Health information systems have the potential to not only improve access to health care but also improve quality, with Electronic Health Records (EHR) playing a pivotal role in the development of digital health services. Germany has introduced two different approaches to increase digital health access for patients, providers, and health insurance companies – the Electronic Health Card Network and the Patient Accessible Electronic Health Records.

Electronic Health Card network

Germany has been developing the national digital health care network since the early 2000s. Even with the project subject to controversies and delays, the system will be operating in 2019. The Electronic Health Card network (elektronische Gesundheitskarte or eGK) will connect all public health stakeholders, including patients, doctors, pharmacists, therapists, health insurance companies, and hospitals. The network will improve efficiency in the delivery of health care services, enhance patient safety, increase access to health care services and reduce medical expenditure.

Unfortunately, the development and implementation of the eGK has not kept pace with technical developments and rising patient expectations to manage their health data through smartphone applications, and connecting medical with further health-related information, for example, activity trackers and other health apps. With patients responsible for their data through the eGK, decisions on the types of data saved and who has access to it should also be managed by the patient.

The telematics infrastructure and data protection requirements will initially affect accessibility to the eGK for patients, requiring some modifications in the future.

Patient Accessible Electronic Health Records

Some German health insurance funds have developed and implemented Patient Accessible Electronic Health Records (PAEHR), with the largest PAEHR (Vivy) employed in mid-September by 13 Statutory Health Insurance (SHI) funds.

These funds have partnered with two private health insurance companies to provide PAEHR, enabling 13.5 million patients to manage their health data via a smartphone application.

The PAEHR provides an opportunity for private health insurers to become more involved in patient healthcare management. When all systems are operational, 70 percent of patients will be able to manage health-related data on their own through smartphone applications.

It is important to note that this is not a stand-alone solution to patient data management and interfaces for data transfer between physicians and labs, along with the integration of data with medical office software is agreed. With rising acceptance by patients and providers, the need for integration in the eGK system will emerge.

Opportunities for the medical device and diagnostic industry

With the increased availability of PAEHR in Germany, the management and communication of health data is changing towards a more patient-related approach. Manufacturers should consider these developments by capturing patient-friendly outcome data, which can be transferred into PAEHR and empower patients’ involvement in decision-making.

In addition, health care services and apps, which utilize the new infrastructure, improve efficiency and increase cost saving, are favored by both SHI and the private health insurance system, providing exciting business opportunities for the industry.

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