What was meant to be a milestone for Germany’s digital healthcare system quickly turned into a rocky debut. As of October 1, 2025, all medical practices nationwide are required to upload patient documents into the new electronic patient record (ePA). But within hours of the official start, the system suffered a massive disruption, leaving both doctors and patients struggling.
Technical breakdown across major health insurers
According to information provided by the state-owned developer Gematik, the issue originated with IT service provider IBM Germany, which powers the infrastructure. The outage affected policyholders of several large statutory health insurers, including AOK, Barmer, Techniker Krankenkasse (TK), VIACTIV, HEK, Knappschaft and Continentale.
Medical practices, dental offices, hospitals and even pharmacies reported significant delays, error messages, and difficulties in processing electronic records.
Why the ePA matters — and why it frustrates
The ePA is designed to streamline Germany’s healthcare system by centralizing patient information in a digital file accessible to medical professionals and patients through apps provided by health insurers. In practice, however, the system is still rudimentary. Family doctors have criticized the platform for functioning largely as a “PDF archive” rather than a fully digital, searchable health database. Features like a digital vaccination certificate or integrated keyword search are still missing.
Doctors warn of financial penalties ahead
Since April, medical institutions have been gradually switching to the new record system. Gematik reported that over 98,000 facilities had already connected in the week leading up to the nationwide rollout. Practices that refuse to implement the system face potential financial penalties starting in 2026, according to the national association of general practitioners.
Patients technically have the right to opt out, but if they do not actively object, their medical records will be automatically uploaded.
Patients slow to adopt
Despite the mandatory rollout, patient participation has remained low. Registration and access are complicated, requiring multiple steps and technical know-how. Critics argue that the digital service is far from user-friendly, leaving many people unable or unwilling to use their new electronic health record.
Outlook: trust still to be built
While policymakers highlight the potential of the ePA to improve efficiency and continuity of care, the bumpy start has raised fresh doubts. Until the system becomes more stable, secure, and genuinely useful for both doctors and patients, the promise of a truly digital healthcare system in Germany remains unfulfilled.
