Parliament allocates millions for breakthrough in e-patient dossier
Published: Tuesday, Feb 27th 2024, 10:50
Updated At: Tuesday, Feb 27th 2024, 10:50
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Parliament wants to provide federal funding for the widespread introduction of electronic patient records (EPR). As the second chamber, the Council of States has agreed to transitional funding despite widespread criticism of the project. There are differences regarding the modalities.
On Tuesday, the small chamber approved a commitment credit of CHF 30 million for a maximum period of five years by 37 votes to 2 with 2 abstentions. The bill is expected to come into force at the end of 2024. The Confederation will then be able to provide a maximum amount of CHF 30 per EPD opened.
This financial aid is tied to a contribution of at least the same amount from the cantons. In order to create an incentive for the parent communities to rapidly disseminate the EPR, the federal government's support contribution is based on the number of electronic patient files opened. The parent communities can apply for this financial aid retrospectively for all EPRs opened since their launch.
Major reform takes time
The associated partial revision of the Federal Act on the Electronic Patient Record also received a clear majority in the Council of States. The Council of States largely followed the Federal Council's draft and rejected more far-reaching resolutions by the National Council in order not to overload the bill.
The tenor of the debate is that the content of the future design of the EPR must be addressed as part of a comprehensive reform. The Federal Council has announced such a reform for summer 2024. Among other things, the distribution of tasks between the Confederation and the cantons and the financing of the EPR should be clarified.
With amendments to the law on the electronic patient file, the Federal Council also wants to ensure that not only inpatient hospitals and care facilities work with the electronic file, but also outpatient healthcare professionals. It also plans to ensure that in future all those with basic health insurance will receive an electronic dossier free of charge if they want one.
According to the Federal Council, this comprehensive revision of the law will take several years. However, in order to promote the dissemination of the EPR in advance, the Federal Council is providing transitional funding for the core communities, i.e. the EPR providers, in the separate bill.
Connection obligation not (yet) an issue
First of all, however, the e-patient dossier must be driven forward with lean transitional funding, said Commission President Damian Müller (FDP/LU) in the Council of States. "When it comes to digitalization in the healthcare sector, Switzerland is at best at the back of the pack."
Unlike the National Council, the Council of States refused to make any substantive changes to the project before the comprehensive reform. For example, the small chamber does not want to force the cantons to support all parent communities equally. The majority argued that this would not sufficiently protect the investments already made by various cantons.
The Council of States also rejected the National Council's decision to make it mandatory for all service providers to connect. Although such a requirement is central to the functioning of the EPR, it must be addressed as part of the comprehensive revision of the e-patient dossier.
"It needs pressure"
A minority took a different view. "If we really want to make progress, the EPD must become mandatory," said Brigitte Häberli-Koller (center/TG). Peter Hegglin (center/ZG) also pleaded for "clear and binding mandates". The spread of the EPD was sobering. "Pressure is needed."
The health directors of Eastern Switzerland even want to abandon the project, as various members of the Council of States noted. "But it's too late to stop the moving train," said Hannes Germann (SVP/SH). The design flaws would have to be addressed later.
With the EPD, all important health information can be clearly stored in one place and accessed easily and securely at any time. However, implementation is still lagging behind. So far, only a few electronic dossiers have been opened.
The bill goes back to the National Council.
©Keystone/SDA
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