Hospital.Help

Berlin – When setting up the electronic patient record (ePA), the health insurance companies have so far received hardly any objection from their insured persons. The CEO of the National Association of Statutory Health Insurance Funds (GKV-SV), Doris Pfeiffer, explained this today at the presentation of the advertising campaign for the ePA with Federal Health Minister Karl Lauterbach (SPD).

Since June, 68 of the 96 health insurance companies have started writing to their insured persons and informing them of their right to object to the establishment of an ePA for them. So far, they have received a negative response, i.e. an opt-out, to less than three percent of their cover letters.

“From our point of view, this is a very good interim result that shows people’s trust in our health system,” emphasized Pfeiffer. The remaining health insurance companies would begin setting up the ePA for their insured persons in October.

At the same time, the AOK Federal Association also reported an extremely low rejection rate: Less than one percent of AOK insured people would object to the institution, emphasized the CEO, Carola Reimann, in a statement today.

The main reason for the redesign of the ePA was that an opt-in regulation was previously in effect, in which insured persons had to actively agree to an institution. This is seen as one of the main reasons for the minimal spread of the ePA among insured persons to date.

The new regulations will now make the ePA “suitable for mass use but also for practical use,” explained Lauterbach, emphasizing the importance of the project. His ministry has already introduced 15 laws, but: “If I can venture a prediction, there are two laws that will change the healthcare system more than any other, namely the ePA and hospital reform.”

The ePA will soon change care for the better in two areas in particular: On the one hand, findings, diagnoses and other treatment-relevant content will usually be available in full in the future. This has only rarely been mentioned so far.

“I also notice this when I am involved in second opinions: findings are usually missing,” he explained. On the other hand, the ePA will massively simplify checking for interactions through medication management. This could prevent up to 60,000 deaths per year.

He also pointed out that the Health Data Use Act (GDNG) gave health insurance companies the opportunity to carry out data-supported evaluations of the individual health protection of their insured persons. This could also include providing tools for analyzing interactions. However, that does not mean that the health insurance companies would monitor the medication of their insured persons.

The federal chairman of the Association of General Practitioners, Markus Beier, was not very enthusiastic about this point: “I warn against carrying out interaction checks on chronically ill people outside of the practice,” he emphasized.

He has already had bad experiences with interaction checks in pharmacies. The individual medical history and knowledge of the patient are of utmost importance. “We can’t outsource this to the health insurance companies,” warned Beier.

What is particularly relevant for success in general practitioner practices is that the system runs automatically, processes data in a structured manner and a full-text search is possible in the content. “The PDF phase must be as short as possible,” he emphasized.

The start of the ePA is to be preceded by a four-week test phase, in which the interdependencies between different applications such as the e-prescription or the electronic certificate of incapacity for work (eAU) as well as the compatibility of the various systems – especially the over a hundred practice management systems (PVS) and the various ePAs from almost one hundred health insurance companies – should be examined.

For this purpose, Gematik operates its own project offices in the two model regions of Franconia and Hamburg, explained the chairman of its management, Florian Fuhrmann. Gematik has concluded contracts with the pilot practices specifically for the testing there. “If all the criteria that we have agreed with the shareholders are met, the roll-out can begin.”

Gematik is in close contact with the over 100 software manufacturers involved and is “in good spirits that they will be able to meet the legally specified deadline”. One should not forget that the ePA is one of the federal government’s largest IT projects.

The ePA has great potential in everyday care, where too much time still has to be spent on telephone calls after findings and other information, explained Beier. However, the application must also run stably. “That wasn’t the case with the previous version.”

In view of the effort required to educate patients, it is also difficult that the start of the ePA falls in the middle of the infection season. “We are happy to answer all questions, but we will not always be able to do so,” said Beier. That’s why it’s good that the federal government is starting an information campaign.

In order to make the project known to the population and reduce reservations, a large-scale information campaign is now starting 100 days before the starting signal. In addition to advertising and flyers, an information mobile will tour through Germany and stop in various major cities. “We want to reach a lot of people so that we can talk to them,” said Lauterbach. © lau/aerzteblatt.de