Key facts
Anyone residing in Switzerland can now choose to open an electronic patient record (EPR). The EPR contains their health-related documents such as hospital discharge reports, assistance and care at home (Spitex) reports and medication lists. This information can be accessed at any time via a secure internet connection by both the EPR holder and any healthcare professionals expressly authorised by them.
The EPR has not yet been successfully rolled out. Fewer than 80,000 people had opened an EPR in 2024. Not even all hospitals and care homes are connected, despite this being a legal requirement since 2020 and 2022, respectively. Taking the situation seriously, the Federal Council in 2022 tasked the Federal Office of Public Health (FOPH) with making two changes to the law. Firstly, it wanted to put transitional funding in place quickly to support the continued existence of the EPR and promote its dissemination by the “core communities”. Secondly, the Federal Department of Home Affairs (FDHA) was to conduct a fundamental review of the Federal Act on the EPR (EPRA). Based on the findings, the Federal Council decided to initiate a revision of the EPRA, which is to be submitted to Parliament in 2025.
The Swiss Federal Audit Office (SFAO) examined the effectiveness of the planned reconfiguration of the EPR, as envisaged in the draft revision proposal. It concluded that, at the time of the office consultation in January 2025, the documents relating to the revision of the law were not yet sufficiently sound to assist the Federal Council and Parliament in making an informed decision. Key information was missing, making it impossible to assess the effectiveness, appropriateness and cost-effectiveness of the measures and their impact on the healthcare system. The SFAO already communicated findings from its audit to the relevant units during the regular office consultation process.
The SFAO identified several elements showing a continued lack of clarity regarding the EPR’s status. Consequently, there are a number of risks involved in pushing ahead with the project without further clarification: an overly expensive transitional solution as well as considerable additional expenses for healthcare facilities, rather than any contribution to reducing healthcare costs. The way the EPR project is set up, there is a risk that, without digitalised end-to-end processes, the benefits will remain limited and subsequent systems could be incompatible. To prevent this, the FOPH would need to pause any further roll-out of the EPR until the design of DigiSanté has advanced to the point where it is sufficiently clear whether and how data can be automatically incorporated into the EPR. This would enable an efficient and integrated solution.