Hospitals are pushing ahead with the implementation of the electronic patient record (ePA) – despite difficult conditions.
03.09.2025 14:38
Almost all hospitals in Germany (98 percent) have begun organizational preparations for the introduction of the electronic patient record (ePA), according to a recent flash survey by the German Hospital Institute (DKI).
At the same time, according to the survey, only slightly more than half of the hospitals (56 percent) currently have the necessary update to their hospital information system (HIS). The reason for this: During the pilot phase from January to April 2025, the industry initially focused on a few pilot facilities. Since the start of the rollout phase in May 2025, the required updates have been gradually rolled out to more hospitals.
The rationale behind this approach is, among other things, that the introduction of the electronic patient record (ePA) in the hospitals of the pilot regions has proven to be very complex. Technical implementation is labor-intensive and ultimately cannot be carried out across the board at the push of a button. Rather, the systems must be adapted to the respective, often highly complex, IT landscape of each hospital. This includes extensive configuration work, the establishment of additional security measures to protect against malware, the implementation of missing functions, and the correction of technical errors.
This is also reflected in the survey results: According to the results, two-thirds of hospitals (66 percent) have begun implementation, but only about 20 percent of the surveyed hospitals have fully completed this process and are about to begin internal piloting. Just under 60 percent of the institutions currently expect that the electronic patient record (ePA) will only be available hospital-wide in the first quarter (31 percent) or from the second quarter (27 percent) of 2026. Approximately 7 percent of respondents indicated that they have already started piloting the ePA in their care processes.
„The results show that hospitals clearly recognize the advantages of the electronic patient record (ePA) and are actively driving its implementation. However, even in the pilot phase, it became clear that introducing the ePA in hospitals is not as simple as a software update. This telematics infrastructure (TI) application also ultimately demonstrates that the requirements in a hospital are not comparable to those in smaller facilities such as doctors' offices, and this was not adequately considered beforehand,“ explains Dr. Gerald Gaß, Chairman of the Board of the German Hospital Federation (DKG).
The intense time pressure, which left manufacturers with no adequate testing opportunities, ultimately led to many updates being released late and requiring adjustments in practice. Furthermore, the specific characteristics of hospital processes—for example, regarding the implementation of legally mandated opt-out procedures—were not sufficiently considered initially. Solutions for this are now being developed and tested under real-world conditions. Adding to the difficulties is the considerable strain on many hospitals caused by the parallel digitization projects under the Hospital Future Act (KHZG).
Despite these challenges, the German Hospital Federation (DKG) views the development positively: „Even if nationwide connectivity won't be possible by October 1st, we are optimistic about the further progress. The introduction of the electronic patient record (ePA) is an important project that is already showing initial benefits for healthcare – particularly through improved availability of medication data. At the same time, it's clear that such a large-scale IT project takes time. We must do everything we can to ensure that the implementation phase runs as smoothly as possible so as not to jeopardize patients' trust in this important undertaking,“ said Gaß.
Click here to go to Survey by the German Hospital Institute (DKI)