Federal Council sets course for the further development of the electronic patient dossier

With a comprehensive revision of the Federal Act on the Electronic Patient Record (EPDG), the Federal Council wants to further develop the EPR so that it can develop its full potential. In order to meet the demand widely expressed in the consultation procedure and to increase the use of the EPR, the technical infrastructure of the EPR is to be provided centrally by the Confederation. The Federal Council took this decision at its meeting on September 27, 2024. This adjustment will be included in the dispatch on the revision of the EPDG.

The Federal Act on the Electronic Patient Record (EPDG) is being revised in two stages. In spring 2024, Parliament approved transitional funding for the dissemination and promotion of the EPR. It will enter into force on October 1, 2024. The federal government can thus provide financial support to EPR providers until the measures of the comprehensive revision have been adopted and implemented.

To further improve the electronic patient record, the Federal Council is also proposing a comprehensive revision of the EPDG. The Federal Council submitted this revision of the law for consultation in summer 2023. The evaluation of the comments showed that the revision met with broad approval. The roles of the Confederation and the cantons are to be more clearly defined and the financing of the EPR is to be secured. In future, the EPR is also to be used on a mandatory basis along the entire treatment chain. In addition to hospitals and care facilities, outpatient service providers such as doctors, pharmacists, physiotherapists and chiropractors will now also be obliged to use the EPR and enter all treatment-related data. All persons who live in Switzerland and have compulsory health or military insurance now receive an EPR automatically and free of charge. Anyone who does not want a dossier can object to the opening of the EPR ("opt-out"). The state E-ID is to be used to access the EPR.

Demand for greater centralization

Feedback from the consultation process has also shown that a majority criticizes the existing decentralized structure adopted when the EPDG was passed and would like to see greater centralization. This includes the cantons and most political parties in particular. The wishes for centralization varied greatly in detail and ranged from a clarification of responsibilities to a complete restart or nationalization. The Federal Department of Home Affairs (FDHA) and the Federal Office of Public Health (FOPH) have therefore examined centralization and analysed possible options.

Technical EPD infrastructure as a federal task

Based on these clarifications, the Federal Council decided to include centralization of the technical EPR infrastructure in the comprehensive revision. At present, each of the eight EPR providers, the so-called parent communities and communities, has its own technical infrastructure. This technical infrastructure is now to be made available as a standardized platform by the federal government.

The Confederation will procure the central technical infrastructure by means of a call for tenders. The operating costs for the use of the technical platform will be passed on to the core communities as usage fees.

Clear division of tasks between the Confederation, cantons and parent communities

With technical centralization, the division of tasks between the Confederation, the cantons and the EPR stakeholders will also be more clearly defined: The Confederation is responsible for procuring the central technical infrastructure and for its further development. The cantons are to ensure the operation of at least one core community on their territory. The core communities will continue to offer the EPR in their area of responsibility. They advise and support patients and service providers in connecting to the EPR.

The Federal Council is convinced that centralizing the technical infrastructure reduces the complexity of the system and the number of interfaces. This improves the seamless exchange of data (interoperability) between the players. This will make the further development of the EPR easier and faster. In the medium to long term, centralization should also be financially advantageous.

The Federal Council has instructed the FDHA to include the centralization of the technical infrastructure for the EPR in the revision of the law. The dispatch is to be submitted to Parliament in spring 2025.

Source: bag.admin.ch