Short answer: Germany's elektronische Patientenakte (ePA) is a personal health record hosted by the patient's statutory health insurer, created by default for everyone insured since early 2025 ("ePA für alle", opt-out), and reachable only through the Telematikinfrastruktur (TI), the secured national health network run by gematik. Doctors, hospitals and pharmacies write documents and structured data into it from their practice systems; patients read and manage it in their insurer's ePA app. Its first fully structured content is the electronic medication list, fed by the E-Rezept; vaccination records, maternity and children's check-up records exist as MIOs (FHIR-based medical information objects). Vendors connect through the TI with gematik-approved components and the ePA's FHIR API.
What the ePA contains
Germany's elektronische Patientenakte (ePA) contains medical documents such as discharge letters and findings, an electronic medication list generated from dispensed E-Rezept prescriptions, structured MIOs for vaccinations, maternity and children's check-ups, laboratory and hospital data being added in stages, documents and app data the patient adds, and a pseudonymised research release unless the person objects.
- Documents: discharge letters, findings, reports, in PDF or as eArztbrief (a CDA document), uploaded by providers or by the patient.
- Electronic medication list (eML): generated automatically from dispensed E-Rezept prescriptions, the first structured, nationwide dataset in the ePA; a full medication plan with dosage instructions follows.
- MIOs: FHIR-based structured records specified by KBV: vaccination record (Impfpass), maternity record (Mutterpass), children's examination record (U-Heft), dental bonus booklet, and others.
- Laboratory results, hospital discharge data and dental records in structured form are being added in stages.
- Patient-provided data: documents the person uploads, and from 2025 data from apps (DiGA) the person connects.
- Research release: pseudonymised data flows to the Forschungsdatenzentrum Gesundheit unless the person objects.
Who may write and read
In Germany's ePA, any provider connected to the Telematikinfrastruktur with a confirmed care relationship may read and write to the record for a default period, 90 days for practices and 3 days for pharmacies, which the patient can change or revoke. The patient can hide documents, delete items and read an access log; insurers host but cannot read the content.
Every provider connected to the TI with a care relationship (established by the insured card being read at the practice, or by the patient granting access in the app) gets access for a default period (90 days for practices, 3 days for pharmacies) that the patient can extend, shorten or revoke per provider. The patient can hide documents from specific providers, delete items and read an access log. Insurers host the record but cannot read its content.
The infrastructure
Germany's Telematikinfrastruktur (TI) is the closed national health network, specified and approved by gematik, that every practice, hospital and pharmacy joins through a connector or TI gateway. It carries the ePA, E-Rezept, KIM secure email and the electronic sick note, using the eHBA, SMC-B and eGK cards and the GesundheitsID for patient identity.
- Telematikinfrastruktur: the closed network every practice, hospital and pharmacy joins through a connector (hardware) or, increasingly, a TI gateway or cloud access; identities are the eHBA (health professional card), the SMC-B (institution card) and the eGK (patient card), with the GesundheitsID as the patient's digital identity for apps.
- gematik specifies and approves everything: ePA, E-Rezept, KIM (secure email between providers), TI-Messenger, the electronic sick note (eAU) and the identity services.
- ePA 3.0 (the 2025 generation) exposes a FHIR R4 API for structured data and a document service built on IHE XDS concepts, with specifications on gematik's GitHub.
- E-Rezept: mandatory for prescriptions since January 2024; redeemed by card, app or paper code; dispensing data feeds the ePA medication list.
How a vendor connects
A vendor connects to Germany's ePA through the Telematikinfrastruktur: practice, hospital and pharmacy software integrates gematik-approved TI components and the ePA 3.0 FHIR client and passes gematik approval; patient apps work as BfArM-listed DiGAs or through the insurer's ePA app; research platforms receive data through the Forschungsdatenzentrum; foreign systems have no direct TI access.
