Electronic Patient Dossier “EPD”

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It is reassuring to know that the Electronic Patient Dossier (EPD) of the Unified Health Insurance Fund (UHI) is already well populated from the outset with the data of the previous KVG health insurers (see the third-to-last line of the initiative text concerning the UHI). 1054-01x 1054x

At the end of 2024, the Federal Council and Parliament decided to continue the existing approximately 130,000 patient dossiers under the new designation “E-GD”. This decision appears to be an obvious wrong path. These dossiers were already voluntary – and it will also be possible to opt out again from the new “e-GD”, which will be automatically assigned to every person in the future. In our view, this is precisely where the fundamental problem lies. For example, where should an emergency responder reliably check a blood group if no complete dossier is guaranteed to exist? The healthcare system needs a comprehensive EPD in order to have a complete overview of a patient’s previous treatments at all times – also to prevent unnecessary duplicate services.

This is particularly important in the case of free choice of doctor. Many people suffer from diseases that are difficult to detect or complex. In the hope of relief, they consult one doctor after another. Each one starts their investigations again from the beginning, which leads to considerable unnecessary costs. With a complete EPD, the newly treating doctor already has the necessary overview before treatment even begins. Thanks to the existing reports, images, and findings, they can build on the available knowledge and provide more targeted help.

Some people understandably fear that they could suffer professional or insurance-related disadvantages if their medical history becomes known. The EPD must strictly exclude such risks. Regarding access authorizations, progress has already been made in the right direction. However, it is also essential that every patient immediately receives a personal notification about every single query and every new entry, for example via SMS, which only they themselves can read. If all parties involved know that every access is transparent and traceable, a large part of these fears will disappear.

The decisive advantage of the Electronic Patient Dossier of the Unified Health Insurance Fund (UHI) lies in the fact that all service providers – including private clinics and private doctors – are required to bill their services via the UHI’s MEDIFACT system, including in connection with privately insured patients. Only after the patient has checked and confirmed the content of the invoice is it forwarded for reimbursement to the competent UHI office or to a supplementary insurance.

Every person receives an AHV number at birth or upon immigration to Switzerland. This also forms the central key element of the UHI. Through the standardized online billing of all service providers via MEDIFACT, all billing data – including diagnostic imaging information – automatically flows into the patient dossier nationwide. This eliminates cantonal barriers and information gaps. For patients, this takes place without additional costs. In reality, however, it is a highly complex infrastructure that must be continuously operated and maintained with considerable technical effort.

All services billed by service providers are visible to authorized persons with the corresponding authorization. At the same time, every access is recorded without gaps. Every patient is informed in real time about who has accessed their data.

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