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Transitional funding for e-patient dossier clears first hurdle

Parliament wants to finance the distribution of the electronic patient dossier with CHF 30 million on a transitional basis. The National Council has resolved the final differences in the corresponding bill. However, it is uncertain whether the bill will clear the final hurdle on Friday.

With 93 votes to 92 and 7 abstentions, the large chamber only approved the proposal of the unification conference by a wafer-thin margin on Wednesday evening. The SP, Center Party and GLP voted almost unanimously in favour, while the SVP and FDP voted against by a large majority. The Greens were divided and abstained in part.

The Council of States' version had previously prevailed in the committee with members of the preliminary consultative commissions of both Councils. In the previous three rounds of consultations, the Council of States had always argued in favor of lean transitional legislation. It pointed out that the major issues would have to be discussed as part of the comprehensive reform of the legislation on the e-patient dossier. The Federal Council intends to present this bill by the end of the year.

The National Council originally wanted to enshrine various conditions in law during the transitional period, such as an obligation for outpatient service providers to join the scheme. In the end, however, it decided against this.

Struggle for modalities

If the bill clears the final hurdle in the final vote on Friday, the federal government will be able to temporarily finance the distribution of the electronic patient dossier with CHF 30 million. The result is again likely to be close.

If the Council passes the bill, the providers of electronic patient dossiers - the so-called master communities - are expected to be compensated with CHF 30 per opened dossier from next year. This financial aid is tied to a contribution of at least the same amount by the cantons.

The transitional funding is intended to promote the currently insufficient dissemination and use of the e-patient dossier in the critical phase until the planned comprehensive revision comes into force. This was also undisputed in Parliament. However, after three rounds of deliberation, there were differences between the Councils regarding the modalities.

The National Council originally wanted to attach various conditions to the credit commitment. For example, all outpatient service providers under the age of sixty - such as GPs - would have had to offer an electronic patient file within three years. Anyone who failed to do so would have faced sanctions.

The Council of States had pleaded for pragmatism. Despite justified criticism of the project, the tenor was that, for the time being, it was a matter of securing temporary funding without establishing additional conditions. Complicating the transitional legislation would not be expedient.

Controversial benefits of the e-patient dossier

Health Minister Elisabeth Baume-Schneider warned the National Council that the bill would fail. "There would then be a practical standstill until the comprehensive reform comes into force, which will be in 2028 at the earliest." Confidence in the electronic patient file would continue to dwindle as a result.

With the electronic patient record, 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 around 40,000 electronic dossiers have been opened.

"Things can't go on as they are today," said Sarah Wyss (SP/BS) on behalf of the responsible National Council committee. A good, holistic reform is needed. According to Wyss, saying no to transitional funding would send the "wrong signal".

Representatives of the SVP, FDP and Greens took a different view. "The bill is simply a mess," said Thomas de Courten (SVP/BL). The e-patient dossier was "a patient in intensive care who should be kept alive with a cash injection".

According to Andri Silberschmidt (FDP/ZH), the electronic patient file is of no benefit to anyone today. "We shouldn't have to help finance this frustration." We need the courage to make a fresh start. The Greens also spoke of an "investment in a non-functioning product".


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