"I find PDF files there like on a digital clothesline, even with meaningless file names, and there is no search function."

In a survey by the Federal Commissioner for Data Protection and Freedom of Information, eleven percent of participants said that the app was too complicated and cumbersome for them, that it did not work or that they did not have a suitable smartphone. The largest proportion of those interviewed resolved the topic for themselves by saying that they had no need because the cases of illness were too rare (42 percent). Others had not yet had time for it (26 percent) or lacked information and knowledge (nine percent).

It is currently not clear what the file should be first: patient- or practitioner-managed, collection of copies of findings, communication channel in the healthcare system, emergency file or data source for research. All these aspects are still mixed. In addition, the existing solution is not technically reliable. The alliance points out another difficulty: Is all the existing and required data actually already in the file? And couldn't medical confidentiality be violated if highly sensitive patient data ends up being viewed by too many people?

Finally, the insured persons were deprived of the opportunity to decide who should have access to it, depending on the document. According to Gematik, which is supposed to organize digitalization in the health sector on a legal basis, the “cure” could be that individual documents can be completely deleted in the future. But that would bring a new dilemma: those treating the patient would never know whether they were seeing the complete data.

But Gebedi has ideas on how weak points could be overcome. She wants a modern link to existing decentralized medical documentation. This would make findings and treatment results available in real time if patients consent. Emergency files with vital information would also be possible, for example in the event of unresponsive patients. In 95 theses, Gebedi also poses questions that urgently need to be clarified in public debate, including the benefits of the ePA for the care of sick people. How can patients' self-determination be maintained? Or how would the area of ​​trust between treating physicians and patients, including the protection of confidentiality, be maintained?

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