Digital patient education – what doctors should know

What is the legal basis for patient information?

Regardless of whether the patient's information is provided physically or digitally, the legislator's Section 630 (1) sentence 1 of the German Civil Code (BGB) generally obliges practitioners to inform patients of all circumstances that are material to their consent to medical treatment. Material circumstances include in particular - but are not limited to - Page 2:

• Kind
• Scope
• Implementation
• Expected consequences and risks of the measure
• their necessity
• Urgency
• Suitability
• Prospects of success with regard to the diagnosis or therapy

Why does information need to be provided?

The aim of informed consent is to safeguard the patient's right to self-determination: Every individual should be able to freely determine their own body and what happens to it within the framework of constitutional law and other fundamental values of the legal system.

It should therefore be up to the patient to decide whether they want to be treated and which risks and opportunities of alternative therapies are available.

Who is allowed to inform the patient and how?

In formal terms, the legislator imposes several requirements:

• The information must always be provided verbally in a personal discussion between doctor and patient.
• It must take place before the actual treatment and in good time so that the patient has the opportunity to weigh up the pros and cons. With the exception of emergencies and special situations, the patient must be given a reasonable period of time to consider the importance of the intervention in order to form a decision.
• Depending on the individual patient, the information must be understandable for them in terms of language and content.

What documents are required for patient information?

The use of accompanying documents as part of the informed consent discussion, such as information sheets, is not required by law. However, such documents can make the content of the informed consent discussion easier for the patient to understand and are therefore regularly used in practice.

In addition, it has proven to be a good idea to record the content of the consultation to protect against possible medical liability claims and to have the patient sign it afterwards in order to be able to prove the proper explanation in any liability proceedings .

Is the digital education of patients permitted?

The law does not impose any formal requirements on the documents used to inform the patient. This means that an information sheet does not have to be physically present or necessarily signed by the patient. If the information is accompanied by information sheets and these are subsequently signed by the patient, the legislator only stipulates that a version must be handed to the patient.

The digital accompaniment of patient information and virtual documentation and signing are therefore permitted.

What is the probative value of digital patient information documents?

In fact, there are even voices in the legal literature that attach greater importance to the evidential value of digital documentation than handwritten documentation:

‍"The evidential value of a digital information sheet, which has been provided with an electronic signature of the patient and is protected against subsequent manipulation by the security measures described, does not have a reduced evidential value compared to the previous handwritten documentation. manipulation can even be reduced and the evidential value thus increased. be increased." (Professor Dr. Andreas Spickhoff in VersR 2013, 1350)

The future of patient education

In conclusion, it can be said that digital support for patient information is both a permissible, legally compliant and less bureaucratic alternative that reduces "paperwork" in a practice. With the help of digital tools such as Nelly, documents accompanying patient information can now be easily signed and stored using a digital signature.

In future, even more documents will be able to be digitally signed effectively. The German government recently laid the foundations for the Fourth Bureaucracy Reduction Act (BEG IV). The aim is to make the electronic form or text form the rule in the German Civil Code (BGB) and to use the written form exclusively as a substitute for the electronic form. This is intended to promote a modern and digitally supported healthcare system.

Dental information sheets from Nelly

Nelly offers your practice dental information sheets. Your advantages:

• Maximum customizability at the touch of a button: design your information sheets quickly and intuitively. Whether material, affected region or specific tooth - you decide what is relevant.
• Clear and transparent preview: Before final approval, you and your patients can check the forms in a clear preview. This ensures maximum precision and patient satisfaction.
• Digital efficiency: All relevant information such as the time of the procedure, the way it was performed and the doctor's notes are recorded digitally and can be called up at any time.
• Improved patient experience: Together with your patients, you can digitally go through and explain all aspects of the treatment - from side effects to rules of conduct before and after the procedure.
• Seamless communication: With just one click, the forms can be sent to the patient via SMS or e-mail. Simple, efficient and uncomplicated.
• Easy access for everyone: documents can be viewed at any time via both the doctor and patient portals. This promotes trust and transparency in your practice.

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‍About the author: Tobias Kirchgessner, General Legal Counsel, worked as a lawyer for nine years, including in medical law, before joining Nelly. Since January 1, 2024, he has been supporting Nelly Solutions GmBH in all legal matters.

Please note that this guide has been prepared for information purposes only, has no legally binding effect and does not constitute legal advice.‍

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