a declaration of participation.

The card can then be filled with data by the doctor. With a so-called “representative regulation” you can allow other people to keep the file for you or, if you have a computer, you can also open it there. However, this requires a desktop client.

Without any digital devices, you can have your doctor’s office determine which authorizations you want to give. You then confirm this at the card terminal in the practice with your card and your PIN.

Can and must I refuse an ePA?

The electronic patient file is an offer, not an obligation. There is an opt-in procedure, which means that you have to request this ePA yourself. If you don’t apply for the card, you won’t get it.

You also have to consider that even when you visit a doctor, you have to authorize access to your data with the combination of insurance card and PIN or biometric key. If you don’t want that, no one can access the data.

However, there are plans to introduce an electronic patient record as an opt-out version. That would mean that everyone would automatically receive such a patient file and would have to object if they didn’t want it.

However, this does not change the fact that you regulate access to the data yourself and nobody can open the file without you “unlocking” it.

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