The Federal Act on the Electronic Patient Record (EPRA) regulates the framework conditions for the introduction and large-scale adoption of the electronic patient record. The Act will undergo comprehensive revision over the next few years.
The electronic patient record is an important tool in healthcare. All the information that is of importance for a patient’s treatment can be stored in it, and can be accessed at any time by the patient or any correspondingly authorised healthcare professional.
The electronic patient record should
- enhance the quality of medical treatment
- improve treatment processes
- increase patient safety
- raise the efficiency of the healthcare system and
- promote health literacy among patients.
For the electronic patient record (EPR) to be successfully introduced and broadly adopted, a clear division of corresponding tasks and competencies between the Confederation and the cantons and the appropriate long-term financing still need to be established. This was determined by the Federal Council in a report in August 2021 (Wehrli postulate 18.4328 - available in German, French and Italian). On the basis of this, on 27 April 2022 the Federal Council mandated the Federal Department of Home Affairs (FDHA) to draw up two consultation documents:
- one for a comprehensive revision of the Federal Act on the Electronic Patient Record (EPRA), and
- one for transitional financing until the comprehensive revision enters into force.
In addition, the implementing legislation is to be revised annually, to ensure that the EPR continues to incorporate the latest available technologies and continues to be further developed and refined.
The core communities (available in German, French and Italian) and the cantons are required to continue to actively promote the adoption and use of the electronic patient record through appropriate measures until the EPRA revisions enter into force.
The FOPH and eHealth Suisse will also support the broad adoption of the electronic patient record by means of a wide-ranging national information campaign which will be conducted over a specific period.
Comprehensive revision of the Federal Act on the Electronic Patient Record (EPRA)
The Federal Council sent the proposal for the comprehensive revision of the Federal Act on the Electronic Patient Record (EPRA) into the consultation phase in summer 2023. Under the proposal, the roles of the Confederation and the cantons in the EPR field should be more clearly regulated, and the EPR’s financing should be secured. Various actions should also be taken to improve and further refine the EPR – such as mandatory participation for all health service providers (i.e. the adoption of Motion 19.3955) or the application of the opting-out principle for all EPR openings. The consultation on the proposal for the comprehensive revision of the EPRA extended from 28 June to 19 October 2023. The resulting opinions and report were duly published.
An evaluation of the consultation shows that the proposal was basically favourably received. Doubts were expressed, however, over the decentralised structure, with a majority of participants calling for greater centralisation. In the light of this, the Federal Council resolved at its meeting of 27 September 2024 that the provision of the technical infrastructure required for the EPR should be newly designated as a federal task. This modification will be incorporated into the dispatch on the EPRA revision.
If the EPR’s technical infrastructure is to be operated as a federal task, the Federal Council proposes that:
- The Confederation should procure the central technical infrastructure required via a tender process, and should also be responsible for its further development. To date, the mandate for the communities and core communities has provided for a range of technical EPR infrastructures offered by various platform providers.
- The EPR suppliers to date, i.e. the communities and core communities, can continue to use their EPR access portals, which they will be provided with by the operator of the technical infrastructure commissioned by the Confederation.
- The core communities will remain responsible for supporting EPR owners, i.e. patients and healthcare professionals.
- The core communities will continue to finance the operation of the technical infrastructure.
- The further technical development of the EPR will be newly assumed and financed by the Confederation.
- Every canton should ensure that it has at least one core community operating on its territory.
- Access to the EPR should be via state e-ID.
The corresponding dispatch is expected to be presented to the Parliament in spring 2025.
Further information will be found on the following factsheet:
Transitional financing, consent and access to query services
The Federal Council wishes to further develop and refine the electronic patient record (EPR) to provide patients and healthcare professionals with even more benefits. The comprehensive revisions of existing legislation that this will require will take several years to effect. So to help accelerate the adoption of the EPR in the meantime, the Federal Council has proposed a transitional financing arrangement for EPR providers to the Swiss Parliament under a separate EPRA revision. The proposal was approved by the Parliament in spring 2024. And at its meeting of 28 August 2024 the Federal Council resolved that this transitional financing would come into effect on 1 October 2024.
In accordance with the amendment to the Federal Act on the Electronic Patient Record of 15 March 2024 (transitional financing, consent and access to query services), the Confederation’s financial support for EPR providers – i.e. the core communities – should promote the EPR’s operation and further development. To encourage the use and the wider adoption of the EPR, the Confederation can grant financial support of up to CHF 30 per EPR opened. These amounts will be paid provided they are at least matched by the canton concerned.
This financial support may be provided for five years from the entry into force of the amendment to the EPRA specified above. The Parliament has approved a total payment of up to CHF 30 million to these ends.
This partial revision of the EPRA also anchors the EPR as an instrument of Switzerland’s compulsory health insurance, and simplifies the procedure for opening an electronic patient record. Patients can confirm, by electronic ID, their consent to an EPR opened for them by a certified EPR provider, so their handwritten or digital signature is no longer required. And in a further innovation, the cantons now have access to the query service for healthcare institutions and healthcare professionals.
The consultation phase on the transitional financing proposal ran from 26 January to 2 May 2023. The final opinions and report were duly published. The dispatch on the transitional financing, the draft new act and the federal decree were passed on to the Parliament for consideration on 6 September 2023. The Parliament’s two chambers approved the transitional financing proposal on 15 March 2024 by a majority of 106 to 74 votes with 11 abstentions in the National Council and 28 to 6 votes with 10 abstentions in the Council of States.
The Federal Council resolved at its meeting of 28 August 2024 that the corresponding amendment to the EPRA would enter into effect on 1 October 2024.
Further information on this EPR financial support, the corresponding application form, a guide to submitting an application and a set of FAQs on the issue will be found on the Financial support for the core communities webpage (available in German, French and Italian).
Annual revision
As part of the annual revisions of the implementing legislation for the EPRA, the FOPH and eHealth Suisse collate the requirements for the updating and the further development of the electronic patient record.
The revised annexes to the FDHA Ordinance on the Electronic Patient Record (EPRO-FDHA) for this annual revision entered into force on 1 June 2024. Stakeholders now have until 31 May 2025 to implement these changes. The updated annexes to the FDHA Ordinance and the associated explanatory notes have been published on the FOPH website: Electronic patient record legislation (EPRA) (available in German, French and Italian).
Documents
Factsheets on the electronic patient record
- Electronic patient records in figures (PDF, 352 kB, 27.09.2024)
- Federal Act on the Electronic Patient Record: The four cornerstones of revision (PDF, 79 kB, 27.06.2023)
- The benefits of electronic patient records (PDF, 117 kB, 27.06.2023)
- Electronic patient records and data security (PDF, 101 kB, 27.06.2023)
Media
Java script is required to display press releases. If you are unable or unwilling to activate Java script you may use the link below to access the Federal Administration News Portal, where you can read the announcements.
Last modification 01.10.2024
Contact
Federal Office of Public Health FOPH
Digital Health Section
Schwarzenburgstrasse 157
3003
Bern
Switzerland