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20.04.2025: electronic patient record in germany

Source: https://www.bfdi.bund.de/DE/Buerger/Inhalte/GesundheitSoziales/eHealth/elektronischePatientenakte.html

The electronic patient record (ePA) is a digital collection of medical data such as doctor’s reports, X-rays, vaccinations, or medication plans. Insured individuals in Germany can decide for themselves which information is stored and which doctors are allowed to access it. The goal is better, more connected healthcare and greater transparency.

πŸ§‘β€πŸ’» As an IT specialist, I have personally opted out of having a digital patient record (ePA) created for myself.
This article reflects my subjective opinion and is based on my experience in the IT field. While the ePA offers potential benefits, such as improved networking in healthcare, I consider the associated risks and challenges to be too great.

πŸ” 1. Data Protection and Security:
The ePA stores highly sensitive health data. Although recently discovered security vulnerabilities highlighted by the Chaos Computer Club (CCC) have been addressed, it still cannot be ruled out that hackers could gain access again through future security gaps.
Furthermore, the health data is not stored on the insurance card itself but on centralized servers located in Germany. Even though the data is encrypted, it is potentially accessible 24/7, since it is stored permanently online.
This central storage significantly increases the risk of hacker attacks and data leaks.

πŸ–₯️ 2. Integration, Compatibility, and User Acceptance:
Each medical practice must keep its IT systems β€” including operating systems β€” consistently up to date to ensure that they do not become the weakest link in the encryption chain and vulnerable to cyberattacks.
Moreover, the widespread implementation of the ePA requires extensive training for doctors, healthcare staff, and patients. Especially older individuals or those unfamiliar with digital systems often struggle to adapt, leading to frustration and resistance.

πŸ“‚ 3. Limitation of Patient Rights:
The ePA stores patient data centrally. Although this is intended to make access easier, it also means patients lose control over where and how their data is stored and used.
They can no longer decide who has access or keep track of how the data is being utilized. This increases the risk of unauthorized access and reduces transparency for the patient.

πŸ‘οΈ 4. Risk of Digital Surveillance:
There is a concern that health data might be used not only for medical purposes but for other interests as well.
In the future, this information could potentially be used by insurers, employers, or other institutions to monitor patient behavior. This kind of digital surveillance could endanger privacy and erode trust in the healthcare system.

πŸ“Œ Conclusion:
Digitization in healthcare can offer many benefits, but all technical, legal, and security-related questions must be thoroughly resolved. Only then can the trust of both patients and professionals be ensured. Digitization must be implemented in a secure, privacy-compliant, and transparent way in order to protect patients and strengthen confidence in the system.

Everyone should be free to decide for themselves whether they want a digital patient record.
As for me, I have chosen to opt out β€” because the risks regarding data protection, security, and potential digital surveillance outweigh the possible benefits in my view.

Sample objections can be found here:

https://widerspruch-epa.de/
https://widerspruch-epa.de/wp-content/uploads/2025/01/widerspruch_EPA.pdf