The introduction of the electronic health record (EHR) (German: Elektronische Patientenakte, ePA) in 2021 as a service offered by health insurance companies is intended to ensure all relevant patient health data availability during treatment. On the one hand, the EHR is supposed to reduce coordinative effort within the healthcare system and improve its processes. On the other hand, it requires a considerable degree of competence on the part of patients (as well as health personnel) in dealing with the digital service. In addition, the electronic health record offers the possibility of inspection and control over health-related data. However, the use of this digital service depends on the digital literacy of the users. For older people who often have less experience using digital technologies introducing the electronic health record might challenge them in terms of participation in the health care system. The ePA-Coach project addresses this problem and aims to develop an interactive learning platform to support the digital literacy of older people for the competent and self-determined use of the EHR. The basis for the development of the learning platform is the identification and conceptualization of relevant digital competencies for exercising digital sovereignty in the context of the electronic health record. This publication presents the initial concept of competencies, which was developed based on the European Digital Competence Framework (DigComp). Based on a requirements analysis with the target group, we identified subject areas and learning topics for using the EHR and then derived competence levels and initial learning objectives. This paper addresses the theoretical foundations, outlines the underlying DigComp Framework, and then describes the concrete procedure for developing our approach. The developed ePA-Coach competence concept, as well as learning objectives and methods, are presented. Our concept provides an initial approach to increasing digital literacy for confident use of the electronic health record. It will be iteratively evaluated throughout the project. In the future, the approach could assist researchers and educators in developing digital literacy interventions for seniors. Finally, the future steps in the ePA-Coach project and implications for further research are outlined.