| You are… | Route |
|---|---|
| A practice, hospital or pharmacy software vendor (Primärsystem) | Integrate the TI components (connector or gateway, card terminals, eHBA/SMC-B), implement the ePA 3.0 client and KIM; pass gematik's conformity and approval |
| A patient app (DiGA or health app) | DiGA listed by BfArM can write to the ePA; other apps work through the insurer's ePA app and the patient's own exports; GesundheitsID is the identity |
| A research platform | Data arrives through the Forschungsdatenzentrum under the Gesundheitsdatennutzungsgesetz, not through the TI |
| A FHIR platform or record abroad | No direct TI access; data reaches you through the patient (exports, documents, DiGA interfaces) or a connected German partner |
National FHIR profiles are the Basisprofile DE (HL7 Deutschland), the KBV MIO profiles and gematik's ePA profiles; code systems include ICD-10-GM (ICD-10 variants), the PZN for pharmaceuticals and ATC.
The legal frame
Germany's ePA rests on three laws: the Digital-Gesetz (DigiG, 2024), which made the record opt-out and mandated the medication list; the Gesundheitsdatennutzungsgesetz (GDNG), which opened pseudonymised ePA data for research with an opt-out; and the SGB V, which sets insurers' and providers' duties. The European EHDS regulation adds the European exchange format on top.
The Digital-Gesetz (DigiG, 2024) made the ePA opt-out and mandated the medication list; the Gesundheitsdatennutzungsgesetz (GDNG) opened pseudonymised ePA data for research with an opt-out; the SGB V sets the insurers' and providers' duties. The EHDS will add the European exchange format and MyHealth@EU participation on top; Germany already exchanges the patient summary and ePrescription with some member states through its national contact point.
For a person with an ePA
A person with a German ePA uses their health insurer's app to read documents and the medication list, grant or withdraw access for each provider, hide individual items, check who accessed the record and download documents. Downloaded documents and medication data can be kept in a personal record such as Anpheros Daily for use abroad.
In the insurer's app you can see your documents and medication list, grant or withdraw access per provider, hide items, read who accessed what, and download documents. A record such as Anpheros Daily can hold the documents and medication data you export from the ePA, in FHIR with provenance, so they travel with you to a clinic abroad; see How to transfer your medical records.
National systems change often. This page describes the situation as published by the operators linked under Sources, last reviewed in October 2026; the operator's documentation is the authority for connection requirements.
Related pages
- National electronic health records in Europe and the US
- MyHealth@EU and the cross-border patient summary
- Your medical data in the EU: GDPR, EHDS and your rights
- Health records online: how to access yours in the EU, UK and US
- ICD-10 vs ICD-10-CM vs ICD-10-GM
- ePrescription across EU borders
Sources
- gematik: elektronische Patientenakte
- gematik: specifications (Fachportal)
- gematik on GitHub: ePA specifications
- KBV: Medizinische Informationsobjekte (MIO)
- BfArM: DiGA directory
- Bundesministerium für Gesundheit: ePA
- HL7 Deutschland: Basisprofile DE
Frequently asked questions
Is the ePA mandatory?
It is created by default for every statutorily insured person unless they object, and objection is possible at any time, in whole or for specific uses (for example research). Privately insured people get an ePA if their insurer offers one.
Who hosts the data?
The patient's health insurer, through certified providers, in encrypted form. Insurers cannot read the content. The record moves when the person changes insurer.
Can a foreign clinic access a German ePA?
Not through the TI. The person can download documents and share them, and the patient summary and ePrescription are exchanged with participating countries through MyHealth@EU.
What is the difference between ePA and E-Rezept?
E-Rezept is the national e-prescription service, mandatory since 2024; the ePA is the record. Dispensed prescriptions flow from the E-Rezept service into the ePA's medication list.
Try it free in the sandbox
Your first FHIR call in 5 minutes. An HL7 FHIR R4 API with the patient's consent built in: try it in the sandbox, then connect your own app or clinic system.
Free · 30 synthetic patients · no card
Anpheros builds a medical record that the patient controls and can share with any clinic, on an HL7 FHIR R4 platform, based in the EU. These guides help you understand and organise your health; they do not replace your doctor.
About Anpheros →
AnpherosThe more you log, the clearer your record
Your health history in one place, under your control.
Free · Works in your browser · No card
