Nearly All Insured Individuals in Germany Have Electronic Health Records

As of February 7, 2025, nearly all individuals covered by statutory health insurance in Germany now possess an electronic health record (EHR). This development has been welcomed by health insurers, as it marks compliance with regulatory deadlines.

According to recent statistics, a total of 69,895,552 electronic health records have been created for insured individuals, indicating that the process is nearing completion just a week before the deadline. Major health insurance providers, including their technology partners IBM and RISE, have successfully established these records.

The AOK Federal Association reported that all clients who did not object to the implementation of the 'EHR for all' initiative have been assigned their personal records. Notably, the eleven AOK entities have collectively registered approximately 26.4 million EHRs, achieving this milestone ahead of the stipulated timeline, as expressed by Dr. Carola Reimann, chairwoman of the AOK.

In the three pilot regions--Hamburg, Franken, and North Rhine-Westphalia--records were fully set up by the end of January. A spokesperson from Bitmarck confirmed that the establishment of EHRs for all insured individuals in these areas was completed earlier this week, with around 23 million records created in this phase. The AOK Federal Association also noted a current objection rate of just 3.8 percent from insured individuals.

Moving forward, the focus will shift to securely connecting physician offices, hospitals, and other healthcare providers, while also training them in the practical use of EHRs. The AOK estimates that a nationwide rollout will commence in April. However, concerns remain regarding potential security vulnerabilities, which must be addressed before the full implementation, as stated by Health Minister Karl Lauterbach.

Currently, healthcare professionals in the pilot regions of Franken, Hamburg, Westfalen-Lippe, and North Rhine are included on a 'whitelist' and can theoretically access the electronic health records of all statutory insured individuals. In the future, access will only be granted in specific treatment contexts, ensuring patient privacy and security.

For insured individuals seeking to access their electronic health records, they must utilize an application, a PIN from their electronic ID card or health insurance card, and a card reader, which can also be facilitated by an NFC-enabled smartphone. Additionally, individuals must create a Health ID if they do not already have one. Approximately 2.2 million insured individuals have successfully created their Health IDs, which are essential for accessing electronic health records.

The Gematik organization provided insights into the evolving landscape of telematics infrastructure applications, noting that fluctuations in the number of created Health IDs stem from provider data transmission issues. These challenges are attributed to provider transitions linked to the launch of the 'EHR for all' program, as well as a provider switch by the AOK in January 2025.

Moreover, both healthcare providers and insured individuals are testing the new EHR system, including its seemingly unlimited cloud storage capabilities. Although each file is limited to a maximum size of 25 MB, users are reportedly able to upload an unlimited number of documents. One individual claimed to have stored an entire terabyte of data in their electronic health record. However, this led to multiple communications from their health insurer regarding exceeding storage limits, which were subsequently adjusted.