How the electronic patient record affects small therapy practices

Digital healthcare, a big plan with small gaps

Switzerland has been working to digitalize healthcare for years. The electronic patient record is a central tool in this regard. It is intended to ensure that important medical information is bundled in one place and accessible to authorized health professionals — with the consent of patients.

But while hospitals and larger institutions have been required by law to actively use the EPD for some time, the reality is different in small therapy practices. Participation in the EPD has so far been voluntary, especially in professional groups such as occupational therapy, speech therapy, physiotherapy, psychotherapy or podiatry. Many of these practices stay away from the system, for reasons that are easy to understand.

What the EPD should do and why it would be important

The EPD is not a classic medical history and is also no substitute for practice software. Rather, it is a complementary, higher-level platform. It is used to make treatment-relevant information available:

• Diagnoses
• Laboratory values and findings
• Medical reports and hospital withdrawals
• Medication lists
• Therapy reports

Access is only possible with express permission from the patient. In this way, you always have control over who can see which data. The idea behind this is convincing: Health professionals should be able to work with as complete information as possible for better, coordinated and more efficient care.

Why many practices have not yet used the EPD

Despite the sensible basic idea, many smaller therapy practices are reluctant to enter the EPD. The reasons are manifold:

1. Lack of legal pressure
   Existing outpatient practices are currently not required to participate. The EPD is voluntary in this area — unlike for hospitals or newly opened medical practices, for example. Without binding requirements, there is often no incentive to address the issue.
2. Technical barriers to entry
   Joining an EPD community requires certain technical requirements. Not all practice software is compatible. An additional web portal must often be used — with a separate login, new processes and increased complexity. For practices without IT expertise or with a very reduced infrastructure, this is a real challenge.
3. Additional organizational effort
   Documents must be prepared, uploaded and correctly tagged. There are additional tasks in the already busy everyday practice. Managing patients' access rights also requires coordination.
4. Cost question
   Many EPD communities charge connection fees and ongoing annual contributions. For small practices that are already cost-sensitive, this represents a hurdle that should not be underestimated — especially when it is unclear whether the benefits justify the investment.
5. Low patient benefits so far
   As of 2025, only around 100,000 people in Switzerland have opened an active EPD. That is less than 2 percent of the population. So if hardly any patients have an EPD, the effort required by the provider practice is also difficult to justify.

What the EPD can do for therapeutic practices

Even though the direct benefits are currently still limited: In the long term, the EPD offers therapists a whole range of benefits, especially for complex cases or older patients with several treating specialists.

• Better preparation
  Treating persons can view relevant documents even before the first meeting and prepare themselves in a more targeted manner.
• Less loss of information
  When previous information from the clinic or from the general practitioner is available digitally, there is less reliance on narratives. This is particularly helpful for language barriers or cognitive limitations.
• Structured exchange with other stakeholders
  Reports from therapy can be stored centrally. Family doctors, Spitex or rehabilitation facilities then have access, provided that the patient allows this. This promotes collaboration and saves time.
• Safety and transparency
  Everything that ends up in the EPD is traceable. This creates clarity for everyone involved. At the same time, patients remain in control at all times.
• Strengthening the practice image
  Whoever takes part in the EPD shows that we move with the times, we work in a networked way, we focus on quality.

Why the benefits still often fizzle out today

At the same time, it is clear in many discussions with practice owners that the system feels like a foreign body in its current form. Integration into existing work processes rarely goes smoothly. Many perceive the use as:

• too complicated
• too expensive
• explained too poorly
• too little useful in everyday life.

This quickly gives the impression that the EPD primarily brings additional bureaucracy, especially for small teams without time reserves or technical support. Data protection issues also cause uncertainty: Which notes can I upload? How much needs to be documented? And what if the patient suddenly has access to internal assessments?

What is currently changing and giving hope

Despite all initial difficulties, there are also positive developments:

• The Federal Council plans to make the use of the EPD mandatory for all health professionals in the future, including therapists.
• At the same time, the so-called Opt-out model be introduced: Every person automatically receives an EPD unless they actively object. This will significantly increase the number of dossiers.
• Many cantons and EPD providers are now investing in advice centers and digital support.
• With the so-called EPD mail bus Is a mobile EPD opening office touring Switzerland. There, citizens can easily open their dossier and get advice, a low-threshold bridge to digitization.
• Some providers are now using simpler, cheaper entry-level packages specifically for small practices. Technical integration should also be simplified.

What small practices can do now

Even though the EPD is not yet mandatory, it is worthwhile to plan the first steps now. Subsequent coercion comes with greater effort. If you are prepared, you save time and nerves.

It is recommended to:

• Find out more about the EPD community in your own canton.
• Have technical requirements checked.
• Talk to the team about possible effects at an early stage.
• Take advantage of targeted advice from associations or providers.
• Consider a simple test phase with individual cases.

The earlier a practice starts, the easier it is to adapt processes and answer questions.

Conclusion

The electronic patient record has not yet arrived where it should be, primarily not in small treatment practices. But we're heading in the right direction. If technical and organizational hurdles are removed, the EPD can also be an asset for therapists. More information, better collaboration and a stronger relationship of trust with the patient are just some of the potential benefits.