Berlin There is one thing with health records: there is the index card with the family doctor. And one more in each additional practice. X-rays and vaccination records are already in drawers somewhere. As an insured person, you can lose track of this. The electronic patient file (EPR) is considered to be a great solution for the mass of data.
It is a prestige project by the Federal Minister of Health Jens Spahn. The CDU politician finally wants to push ahead with digitization in the healthcare system.
And the e-file, which has been available since the beginning of 2021, is a central element that is intended to make things easier for patients and doctors. Medical findings, for example, can be saved and shared there.
For Spahn, the advantages for the more than 73 million insured are in the foreground. He therefore has little understanding for the procedure of the Federal Data Protection Commissioner Ulrich Kelber, who has been arguing publicly with the health insurance companies about additional data protection functions in the digital patient file for months. Kelber is responsible for a total of 63 statutory health insurance companies with 44.5 million insured persons.
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“This conflict shows the whole problem around data protection in Germany,” said Spahn to the Handelsblatt. Instead of “looking forward to the progress of the e-file and improving it over the years, it is better to try to prevent every small step forward”. Spahn even sees data protection as a major hurdle for digitization. “The Federal Commissioner for Data Protection has not made digitization any easier.”
In the near future, doctors should have everything at a glance.
(Photo: dpa)
Kelber doesn’t let the criticism sit on him. “Jens Spahn’s claim that it was up to my authority that new digital applications in the health sector were not implemented or not implemented on schedule is simply untrue,” he told Handelsblatt. Spahn himself says, for example, that the EPR has been in law since 2004 and should have been there long ago. The agreed requirements have also been fixed for years. “Every user must be able to decide for himself who he makes which document accessible.” This corresponds to the General Data Protection Regulation (GDPR) and the national law on electronic records.
Kassen threatens to stop the e-file
Because there are obviously deficiencies here, Kelber recently instructed four large statutory health insurance companies to add additional data protection functions to the new electronic patient record. Without these extensions, the new instrument would violate the GDPR.
An initially “stripped down” version of the access rights has been criticized. In the first year, patients can only share all or no data with doctors. Finer access depending on the doctor and only for individual documents will not come until the beginning of 2022 – but only for patients who use the ePA via smartphone or tablet. Kelber sees this as a violation of European law.
He now expects the health insurers to enable document-specific approval by the end of the year, even for insured persons without a smartphone or tablet. If that does not happen, Kelber could forbid the health insurers to offer the EPR.
The dispute could lead to legal action. Experts assume that virtually all health insurance companies will sue Kelber’s instructions.
Kelber sees himself as a “great advocate of digitization”
Spahn admits that the partial blocking of patient data for individual doctors is not technically possible at the beginning. However, he also says: “In my opinion, leading a protracted legal dispute on the part of the data protection officer is completely past the patient’s everyday life.”
The use of the electronic patient file is voluntary, the release to a doctor is voluntary and nobody has to share their data, the minister emphasized. “But the patients have the right to have their data transferred to their EPR.”
Kelber can do little with the portrayal of Spahn. “I think people who point out that the use of this central instrument of health care is voluntarily to restrict their self-determination are cynical,” said the data protection officer.
Instead of paper receipts, pharmacies should soon also accept the digital form of the prescription on the mobile phone.
(Photo: dpa)
In this context, he is just as critical of any legal disputes with the cash registers about the e-files. “The fact that the health insurances are now going to court at the expense of the contributions of their insured persons in order not to have to create the same rights for all insured persons completes the absurd scenario,” he said.
Kelber also thinks it absurd that he is repeatedly portrayed as a blocker of digitization – also by Spahn. As a computer scientist and privacy advocate, he is a “great advocate of digitization,” he said. “Most of the time, clever digital solutions are even superior to analog processes in data protection matters.”
More: “For some doctors, digitization is simply too exhausting” – Jens Spahn takes stock