The Electronic patient file 3.0 is the focus of the Cybersecurity in the healthcare sector. At the 38th Chaos Communication Congress in Hamburg, security experts Martin Tschirsich and Bianca Kastl presented serious security vulnerabilities. They were able to gain access to the "ePA for all" without any major hurdles.
The researchers found that they were able to create access tokens for the files of any insured person without using the electronic health card. These security flaws in electronic records have been known for years and point to fundamental problems in the development process.
It is particularly alarming that electronic health cards could be ordered in someone else's name simply by calling health insurance companies. This was possible in just 10 to 20 minutes. The experts warn that various vulnerabilities could allow access to all 70 million patient files.
Gematik, which is responsible for the development of the ePA, described some of the attacks identified as "not very likely". Nevertheless, experts are calling for transparent communication of the risks and an open development process in order to protect the Data protection for electronic files to improve.
Important findings
- Serious security vulnerabilities discovered in the ePA 3.0
- Access to third-party files possible without a health card
- Ordering health cards in someone else's name in minutes
- Potential access to 70 million patient records
- Demand for transparent risk communication
- Need for an open development process for the ePA
Introduction to the electronic patient file 3.0
The Electronic patient file 3.0 marks a milestone in the Digitization in the healthcare sector. It is part of the E-health applicationswhich are intended to modernize the German healthcare system.
What is the electronic patient file 3.0?
The Electronic patient file 3.0 is a digital collection of health data. It is automatically created for around 70 million people with statutory health insurance unless they object. This new version brings important changes, such as the elimination of the PIN requirement when visiting a doctor's surgery.
Aim and benefits of the patient file
The main aim of ePA 3.0 is to improve the exchange of information between patients and healthcare providers. It is intended to increase the quality of treatment and reduce administrative work. Doctors and pharmacies can access the data depending on the patient's settings.
Development of the patient file in the digital age
The introduction of ePA 3.0 is a major step in the digitalization of the healthcare system. It builds on previous versions and integrates new functions. Further improvements are planned until 2026 to increase security and functionality. This development shows the rapid progress of E-health applications in Germany.
Importance of safety aspects
The safety and Data protection for electronic files are of the utmost importance. With the introduction of the electronic patient record (EPR) in 2021, these issues are coming into focus. The GDPR compliance of digital healthcare systems is a central aspect of this.
Relevance of security and data protection
Electronic patient files contain sensitive health data. From 2022, vaccination records, maternity passports and other important documents can be stored digitally alongside medical reports. Protecting this information is crucial for patients' trust in the system.
Consequences of safety deficiencies
Security gaps can have serious consequences. Unauthorized access to patient data can lead to misuse. Operators of services within the telematics infrastructure must report faults and security deficiencies immediately. Violations can result in fines of up to 300,000 euros.
Patients' rights
Patients have extensive rights in dealing with their electronic file. They can decide which data is stored. From 2022, it will even be possible to transfer data when changing health insurance provider. From 2023, insured persons can voluntarily make their data available for research purposes.
| Year | Milestone |
|---|---|
| 2021 | Introduction of the ePA |
| 2022 | Expansion of storage options |
| 2023 | Option to donate data for research |
Identification of safety deficiencies
The electronic patient record 3.0 faces considerable challenges in terms of data security. Current studies and reports reveal alarming vulnerabilities that could jeopardize trust in this system.
Current reports and studies
Experts have recently identified serious IT security gaps in practice software uncovered. These flaws allow potentially unauthorized access to sensitive patient data. A study by the German Federal Office for Information Security (BSI) found that 73% of the systems examined had security problems.
Examples of detected vulnerabilities
The findings of security experts are particularly worrying:
- Ordering health cards in other people's names by making simple phone calls
- Obtaining practice access within a few hours
- Access to up to 1,500 patient files via compromised practice access
- Possibility of SQL injection attacks on card issuer portals
Affected areas within the patient file
The Data leaks of medical data affect various areas of the electronic patient record. An analysis shows the data that is most at risk:
| Range | Risk | Potential effects |
|---|---|---|
| Personal identification data | High | Identity theft |
| Medical diagnoses | Very high | Violation of privacy, discrimination |
| Prescription drugs | Medium | Abuse, financial damage |
| Treatment history | High | Profiling, manipulation |
These security deficiencies require urgent measures to ensure the integrity and confidentiality of patient data and to restore confidence in the electronic patient record.
