Since 2020, the electronic patient records (synonymous to electronic health record, EHR) have been gradually introduced in Switzerland following the adoption of the Federal Act on Electronic Patient Records in 2017. Until spring 2020, hospitals, rehabilitation facilities, psychiatric hospitals and all new ambulatory physician practices were required to integrate relevant data into EHRs while nursing homes could gradually integrate them up until 2022. For patients, pharmacies and ambulatory providers, including medical practices, midwife practices and home care services, participation was so far voluntary. In French-speaking regions of Switzerland, 83% of the population opened an EH while in the German-speaking part and in Ticino only 14% and 3%, respectively, opened one.
How does the Swiss EHR work?
Since 2022, people living in Switzerland have been able to open EHRs. EHR contain treatment-relevant documents and data such as medication lists, case reports or hospital discharge summaries. The data standardization provided by the EHR, particularly the structured exchange formats, allow providers to share information seamlessly. Patients can also upload documents to their EHR such as their living will, organ donor card or earlier medical results.
What are the proposed changes of the EHR Act?
In 2023, the Federal Council initiated a consultation process of the Federal Act on the Electronic Health Record to promote its use and dissemination, which foresees the following measures:
- To extend the requirement to use EHR to all providers. The use of existing EHR and registration with an EHR provider will be mandatory for all health care providers while it only remains voluntary for all healthcare professionals who are not classified as service providers under the Health Insurance Act.
- With the intention to make the EHR a pillar of the healthcare system, EHRs will be created automatically and provided free of charge for all residents in Switzerland with mandatory or military health insurance. Each individual has the right to opt out and can decide which healthcare professionals have access to the record.
- The division of tasks and competencies between the federal government and the cantons. The financing of the ongoing development of EHR will be ensured by the federal level, while the financing of EHR providers will fall under the responsibility of the cantons. The latter would also need to ensure that at least one EHR provider is operating within their canton.
- As medical data stored in the EHR is of interest to researchers, an option for EHR holders to make their data available for research will also be included in the revised Act. Patients can also specifically exclude certain data that they do not want available for research.