ROUNDUP: Millions of patients still don't look at their electronic records

BERLIN (dpa-AFX) - The vast majority of statutory health insurance holders now have an electronic patient record (ePA) for important health data such as examination results and laboratory values. However, millions of them have not yet used it for themselves, to view it or to block sensitive information. At the Techniker Krankenkasse (TK), the Allgemeine Ortskrankenkassen (AOK), and Barmer, with a total of over 44 million electronic records, around 1.2 million are currently actively in use, the insurers stated upon request. Consumer advocates are calling for more useful functions to be implemented quickly.

The head of the AOK Federal Association, Carola Reimann, told the German Press Agency: "So far, the number of insured persons logging into their electronic patient records is still manageable. Hopefully, this will change starting in October, because from then on, doctors will be legally obligated to use the ePA and fill it with relevant documents." TK CEO Jens Baas told the dpa: "We are now in the phase where the ePA must reach the general population." Only when the record is filled and established in everyday life can it fulfill its potential for care.

More and more practices should fill e-files

Following a reform by the "traffic light" coalition, 70 million of the 74 million people with statutory health insurance have received an electronic health record from their health insurance provider since January. Those who don't want one must actively opt out. Following a test phase, its use in practices and clinics is currently being expanded nationwide. Doctors can fill out and view the ePA, even if the insured person isn't actively using it themselves. Practices have access to the record by presenting their insurance card at the reception desk – valid for 90 days by default.

For patients, the following applies: You can log into the ePA, but you don't have to. Only if you do, however, can you specify online which doctors can see which data and which you prefer not to. To use the app for the first time, however, you must first identify yourself and be activated. This requires an electronic ID card with a PIN or an e-health card with a PIN, which you can request from your health insurance provider.

TK, the largest health insurance company, has created eleven million e-records, currently actively used by 750,000 insured persons. Barmer has 7.8 million ePAs and approximately 250,000 active users. At the eleven AOK health insurance companies nationwide, with 25.8 million e-records, 200,000 insured persons have so far created a digital identity as an access point. According to the majority-owned federal digital agency Gematik, there are a total of 3.1 million such "health IDs."

Pooled data for better treatments

Health insurance companies are counting on increasing use of the ePA, which is intended to accompany patients throughout their lives. Bundling otherwise scattered or missing data is intended to enable better treatments and avoid duplicate examinations. According to Gematik, 40 million electronic files were recently opened weekly in practices, clinics, and pharmacies. A good 70,000 facilities are participating, with the number potentially reaching 160,000. The Association of Statutory Health Insurance Funds (SKVs) calls this a "satisfactory start." However, it also shows that there is still much to be done for the true digitalization of the healthcare system.

Survey data shows that many insured people are interested in accessing health data such as doctor's letters or laboratory data via their ePA, said AOK CEO Reimann. New, useful features are expected to further encourage use. For example, there is already a list of medications taken. A medication plan with information on medication dosages, for example, will soon be added.

More features to come

Gematik recently introduced an update with several new features. A version will be gradually rolled out that allows the ePA to be managed on a PC as well as a smartphone. This will require a reader for the electronic health card. It will also be possible to hide a medication list in the ePA, which is fed from redeemed e-prescriptions, only for specific practices—and not always for all. This should prevent any conclusions about sensitive medical conditions from being drawn.

From the consumer advice centers' perspective, this is a decisive improvement, but only a start. Patients should also be able to decide for themselves which institutions have access to what, including medical findings and billing data. It is not absolutely necessary "for the dentist's office to learn about psychotherapy," said the federal association's health expert, Lucas Auer. Relevant information such as vaccination records, bonus booklets, or x-rays should also soon be accessible via the electronic file. "Because the ePA will only find broad acceptance if it offers tangible benefits."/sam/DP/zb