The electronic health record of the future
Revision of EPRA is urgently needed

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The electronic patient record (EPR) is now called the electronic health record (E-GD). It can serve as the core of a digitized healthcare system and its benefits are undisputed. However, they have not yet been realized. Swiss Post and the Sanela reference community are committed to and want to promote a successful E-GD in the future. A revision of the legal basis is necessary for the E-GD to develop its potential. Swiss Post supports the further development of the E-GD initiated by the Federal Council and is taking a position on the most important points.

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The digital transformation of the healthcare sector promises increased efficiency and improved patient care. The E-GD is ideally placed to play a key role in the digitization of healthcare.

It offers clear benefits:

  • Better quality of treatment, more safety and transparency
  • Access for patients to their health data and access for their attending health professionals to the relevant health data
  • Patients have control over their data
  • Immediate availability of data in an emergency

The E-GD needs to be further developed in order to reach its full potential. For this reason, the Federal Council has initiated a revision of the Federal Act on the Electronic Patient Record.

Swiss Post is continuing to develop its new EPR platform. Hospitals, medical professionals and private users are already using the EPR. The current solution is therefore also important during the transition phase. Opened EPRs will automatically be converted into E-GDs as soon as these are available (planned from 2030).

Swiss Post will make the new platform available to communities in 2026 to prevent a standstill with regard to digitization in the healthcare sector.

Positions

We consider the following issues to be the key success factors for the future E-GD:

1. Promote widespread use

  • All service providers will be obliged to join the E-GD and to feed data into the E-GD.
  • The opt-out model is a prerequisite for the rapid dissemination of the E-GD.
  • In addition, we would like to see providers of practice and hospital information systems obliged to ensure automated delivery and reading of medical data in structured form both in and from the E-GD.

The abolition of “dual voluntary action”, as proposed by the Federal Council, is an essential prerequisite for the E-GD’s successful further development: The E-GD will be of maximum benefit if all stakeholders in the healthcare sector are involved in the E-GD system and feed it medically relevant information. During a doctor’s visit, relevant medical data needs to be available in and able to be added to the E-GD with little effort.

The opt-out model, as proposed by the Federal Council, is a good instrument for the necessary dissemination of the E-GD: We support the opt-out model as envisaged by the Federal Council. Only through an opt-out will the E-GD rapidly gain the required level of dissemination and anchoring in the health system and become a central source of information for treatments. The E-GD will remain voluntary for the population.

Practice and hospital information systems interoperable with the E-GD as a supplement: Data flows go beyond the E-GD. Primary systems such as practice and hospital information systems must allow for the standard-compliant and seamless delivery and reading of medical data. In-depth integration is an essential prerequisite. We are calling for deep integration to be enshrined in the EPRA as a precondition for the approval of practice and hospital information system providers, as is already being successfully implemented in other countries (e.g. Denmark).

2. Provide benefits

  • The benefits of the E-GD for service providers are currently too limited. The revision of the EPRA remains too vague in this respect. It must bring tangible added value.

Enable B2B communication: The E-GD is designed to be patient-centered (“The data belongs to the patient”), i.e. the patient can manage their own data. The owner of an E-GD can upload and/or delete data independently. The revised EPRA obliges service providers to participate in the E-GD and to feed in data. However, it does not define which data will be continuously and automatically entered into the E-GD. As a result, the E-GD is not a reliable data source for communication and data exchange between service providers. The revised EPRA must enable B2B communication in order to create significant benefits for service providers. The Federal Council refers to the Swiss Health Data Space (SwissHDS). It will take several more years for SwissHDS to be implemented. The role of the E-GD in DigiSanté must be defined precisely.

3. Financing by the Confederation

  • The Federal Council is proposing dual financing between the Confederation and the cantons. We are calling for central financing and control exclusively by the
    Confederation.

So far, no market has been established. From Swiss Post’s point of view, funding from the Confederation is necessary, more promising and easier to manage: With the revision of the EPRA, the roles between the Confederation and the cantons are clearly regulated and the sustainable funding of the E-GD is to be ensured. The Federal Council is proposing dual financing between the Confederation and the cantons. The federal government will bear the costs of the further development of the E-GD; operating costs will be passed on to the cantons (based on population). We believe that the Confederation should finance both the development and operation by itself and also manage it on its own authority, with the involvement of the cantons and the technical provider. Centralized governance facilitates efficient and clear structures and, in turn, simplifies the national implementation of the E-GD.

4. Standardization of technical infrastructure

  • Standardizing the technical infrastructure is the right approach.
  • Investments made to date must be protected by building on existing ones.
  • Digital sovereignty must be safeguarded.

Standardization increases efficiency and simplifies implementation: A central, standardized E-GD platform, as proposed by the Federal Council, simplifies development on the part of E-GD providers and integration of the platform by healthcare providers. This will give all stakeholders the necessary impetus for the nationwide dissemination of the E-GD.

It is important to build on what already exists: The cantons, healthcare providers, reference communities and platform providers have already invested a great deal in the current EPR. The existing connections and integrations of service providers and their IT systems with existing platforms and the associated specially developed additional services (e.g. e-vaccination module, mobile applications, etc.) must remain cost-neutral and available in the centralized future solution. In this regard, it is also important to quickly clarify the integration of the E-GD into Digisanté and SwissHDS so that the new E-GD can be technically connected to the current EPR solution.

Solution development and operations remain in Switzerland: Sensitive, personal data is stored and exchanged in the E-GD. The operation of the national E-GD platform must be close to users and regulators. For this reason, these are to be developed and operated by an established company in Switzerland. The basis for this is modern and secure technology.

Other success factors

Information: The more participants there are in the E-GD and the more data is available in the E-GD, the greater the overall benefits of the E-GD will be. This makes it all the more important that all parties concerned have the necessary information on the E-GD and how it works. We welcome the fact that the Confederation is planning an information campaign on this during the introductory phase.

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