Electronic Health Record (ePA) Now Automatic for All Statutory Insurees; Opt-Out Available
Germany's electronic patient record has shifted from voluntary to automatic enrollment for all 73 million public insurance holders as of January 2025. From October 1, 2025, doctors are mandated to upload medical data to ePA; patients retain control over access and can opt out entirely.
Germany's push to digitize healthcare has crossed a major milestone: the electronic health record (ePA, or elektronische Patientenakte) is now automatically created for every person with statutory insurance, marking a shift from opt-in to opt-out enrollment.
Automatic Enrollment Begins
From January 2025, everyone in Germany with statutory health insurance will have an electronic patient record ("ePA for all"). An ePA will be created automatically for you, unless you decide to opt out. However, use of the ePA remains optional. Since April 29, 2025, the electronic patient file (ePA) is available to all 73 million people with statutory health insurance in Germany.
What Data Is Stored
The electronic patient record can be used to store personal information about health in digital format in a single place. This includes medical findings and doctors' letters, as well as reports on operations and information about recommended treatments. As of October 1, 2025, it will be mandatory for office-based physicians and hospital doctors in Germany to upload medical health data into existing electronic patient records (ePAs).
Data Control and Security
It is no longer necessary for patients to individually approve every access to their data. It is possible to deny specific healthcare facilities access to your ePA via the ePA app or the Ombudsman's offices of the health insurance providers. If you don't want your ePA to be used by any healthcare facility, you can opt out of having an ePA created for you. This can be done via your health insurance provider. The ePA file system is accessed via the telematics infrastructure, a secure, self-contained network. The servers for processing the data are located in Germany, are subject to German and European data protection regulations and are checked on a regular basis. All documents are transmitted in encrypted format end-to-end.
Access and App Setup
Each health insurance company provides an app for this purpose, which policyholders can use to view and manage their data. Insured persons also retain full control via the app: they can see who has access to their data, change access rights or deny access to individual institutions. If necessary, they can also authorize a deputy – such as a family member, a trusted person or a legal representative – to manage the ePA. The use of the ePA remains voluntary and free of charge for all insured people. If you don't want to have an ePA, you can opt out by letting your health insurer know. You can also determine which information is to be saved there and who is allowed to access it.
What this means for you as a foreigner: You do not have to use your ePA, but your Krankenkasse will automatically create one unless you opt out. Download your insurer's ePA app (available from TK, Barmer, DAK, AOK, etc.) to view and control your health data. From October 2025, doctors must upload your medical records—you can restrict access to individual doctors or facilities via the app. If concerned about privacy, contact your health insurer to opt out entirely. English-speakers should note that most insurer apps now include English-language support. The ePA is free and works across all hospitals, practices, and pharmacies using Germany's telematics infrastructure.
Sources
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