Can electronic patient files be changed?
The electronic patient record (EPR)
questions and answers
Why do we need an EPR at all?
The better doctors and other service providers can understand the medical history of their patients, the better they can choose the appropriate treatment. The electronic patient record (ePA) is an important source of information for this. The ePA connects the insured with doctors, pharmacies and hospitals. Many work steps that were previously carried out in analog or paper form can be digitized and simplified by the ePA. Instead of collecting loose sheets of paper at home or individual findings in the practice systems of different practices, doctors and patients have all relevant documents safely available at a glance. In this way, stressful multiple examinations can be avoided.
When is the EPR coming?
The ePA will be introduced on January 1, 2021 in three phases that build on each other: To start with, the health insurances offer their insured persons an app to download, which gives them access to the electronic medical record. This allows insured persons to use their ePA access independently via a smartphone or tablet. At the same time, a test and introductory phase begins with selected medical practices. In phase 2, all doctors will be connected to the EPR in the 2nd quarter. In phase 3 on July 1, 2021, all service providers who are contracted doctors must be able to use and fill in the ePA. In hospitals, the EPR must run by January 1, 2022 at the latest.
What can the ePA do at the start?
To start with, the ePA can be filled with documents, doctor's letters, findings, etc. by patients using the health insurance app using a smartphone or tablet.
Does the health insured have to use the ePA?
No, the EPR is an offer. Insured persons decide for themselves whether and how they want to use the EPR.
How can a patient fill in the ePA?
The ePA will be provided by the health insurance companies on January 1st together with an app. With this app, patients can fill their ePA with documents, doctor's letters, findings, etc. Like every digital project, the EPR is a learning system. Initially, the documents that are not available to the insured in digital form still have to be scanned in with a mobile phone or tablet. In further stages, filing should also be possible in a structured manner.
What does the EPR help with?
The ePA enables important information for patient treatment to be quickly available, for example findings, diagnoses, therapeutic measures, treatment reports and electronic medication plans.
Can doctors alone determine what is stored in the EPR?
No, the patients determine whether and which data from the current treatment context is stored in the EPR and which data should be deleted again.
When do doctors have access to the EPR?
Doctors do not have direct access to the EPR, but are only allowed to access the EPR after the patient's consent and technical access approval, for example by entering a PIN in the practice. From July 1, 2021, all contracted doctors must be able to fill in the ePAs. They are legally obliged to do so. Technically, this works via an interface in your practice management system.
Can others also access the EPR?
The group of those who may access the ePA with the consent and access authorization (PIN) of the insured person is strictly regulated by law. Patients can release the EPR for doctors, therapists or pharmacies as well as for other service providers who are involved in their treatment - either only for the current treatment or for a longer period of time (e.g. in the family doctor's practice). Without the consent of the patient, data can neither be saved nor read out in the EPR. In the introductory year, patients can restrict access to the medical information that doctors and other service providers have given their consent to in the EPR, or only to the documents they have uploaded themselves. From 2022, patients should be able to set access authorization for each document individually via their app, for example for an examination by a specialist.
What is stored in the EPR?
In the first step, for example, medical reports, the medication plan or even blood values can be saved in the EPR, and from 2022 the vaccination card, the maternity record, the examination booklet for children and the dental bonus booklet should also be available digitally.
Are my data safe in the EPR?
The data is stored in the EPR in encrypted form. Nobody except the insured person and those who have been authorized can read the content - not even the health insurance company. The ePA is accessed via the telematics infrastructure, a secure, self-contained network.
Why does the EPR have to be tested again?
As in any large digital infrastructure project, testing in live operation is required. The EPR is a learning system. A group of doctors in Berlin and Westphalia-Lippe and some hospitals are taking part in the test phase. At the end of the second quarter of 2021 - as planned - all 70 million GKV insured persons will be connected to the nearly 200,000 resident doctors, therapists and hospitals.
Can I use the ePA without the app?
Yes. From July 2021, insured persons can use their electronic health card with their electronic health card and a PIN, which will be sent to them by their health insurance company, directly in the doctor's practice or at the service provider. You can have it filled with data that your practitioners have digitally available in connection with the current treatment. The doctor's practice uses its practice management system (PVS) and uploads the locally stored data to the EPR. Alternatively, you can hire a third person, for example a family member, to manage the ePA via the app.
Can a health insurer only allow doctors limited access to the eHR data?
Yes. Insured persons can limit the access authorization both in terms of time and content. In the introductory year, access can be restricted to the information made available by doctors and other service providers. At the same time, the documents uploaded by the insured themselves can be excluded from access. Conversely, insured persons can only grant access to the documents they have entered. From 2022 it will also be possible to use the app to specify who is allowed to access each document individually. In the doctor's practice or with other service providers, from 2022 access can also be limited to certain categories of documents and data records within the EPR, such as specialty categories.
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