Technological challenges
The electronic patient record 3.0 faces considerable technical hurdles. The integration of old systems with new technologies complicates the Cybersecurity in the healthcare sector. The interoperability of data poses a particular challenge.
Old systems versus new technologies
Many healthcare facilities use outdated IT infrastructures. These are often not compatible with modern E-health applications. The Risk management for e-health applications must bridge this gap.
Interoperability of data
The smooth exchange of health information is crucial. However, different systems often do not speak the same language. This jeopardizes data integrity and complicates the Cybersecurity in the healthcare sector.
Use of cloud solutions and their risks
Cloud solutions offer flexibility, but bring new security risks. A study shows that 67% of healthcare facilities use cloud services. However, only 45% have implemented adequate security measures. The Risk management for e-health applications must close this gap.
"The security of patient data must have top priority. We cannot afford to compromise on the digitalization of the healthcare system."
The use of used card terminals from classified ads enabled researchers to access sensitive data. This underlines the need for secure disposal of old hardware and shows the urgency of improved security measures in the electronic patient record 3.0.
Data protection legislation in Germany
Data protection legislation in Germany plays a central role in the GDPR compliance of digital healthcare systems. It regulates the handling of sensitive health data and ensures that the Data protection for electronic files is guaranteed.
The General Data Protection Regulation (GDPR)
The GDPR forms the basis for data protection in the EU. It lays down strict rules for the processing of personal data. Particularly high requirements apply to health data. Doctors and hospitals must ensure that their digital systems are GDPR-compliant.
National requirements for health data
In addition to the GDPR, there are other laws in Germany for the protection of patient data. The Federal Data Protection Act (BDSG) supplements the GDPR at national level. It requires special protective measures for the electronic storage of health data.
Penalties for violations and their consequences
Violations of data protection regulations can result in severe penalties. Fines can amount to up to 20 million euros. There is also the threat of damage to image and loss of trust among patients. It is therefore essential for medical practices and hospitals to regularly check their IT systems and close security gaps.
- Raising doctors' awareness of safety measures
- Development of catalogs of measures to protect patient data
- Regular safety analyses and training
Strict compliance with data protection laws is crucial for patient trust in digital healthcare systems. This is the only way to guarantee data protection for electronic records in the long term.
Procedure for improving safety
The security of electronic health records is of paramount importance. To IT security gaps in practice software various measures are required. A comprehensive strategy includes regular checks, training and robust safety protocols.
Audits and regular safety checks
The Auditing of electronic health records is a central component of the security strategy. According to statistics, around 73 million insured persons in Germany are entitled to digital health applications (DiGA). To ensure their security, DiGA developers must adhere to strict data protection and cyber security standards.
Training of employees in the healthcare sector
Employees in the healthcare sector play an important role in the security of patient data. Regular training on IT security is essential. This includes handling sensitive data and recognizing potential security risks.
Implementation of powerful security protocols
Implementing strong security protocols is critical. DiGA manufacturers must implement an information security management system (ISMS) in accordance with ISO 27001 or IT-Grundschutz. In the event of security deficiencies, they are obliged to rectify them immediately.
| Safety aspect | Requirement | Consequences of non-fulfillment |
|---|---|---|
| Privacy | Compliance with the GDPR | Possible removal from the DiGA directory |
| Cybersecurity | Penetration tests | Sanctions according to §139e SGB V |
| ISMS | ISO 27001 or IT baseline protection | Refusal of listing as DiGA |
Continuously improving the security of electronic health records requires the interaction of technology, processes and people. Only in this way can IT security gaps in practice software effectively closed and confidence in digital healthcare solutions strengthened.
Innovative solutions for protection
The Encryption of sensitive patient data is the focus of modern security concepts. In view of the threats posed by cyberattacks, innovative approaches are needed to strengthen cybersecurity in the healthcare sector.
Use of blockchain technology
Blockchain offers promising possibilities for the protection of health data. This technology enables decentralized and tamper-proof storage of information. This makes it considerably more difficult to change or delete patient records without authorization.
Artificial intelligence for threat detection
AI systems can detect anomalies and suspicious activities in real time. They analyze large amounts of data and identify potential security risks before they become real threats. This significantly improves the response time to cyber attacks.
Focus on encryption techniques
Modern encryption methods form the backbone for secure electronic patient records. End-to-end encryption ensures that only authorized persons can access sensitive health data. The implementation of such techniques is crucial for the protection of patient privacy.
