SWITZERLAND Trends and Developments Contributed by: Tobias Meili and André Berne, Wenger Plattner
Electronic patient records To promote the use of electronic patient records (EPRs), the Federal Electronic Patient Record Act (EPRA) came into force in April 2017. The purpose of the law is to ensure that, in the future, all patient records are maintained exclusively in digital format and that all essential health docu- ments (eg, nursing and hospital reports, exami- nation results, and x-rays) are centrally stored and securely shareable among healthcare pro- fessionals. To implement this, all hospitals are required to join a state-certified parent organisa- tion that provides EPRs to private individuals. However, the use of an EPR is currently volun- tary both for physicians and the general pub- lic. Consequently, implementation is advanc- ing only incrementally – although there is great public interest and extensive media coverage. According to the Swiss Federal Office of Pub- lic Health, only 72,000 EPRs have been opened until August 2024. Therefore, to further promote EPRs, the EPRA is currently undergoing a revi- sion with the aim of mandating all healthcare pro- viders to use EPRs. Thus, it is envisaged that all Swiss residents subject to compulsory health or military insurance will automatically get an EPR. However, individuals may contest the issuance of an individual EPR (opt-out). The implementa- tion date of the revision remains undetermined. Organ donation Digitisation also affects organ donation. In a ref- erendum held on 15 May 2022, voters approved an amendment to the Transplantation Act intro- ducing an opt-out system. As soon as the law comes into effect, it will in principle be possible to remove organs, tissues and cells from per- sons after their death, provided that they did not object to this during their lifetime (nevertheless, numerous exceptions will persist).
Digitisation plays an important role, as an elec- tronic register will be established to document objections or consents to organ donation. The electronic identity ( “e-ID” ) will ensure the reliable and accurate identification of each registered individual. However, the implementation of such identification method – and thus the register – is contingent upon the enactment of the Federal Act on Electronic Identity, which is currently scheduled for 2026. Increasing costs of Swiss healthcare system The healthcare system in Switzerland is based on a social health insurance system – accord- ing to which, every Swiss resident is required to be insured with a compulsory health insurance provider. This system is designed to guarantee high-quality care at the lowest possible cost while also fostering greater solidarity between those who are ill and those who are healthy. However, this also means that all Swiss citizens are equally affected by cost increases in the Swiss healthcare system in the form of higher insurance premiums. Insurance premiums have been rising continu- ously for the past 15 years. For 2025, health insurance premiums rose by an average of 6% compared to the previous year, even though inflation is low compared to other European countries. Thus, in recent years, these ongoing cost and premium hikes have become a sig- nificant economic challenge and political topic. In addition to the above-mentioned uniform financing of outpatient and inpatient treatments in an effort to reduce disincentives, the feder- al government addresses this issue through a cost-containment programme, whereby various stakeholders of the healthcare system convene biannually to collaboratively formulate specific cost-containment strategies. During an initial meeting in November 2024, stakeholders con-
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