Warken: By 2030, 20 Million People Should Use Electronic Health Records - Germany's Digital Health Push Struggles Despite 75 Million Electronic Patient Records

Germany's electronic patient record (ePA) has reached a critical stage in its rollout, with Health Minister Nina Warken pushing for wider adoption. Although 75 million records have been created, active usage remains low—just 4 million people currently use the system. Warken now aims to increase this number to 20 million by 2030 while addressing ongoing technical and practical challenges.

The ePA was launched nationwide in April 2021, allowing patients to opt out of having an electronic record. Since October 1, 2025, all German doctors have been legally required to offer the system to patients covered by statutory health insurance. From January 1, 2026, failure to do so could result in penalties. Yet, despite these measures, engagement has stayed minimal. For example, at Techniker Krankenkasse (TK), only 850,000 of 11.5 million created records are actively used. Barmer reports 440,000 active users out of 8 million, while AOK sees just 365,000 out of 26 million. Opt-out rates, however, remain low, between 3.8% and 7%.

Technical problems have also hindered progress. Some records, such as those at AOK Bayern, were accidentally deleted. Integration into daily medical practice has been slow, even after pilot phases in regions like Hamburg, Franken, and North Rhine-Westphalia. Despite these setbacks, the ePA is set to become the core of Germany's upcoming primary care physician system, linking with other digital tools.

Warken's strategy includes two key legislative moves. By late March, the Health Ministry will present a draft bill on 'digital healthcare and the health data space.' A second proposal, focusing on the primary care physician system, is planned for summer. Both aim to improve outpatient care and expand the use of digital health data, including AI integration. The minister has stressed the need to make the ePA attractive to all insured individuals, not just those with complex medical histories.

The push for 20 million active ePA users by 2030 will depend on overcoming current barriers. With mandatory doctor participation now in effect and new laws on the horizon, the system's success hinges on resolving technical issues and increasing patient engagement. The next phase of Germany's healthcare digitalisation will also focus on integrating AI and improving data utilisation.