EHR and PHR: digital records in the German healthcare system

EHRs, i.e. electronic health records (German: Patientenakte, ePA), are hailed as the key to increasing the quality of care. The Appointment Service and Supply Act (TSVG), adopted on 14th March 2019, requires the German statutory health insurance funds to provide policyholders with electronic health records from 1st January 2021 onwards. But what are EHRs and what makes them different from the personal health records (PHRs; German: elektronische Gesundheitsakte, eGA) that various companies have already placed on the market?

The German Social Security Code (§ 291a SGB V) requests that "data on findings, diagnoses, therapeutic measures, treatment reports and vaccinations for cross-case and multi-patient documentation about the patient" be stored in electronic health records (EHR). The technical requirements for EHRs were specified by a company called gematik Gesellschaft für Telematikwendungen der Gesundheitskarte mbH (a company for telematics applications for the electronic health card) in December 2018. It defined various components such as the "EHR system" (the backend), the "EHR module connectors", the "EHR front end for policyholders" and the "primary systems" (for healthcare service providers). Product data sheets list binding requirements for individual components of EHRs and form the basis for approval by gematik. 1,2