DiGA and ePA: Opportunities for IT service providers
4 min read
Updated 3 November 2026 · Originally published 8 May 2026
The electronic patient record has become part of everyday healthcare across Germany. Certain digital health applications also have dedicated billing codes for medical services. This creates potential work for IT service providers in interfaces, testing and integration with practice software. Whether that leads to a contract depends on the specific needs and requirements of each client.
Key points at a glance
- The ePA is used in healthcare. Healthcare providers are required to use it. Insured people can opt out of having a record.
- DiGA reimbursement depends on the application. Dedicated billing codes for monitoring and evaluation exist for certain applications.
- Technical requirements must be assessed individually. The ePA medication service and document management use different interfaces.
What the ePA means for practice software providers
The ePA for everyone launched nationwide on 29 April 2025. Since 1 October 2025, doctors and other healthcare providers have been required to use it. For insured people, use remains voluntary. They can object to the creation of a record or its subsequent use, explains the Federal Ministry of Health.
For a software project, this difference makes one practical scenario relevant: a practice may need the ePA in its workflow while no usable record exists for a person receiving treatment. The interface and internal processes should handle such cases clearly. Nor can the number of actively used records be inferred from the number of people with statutory health insurance.
What is a primary system? In the ePA context, the term refers to the software an organisation uses to access patient record functions, such as a practice management system.
Which DiGA services are reimbursed
Digital health applications, known as DiGA, support care for certain conditions. Which additional medical or psychotherapeutic services are reimbursed depends on the application and the applicable billing rules.
The National Association of Statutory Health Insurance Physicians lists individual billing codes for this purpose. For the application “Invirto”, for example, it describes a code for monitoring and evaluation with requirements governing which medical specialities may bill for it. These codes do not provide general reimbursement for all support provided for every DiGA.
The 2024 Uniform Assessment Standard already included codes for monitoring and evaluating individual applications. A blanket new entitlement to reimbursement from April 2026 cannot be inferred from this. For manufacturers and their IT partners, the starting point is therefore the specific care process for each application.
Where interface work arises
The gematik implementation guide describes different ePA interfaces. For the medication service, it specifies FHIR interfaces for managing the medication list and medication plan. For document management, it describes a profile of the IHE XDS.b standard. Anyone planning an integration must therefore check the specific use case and the specifications that apply to it.
A second point to check is access rights. According to the guide, the record system checks an organisation’s authorisation to access it. If authorisation is absent or has been withdrawn, content cannot be read and documents cannot be uploaded. For development, this means that tests should also cover denied access and appropriate messages for practice staff.
In the guide, gematik refers to a model of the ePA record system for development and testing. Such a model can help with preparation. Any further tests and evidence required for a specific product must be established for the relevant product type.
How service providers can assess potential contracts
From an editorial perspective, three potential starting points are integration with practice software, technical support for DiGA manufacturers and assessment of individual procurement opportunities. These do not establish a proven volume of contracts or a guarantee of future projects.
Before submitting a proposal, service providers should identify the client and the product concerned. Does the project involve displaying a medication list, exchanging documents or providing a function within a DiGA? The interfaces, access rights and tests depend on the answer. For a tender, the scope of services, qualification requirements and deadlines are also set out in the relevant procurement documents.
For cost estimates, it is useful to clarify responsibilities early: Who provides the test environment? Who handles the clinical side and who checks the implementation? These questions make the workload easier to assess than a blanket assumption about a rapidly growing market.
Frequently asked questions
Do insured people have to use the electronic patient record?
No. Insured people can object to the creation and subsequent use of an ePA. Separate obligations to use it apply to healthcare providers.
Is support for every DiGA reimbursed separately?
There is no blanket answer. The KBV lists dedicated codes for certain applications and describes the requirements for each one.
Do all ePA interfaces use the same standard?
The gematik guide distinguishes between interfaces including FHIR interfaces for the medication service and IHE XDS.b for document management. The specific use case determines which applies.
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Translated from the German original using artificial intelligence. The German version is authoritative.
