Summary
Health Minister Elisabeth Baume-Schneider submitted a draft law in November 2025 for a new Electronic Health Record (EGD) to replace the failed Electronic Patient Record (EPD). The draft provides that all persons with Swiss residence automatically receive a record, but can reject or delete it. Despite this improvement, experts such as Samuel Eglin and Felix Schneuwly fundamentally criticize the project because of the retained voluntary nature for patients and service providers. The old EPD failed after 20 years: Only about 1.4 percent of the population use it – far below the necessary critical mass of 30 percent.
Persons
- Elisabeth Baume-Schneider (Health Minister)
- Samuel Eglin (Health Expert, former CEO Axsana AG)
- Felix Schneuwly (Public Affairs Comparis, Health Policy Expert)
Topics
- Healthcare digitalization
- Electronic patient records
- Swiss legislation
- Data protection and data sovereignty
- Health policy
Clarus Lead
The draft law reveals a classic dilemma in digitalization policy: The Federal Council relies on voluntary participation to secure political acceptance (as with the narrow E-ID referendum in 2025), but thereby undermines the technical functionality of the system. Experts warn that the EGD without mandatory principles – for both patients and service providers – will become the next money pit. This raises the question of whether a voluntary, decentralized patient record is meaningful as a state function at all.
Detailed Summary
The old EPD is considered a negative example of nationwide digitalization policy in Switzerland. After nearly 20 years of development, only around 133,000 people (1.4 percent) have a record. As early as 2022, Samuel Eglin predicted failure: The combination of decentralized structures, voluntary participation for patients and service providers, and unclear financing was not sustainable. His prediction proved correct – even hospitals and care homes that were legally obligated did not participate comprehensively.
The Federal Council's new draft is based on automatic file opening: cantons inform all citizens extensively, and they can object. Despite this improvement, central weaknesses remain. Eglin criticizes three points: First, the "doubly stitched" opt-out solution, which is administratively expensive but creates only confusion for the user. Second, the lack of data sovereignty: patients continue to decide which data is accessible – the EGD becomes a free "health dropbox" instead of a reliable information source for doctors. Third, Eglin calls for a solidarity principle for data: those who benefit from the solidarily financed healthcare system must release all treatment-relevant data.
Felix Schneuwly goes further. He proposes abandoning a state patient record and instead focusing on binding digital standards (Digisanté project). The EGD is "nice to have," but has no priority given state budget constraints. His model: Denmark. The country has a central, national health data authority (Danish Health Data Authority), mandatory participation, nearly 100 percent coverage, and comprehensive transparency controls with graduated penalties for misuse.
A recent GfS survey, however, shows growing acceptance: 25 percent support electronic storage unreservedly, another 47 percent tend to support it. The camp of critics and undecided shrinks to 28 percent – the lowest value since 2020. Political feasibility of a mandatory system remains questionable, however, after the E-ID referendum barely passed.
Key Statements
The new EGD preserves the central weakness of the old EPD: voluntary participation for patients and service providers, without being able to reach the critical mass of 30 percent usage.
Experts call for either a solidarity principle for data (with veto option instead of opt-in logic) or prioritization of digitalization standards instead of a central record.
The Danish model shows an alternative: central, mandatory data management with transparency controls instead of a decentralized, voluntary system.
Public acceptance for health data storage is rising, but political feasibility of a mandatory system remains uncertain after the narrow E-ID approval.
Critical Questions
Evidence Quality: The old EPD failure is justified with "1.4 percent usage" and "critical mass from 30 percent" – on what system comparisons is this 30 percent threshold specifically based?
Conflicts of Interest: Samuel Eglin was CEO of Axsana AG (now Post subsidiary), which was involved in the EPD – does this connection contribute to his current criticism or is it irrelevant?
Causality: Will EGD failure be caused by voluntary participation or by poor user experience, lack of provider offerings, or overly complex technology? The text does not distinguish clearly.
Feasibility: The opt-out solution costs "millions" according to Eglin – where does this estimate come from, and how realistic are the "double-digit millions" total budget of the Confederation?
Alternatives: Schneuwly's proposal to forgo EGD and prioritize Digisanté – is this trade-off politically negotiable or already decided?
Denmark Comparison: Denmark has central data sovereignty, Switzerland has a decentralized federalism system – is the Danish model legally and structurally transferable to Switzerland?
References
Primary Source: Digital Patient Record: Why Baume-Schneider's Plans Are Criticized – NZZ, 13.04.2026
Verification Status: ✓ 13.04.2026
This text was created with the support of an AI model. Editorial Responsibility: clarus.news | Fact-Checking: 13.04.2026