EHR as a B2B Growth Market
8 Min. Read Time
85 percent of approximately 160,000 service providers are actively using the ePA today – compared to 60 percent seven months ago. Over 70 million insured individuals have an electronic patient record. Logins have increased fourfold since May 2025, reaching 4.5 million. Any IT service provider or software vendor in the healthcare sector who still views this rollout as incomplete is likely missing the trend.
Key Takeaways
- Adoption is progressing faster than expected. Active usage has increased from 60 to 85 percent in seven months, with logins quadrupling. The market is not waiting for final product readiness.
- Integration projects are the bottleneck. Primary system vendors, DiGA providers, and clinics require integration infrastructure, consulting on TI connectors, and FHIR implementations. This is the current demand.
- Interoperability remains the unsolved issue. The German Hospital Association identifies interoperability and unstable systems as the main obstacles. Solving this will unlock market potential.
- 2026 brings new obligations. The electronic medication plan (eMP) and DiGAV interoperability requirements will drive new tenders for service providers and health insurers.
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What the ePA Adoption Means for the B2B Market in 2026
What is the electronic patient record (ePA)? The ePA is a central digital record where insured individuals can store, manage, and share their health data with service providers. It operates over the telematics infrastructure (TI), is provided by health insurers, and has been automatically created for all insured individuals in Germany since early 2025, unless they have actively objected.
The rollout is no longer a pilot project. It is an operational reality for 160,000 service providers, for Bitmarck as an IT infrastructure provider for about a third of the insured individuals, and for DiGA vendors required to connect via DiGAV. What is changing now is the structure of demand – and with it, the landscape for IT service providers, software vendors, and consultants in the healthcare sector.
Market Data 2026
- Over 70 million insured individuals have an ePA
- 4.5 million logins at Bitmarck (quadrupled since May 2025)
- 85 percent of approximately 160,000 service provider facilities are active (vs. 60 percent in September 2025)
- Bitmarck operates the ePA infrastructure for about a third of the insured individuals
Where the Demand for IT Providers is Materially Emerging Today
The DMEA 2026 in April in Berlin has shown where the discussion stands: not on fundamental questions about ePA, but on the reality of implementation. Conferences with titles like “Medical Practices on the Path to the Digital Ecosystem” and “Implementation Before Vision” demonstrate the shift from concept to infrastructure issues.
gematik has communicated concrete future plans at the DMEA: ePA as the central platform for primary care. This is not just strategic communication. It is a guiding principle for investment decisions on the software provider side. Those developing primary systems, laboratory IT, or DiGA software today are building on an infrastructure whose requirements profile gematik will gradually expand over the next few years.
For IT providers, this means three concrete areas of demand:
Primary System Integration: Practice software, hospital information systems, and laboratory solutions must be able to read and write ePA data. This requires TI connectors, FHIR implementations, and certified interfaces. Manufacturers who still need to catch up in this area are under time pressure.
DiGA Integration: The DiGA regulation obliges digital health application manufacturers to integrate with ePA. This creates a clear mandate for consulting firms with a focus on health IT to support in implementation and certification.
Interoperability Projects: Lack of semantic and organizational interoperability is the most discussed issue according to the DMEA. Those offering FHIR-based integration solutions or consulting in this area have a demand that is not decreasing.
What Works and What Still Holds Back IT Providers
The picture is mixed. Some segments clearly benefit, while others face problems that cannot be solved through better market communication.
What Works
- Adoption is faster than the provider pipeline
- Clear regulatory obligations create project frameworks
- Bitmarck, IBM, and specialized TI service providers have reference projects
- eMP 2026 drives new tendering rounds
What Holds Back
- Lack of interoperability on all four levels
- Unstable ePA modules from individual IT manufacturers
- Implementation complexity remains high according to DKG
- Media breaks remain a structural issue
This is not a statement that the market is not functioning. It is an acknowledgment of the realistically measurable bottlenecks. Providers who focus on these areas have better starting conditions than those attempting to address the entire ePA ecosystem as a whole.
“Those who offer IT services or software products in the healthcare environment and still consider the rollout as ‘not yet fully operational’ may have missed the curve.”
What Consultants and Software Providers Can Do Specifically
There is a pattern that reliably works in large-scale digitalization projects in the regulated public sector: specialize early and scale up. The ePA is not a project that can be won by a generalist. It is an ecosystem composed of many specialized components.
For consulting firms without an existing healthcare IT focus, the most pragmatic entry point is a partnership with a certified TI service provider. Gematik certifications, primary system specifications, and DiGAV compliance are hurdles that cannot be overcome by good intentions alone. However, a consulting firm with change management expertise working alongside a certified TI partner offers a differentiated proposition for clinics and practice associations struggling with implementation complexity.
For software providers, the question is different: not whether ePA integration is meaningful, as it is already a regulatory requirement in many segments or will become one. The question is in which order to address the integration layers and how to plan the certification cycles without blocking the core product. This is an architecture and roadmap issue, not a market decision problem.
Frequently Asked Questions
Which IT service providers will benefit the most from the 2026 ePA rollout?
Primary providers of TI connectors, primary system integrations, and FHIR-based interoperability infrastructure will benefit the most. Additionally, consulting firms with experience in DiGA certification and change management for service providers will see significant advantages. Generic IT system houses without a healthcare IT focus may face challenges due to the high certification requirements that set specific hurdles.
What is the electronic Medication Plan (eMP) and why is it relevant for IT providers?
The eMP is part of the 2026 ePA expansion: a structured document containing all current medications that will be accessible via the ePA for service providers. For IT providers, this means new integration projects with pharmacy software, hospital information systems, and medical practice software that need to read and write the eMP.
What obligations arise for DiGA manufacturers due to the DiGAV interoperability requirement?
DiGA manufacturers must transfer supply-relevant data into the ePA at the request of users. Treating service providers should be able to view these data from their primary system without using a DiGA-specific interface. This requires standardized data formats (FHIR) and certification of the transmission interface according to Gematik specifications.
Why is lack of interoperability the central problem rather than lack of adoption?
Adoption rates are good. The problem is not that no one uses the ePA – it is that systems do not communicate consistently with each other. Structural, syntactic, semantic, and organizational interoperability remain unresolved according to expert consensus. This leads to media breaks: documents arrive in the record but are not machine-readable because data models diverge.
Is it worth entering the healthcare IT market for IT consulting firms without a health focus?
Only with a clear specialization strategy. Regulatory requirements (Gematik certifications, DiGAV, DSGVO health data) set high entry barriers. Generic IT consulting without a healthcare context has little differentiation potential compared to established providers like Bitmarck, CompuGroup, and KPMG Health. Recommended entry path: Partnership with a certified TI service provider rather than building the own certification infrastructure.
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