Limited Adoption of Electronic Health Records in Germany

Tue 22nd Jul, 2025

Currently, only 1.2 million individuals in Germany are utilizing the electronic patient record (ePA), despite a large number of citizens having access to it. Most insured citizens have set up their ePA for essential health data such as examination results and laboratory values, yet the majority have yet to engage with their records actively.

According to recent data from major health insurance providers, including Techniker Krankenkasse (TK), Allgemeine Ortskrankenkassen (AOK), and Barmer, which collectively manage over 44 million ePAs, only a small fraction--1.2 million--are being actively used. Consumer advocates are urging for the introduction of additional features to enhance the utility of the ePA.

Carola Reimann, the head of the AOK Federal Association, expressed hope that the number of users would increase starting in October when medical professionals will be legally required to utilize the ePA and populate it with relevant documents. Jens Baas, CEO of TK, emphasized that the ePA needs to become a part of everyday life for patients to reach its full potential in healthcare delivery.

Patients have the option to log into their ePA, although it is not mandatory. If they do choose to log in, they can specify which healthcare providers have access to their data and which details should remain confidential. The German Foundation for Patient Protection recommends utilizing the insurance apps to manage this access effectively, as failing to do so could allow any health service provider to view all data.

To initially access the app, patients must complete a one-time identification process. This requires either an electronic ID card with a personal identification number (PIN) or an E-health card, which can be requested from their insurer.

As the largest health insurance provider, TK has created 11 million ePAs, with 750,000 users actively engaging with the platform. Barmer has established 7.8 million ePAs and approximately 250,000 active users. Meanwhile, the eleven regional AOKs have generated 25.8 million ePAs, with only 200,000 insured individuals creating a digital identity for access. The Digital Agency Gematik, which is predominantly state-owned, reports a total of 3.1 million 'health IDs' currently in circulation.

As the ePA continues to evolve, stakeholders within the healthcare system are focused on increasing user engagement and functionality. The upcoming regulatory changes aim to address the barriers to access and utilization, ultimately enhancing patient involvement in their healthcare management.


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