Summary

After nearly two decades of failed development, Health Minister Elisabeth Baume-Schneider is planning a new version of the electronic patient record (EPD) under the name Electronic Health Record (EGD). The new system will be set up automatically for all Swiss citizens with an opt-out option, rather than relying on voluntary participation. However, experts such as Samuel Eglin and Felix Schneuwly warn of similar problems as the failed predecessor. By late February 2026, only 133,000 people (1.4 percent of the population) had an EPD – far short of the critical mass of 30 percent needed for effective network effects. The National Council's health commission will address the proposal for the first time in the coming days.

People

Topics

  • Digitalization of healthcare
  • Electronic patient record
  • Data protection and data sovereignty
  • Swiss health policy

Clarus Lead

The central dilemma of Baume-Schneider's reform initiative lies in the structural contradiction between political acceptability and technical success: While the Federal Council relies on voluntary participation – backed by the narrow e-ID vote of 2025 – experts warn that this very voluntariness will cause the project to fail. The planned opt-out solution with mandatory prior notification contradicts itself and causes millions in costs without added value. At the same time, a recent survey shows increasing acceptance of centralized health data storage (72 percent with reservations or unreservedly), signaling a possible way out – if politics has the courage.

Detailed Summary

The core problem lies in the lack of critical mass. Electronic patient record systems only achieve meaningful network effects at approximately 30 percent coverage, from which physicians, hospitals, and overall care benefit. The old EPD failed in part because patients could participate voluntarily and outpatient care providers were not required to participate, even though hospitals and nursing homes were legally obligated to. The result: decentralized, fragmented infrastructure instead of integrated data flow.

Eglin criticizes the new structure as "double-stitched": While all citizens automatically receive a record, they can reject or delete it at any time. This supposed simplification through an opt-out solution costs millions in administrative implementation according to Eglin and leads to confusion rather than efficiency gains. Another weakness is patient data sovereignty: As long as patients can decide themselves which treatment data to release, the system only functions as a "free Dropbox for citizens," not as a reliable information source for care providers. Eglin instead calls for a solidarity principle: those who benefit from collectively financed healthcare should also have to make all treatment-relevant data accessible.

Schneuwly goes even further and advocates shelving the state patient record for now. Instead, the federal government should focus on the Digisanté project – establishing binding digital standards for the entire healthcare system by 2034. The EGD is merely "nice to have," but real efficiency gains only come through central standardization. Schneuwly points to Denmark as a model: the country has a national system with its own authority (Danish Health Data Authority), central platform, mandatory participation, and nearly 100 percent coverage. Denmark punishes unjustified data access with fines up to imprisonment and monitors all access without gaps.

A cautious political signal comes from the population: A GfS survey shows that 72 percent of Swiss citizens at least tentatively agree with electronic health data storage (25 percent unconditionally, 47 percent tentatively). The camp of opponents and the undecided has shrunk to 28 percent – the lowest value since 2020. Schneuwly remains skeptical, however: "The people approved the e-ID only by a very narrow margin. Resistance to a mandatory health record could be greater."

Key Statements

  • The new EGD reproduces the core problem of the failed EPD: lack of critical mass due to voluntariness for patients and care providers
  • The planned opt-out solution is administratively expensive, provides no added value, and creates confusion rather than clarity
  • Experts instead call for central, mandatory systems following the Danish model or prioritizing digital standardization over patient records
  • The population increasingly accepts centralized health data storage (72 percent), but could mobilize politically against mandatory solutions

Critical Questions

  1. Evidence: How does the Federal Council justify that an opt-out model should be more successful than the pure opt-in of the EPD, if the GfS survey shows that even in 2025 28 percent remain skeptical?

  2. Data Quality: If patients can decide themselves which data appears in the EGD, on what factual basis does the Federal Council evaluate that the system will fulfill its efficiency promises?

  3. Conflicts of Interest: What role do care providers (hospitals, physicians) who could benefit from EPD mandates play in shaping the EGD design?

  4. Causality: Is it actually voluntariness or rather the decentralized, incompatible infrastructure that caused the EPD failure – and does EGD address this primary error?

  5. Alternatives: How did the Federal Council examine the Schneuwly option of first establishing Digisanté standards before building a record system on top?

  6. Cost-Benefit: What ROI does the federal government expect from EGD rollout when only 1.4 percent use the EPD and even 30 percent is insufficient for many systems?

  7. Feasibility: What control mechanisms against data abuse does the federal government plan (analogous to Denmark's penalty catalog) to avoid losing the GfS acceptance gains?

Source Directory

Primary Source: Andri Rostetter: Digital Patient Record: Why Baume-Schneider's Plans Face Criticism – Neue Zürcher Zeitung, 13.04.2026 – https://www.nzz.ch/schweiz/digitale-patientenakte-warum-baume-schneiders-plaene-kritisiert-werden-ld.1931320

Verification Status: ✓ 13.04.2026

This text was created with the support of an AI model. Editorial Responsibility: clarus.news | Fact-Check: 13.04.2026