How the Federal Council wants to advance the e-patient dossier
Published: Friday, Sep 27th 2024, 14:40
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The introduction of electronic patient files is stalling. So far, only a few digital dossiers have been opened. The Federal Council is therefore planning a major reform, which will soon be decided on by Parliament. The most important questions and answers at a glance:
WHAT IS THE ELECTRONIC PATIENT RECORD?
The electronic patient record (EPR) is an electronic filing system for documents and data containing important information about patients' health. Patients can open their EPR with an EPR provider, known as a master organization. There are currently eight of these, five regional and three national organizations. The cantons are required to ensure the operation of at least one parent organization on their territory. Use of the EPR is free of charge for the public. Healthcare professionals use the information in the EPR as part of their medical consultations and continually supplement it with up-to-date information on treatments.
WHO CURRENTLY HAS AN ELECTRONIC PATIENT RECORD?
According to figures from the Central Compensation Office (CCO), around 72,000 SPDs have been opened since 2022. Western Switzerland and the German-speaking cantons of Aargau, Zurich, Zug, Basel-Stadt and Bern therefore have the highest number of dossiers in relation to their resident populations. Across Switzerland, only 0.8 percent of the population currently has an electronic patient record.
WHO HAS TO JOIN THE DOSSIER TODAY?
Hospitals, nursing homes and newly licensed medical practices are legally obliged to join the EPR. It is up to the cantons to enforce this obligation. There is currently no obligation for existing medical practices, pharmacies and Spitex services. According to the Federal Office of Public Health (FOPH), the number of healthcare facilities connected to the EPR has been steadily increasing since October 2023. As of August 2024, 82% of hospitals, 57% of nursing homes, 18% of doctors' surgeries, 10% of pharmacies and 3% of Spitex services are connected.
WHY DOES THE FEDERAL COUNCIL WANT TO PUSH THE EPD?
The EPR will strengthen the quality of medical treatment, improve treatment processes, increase patient safety, increase the efficiency of the healthcare system and promote patients' health literacy. According to the Federal Council. Not least the coronavirus pandemic has shown that too much in the healthcare system is still done in analog form. Not only do many medical practices still work with paper, but different tools are also in use.
HOW DOES THE FEDERAL COUNCIL INTEND TO HELP THE E-DOSSIER ACHIEVE A BREAKTHROUGH?
With amendments to the law on the electronic patient record, the Federal Council wants to ensure that not only inpatient hospitals and care facilities work with the electronic record, but also outpatient healthcare professionals such as doctors, pharmacists, physiotherapists and chiropractors. "In future, the EPR is to be used on a mandatory basis along the entire treatment chain," writes the state government. It also plans to ensure that all those with basic insurance will receive an electronic dossier free of charge if they want one. Anyone who does not want a dossier can object to the EPR being opened. This solution is called "opting out". The state E-ID is to be used to access the EPR. The Federal Council submitted this major revision of the law for consultation in summer 2023.
WHAT WERE THE REACTIONS TO THIS?
According to the Federal Council, the evaluation of the comments showed that the revision met with broad approval. However, a majority of the cantons and political parties criticized the existing decentralized structure and would like to see greater centralization. The Swiss Federal Audit Office (SFAO) also expressed the same opinion. The centralization wishes differed greatly in detail and ranged from a clarification of responsibilities to a complete restart or nationalization.
WHAT DOES THE FEDERAL COUNCIL PROPOSE?
In future, the eight parent communities will no longer have to rely on their own technical infrastructure. The federal government is to provide a standardized platform. A call for tenders will clarify which system will be used. The operating costs for the use of the technical platform are to be passed on to the parent communities as usage fees.
HOW DOES THE FEDERAL COUNCIL JUSTIFY THE NEW PROPOSAL?
With the technical centralization, the division of tasks between the Confederation, the cantons and the EPR actors will be more clearly defined, writes the Federal Council. It is also convinced that this will improve the seamless exchange of data between the stakeholders. This will make the further development of the EPR easier and faster. According to the Federal Council, centralization should also be financially advantageous in the medium to long term.
WHAT HAPPENS NOW?
The Federal Council has instructed the Federal Department of Home Affairs FDHA to include the centralization of the technical infrastructure in the major reform of the EPR. The dispatch is to be submitted to Parliament in spring 2025. It will probably be several years before the reform comes into force.
WHAT HAPPENS IN THE MEANTIME?
In spring 2024, Parliament approved transitional funding for the dissemination and promotion of the EPD. It will enter into force on October 1, 2024. The Confederation can thus provide financial support to EPR providers until the measures of the comprehensive revision have been adopted and implemented.
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