To further increase security, the use of cryptographic identities on chip cards is recommended. These can be used to verify the authenticity of the card and thus prevent unauthorized access. An open development process over the entire life cycle of the electronic patient record is essential.
The security of patient data must have top priority. This is the only way we can strengthen trust in digital healthcare solutions and promote their acceptance.
Patient safety awareness
The digital revolution is changing the healthcare sector. Patients' rights in the digital healthcare system are gaining in importance. The electronic patient record brings advantages, but also risks. Patients must be informed about data protection in electronic files.
Information and training for patients
Information is crucial. Many patients do not know their rights. Training courses help to increase safety awareness. Informed patients can handle their data better.
Patients' rights in the event of insecure data
Patients have rights in the event of data protection violations. They can request information and demand deletion. Healthcare facilities must act transparently. Patients should know how they can enforce their rights.
Promotion of the right to have an active say
Patients should be actively involved in the design of the electronic record. Their experiences are valuable for improvements. Surveys show: 62% of respondents reject certain content. This shows the importance of patients' opinions.
Only informed patients can exercise their rights and play an active role in shaping them.
The future of healthcare lies in digitalization. Data protection for electronic records must be a top priority. Only then can Patients' rights in the digital healthcare system are preserved.
The future of the electronic patient file
The Digitization in the healthcare sector is progressing. E-health applications such as the electronic patient record (EPR) are at the heart of this development. Since 2021, statutory health insurance companies have had to offer the ePA and medical practices are obliged to store selected data in it.
Trends in digital medicine
The ePA 3.0 will bring new functions from 2023:
- Hospital discharge letters
- Care transfer forms
- Laboratory values
- Integrated messenger for doctor-patient communication
In addition, electronic certificates of incapacity for work and e-prescriptions are being introduced. Teleconsultations and video consultations complete the digital offering.
Customer feedback and further developments
Despite the progress, there are concerns. Data protectionists have criticized the ePA since its introduction. One important point: currently, only insured persons with suitable mobile devices have access to their file in compliance with data protection regulations. From 2022, a representative should be able to take over administration.
The path to a more secure patient record
The following steps are necessary for a secure future for the ePA:
- Close cooperation between Gematik and data protection authorities
- Strict certification for providers of telematics infrastructure components
- Improvement of access rights and authentication processes
- Compliance with GDPR requirements in all processes
The Digitization in the healthcare sector offers great opportunities. The protection of sensitive patient data must be a top priority.
| Year | Development |
|---|---|
| 2021 | Introduction of the ePA |
| 2022 | E-prescriptions and substitution rules |
| 2023 | ePA 3.0 with extended functions |
Conclusion
The electronic patient file 3.0 faces major challenges. The security flaws that have been uncovered clearly show how important the Data protection in the healthcare sector is. From 2025, ePA will be mandatory for people with statutory health insurance unless they object.
Key points of the security issue
Criticism of the electronic patient file 3.0 is manifold. Doctors, data protectionists and IT experts criticize the inadequate security of data collection, storage and processing. The central storage of sensitive health data significantly increases the risk of unauthorized access.
- Unstable technical infrastructure
- Increased risk due to centralized data storage
- Concerns about data protection and confidentiality
Significance for healthcare
A secure electronic patient record is crucial for trust in digital healthcare. It can contain important medical data such as medication, lab results and emergency information. However, security flaws need to be urgently addressed to ensure the protection of this sensitive data.
The introduction of the ePA harbors both opportunities and risks. On the one hand, it can improve the quality of care, but on the other hand, security concerns must be taken seriously. Only in this way can the electronic patient record 3.0 develop its full potential and at the same time meet the high demands placed on security. Data protection in the healthcare sector do justice to them.
Call to Action
The security of the electronic patient record 3.0 requires the active involvement of all those involved. The Risk management for e-health applications is at the heart of efforts to protect sensitive health data.
What can patients and healthcare providers do?
Patients should inform themselves about their rights and take data protection in electronic records seriously. Healthcare providers must follow strict security guidelines and train their staff regularly. Gematik and the authorities are called upon to communicate more transparently and close security gaps quickly.
Planned initiatives to improve safety
New approaches such as blockchain technology and AI for threat detection can improve risk management for e-health applications. Regular security audits and the implementation of strong encryption techniques are crucial for data protection in electronic records.
Final thoughts on the responsibility of all parties involved
The protection of sensitive health data is everyone's responsibility. Only through joint efforts can we ensure the integrity of the digital healthcare system and strengthen trust in electronic patient records.
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