Successfully digitizing health - the digitization strategy of the Federal Ministry of Health
A shortage of doctors and overworked healthcare staff, care for rural areas, an aging society and rising costs for the solidarity system – the current challenges for the German healthcare system are enormous, diverse and complex. A major opportunity to successfully meet these challenges is to drive forward digitization in healthcare and to exploit the potential for digitization in care.
Since the pandemic at the latest, there has been a broad consensus in society and politics that digitization gaps must be closed. For example, data are collected in many places in the health care system, but so far they cannot be used meaningfully in research and care. This requires standards and interfaces as well as a functioning electronic patient record (ePA) that is used across the board.
The question of how the medical profession and patients can be convinced of the benefits of far-reaching digitization and the design of data protection, which has been very restrictive up to now, are also open flanks that have hampered digitization potential to date, in addition to the solution of interface problems.
The Federal Ministry of Health wants to provide a roadmap for implementing these topics with its new digitization strategy.
What is the digitization strategy and what are its goals?
With its digitization strategy, the Federal Ministry of Health aims to develop clear goals and a vision of the framework conditions and prerequisites under which the digitization of the healthcare system can succeed and the potential for digitization in healthcare can be realized.
The strategy’s goal is titled “Vision 2030.” Specifically, digital innovations are intended to help “live healthier longer,” “improve quality of outcomes at stable costs,” “improve working conditions,” and ensure “demand-driven access to excellent care.” The strategy process will determine which adjustments need to be made to bring these keywords to life.
The BMG’s Digitization Department 5, headed by Susanne Ozegowski, is in charge of this project. The Federal Data Protection Commissioner, Dr. Ulrich Kelber, will also have to be significantly involved in the development of the strategy. The latter recently criticized the data security of the electronic prescription and the ePA.
The ministry would like to pay special attention to supply problems and the user perspective. To this end, he said, the BMG is also prepared to “abandon the paths we have taken in the digitalization of the healthcare system if there are good reasons for doing so.
This could also mean a restart of certain projects of the telematics infrastructure applications of the semi-public operating company gematik, because Lauterbach himself describes, for example, the electronic prescription as an application that has not yet arrived in the reality of care and whose direct benefit for doctors, patients and pharmacies is not yet tangible.
At the heart of a digitized healthcare system would also be ePA 4.0. This is to be established nationwide and made usable for research purposes. In the opinion of the BMG, an opt-out solution is indispensable for this, so that every insured person receives a file if there is no explicit objection. The German government’s digital strategy, which was presented in the summer, already set the ambitious goal that 80% of insured persons should be in possession of electronic patient records by 2025.
How does the strategy process work? Who is involved?
The strategy process was first announced back in April of this year. Repeatedly, the need for a participatory process was emphasized in order to take into account the perspectives of many stakeholders. Various participation and dialog formats should provide a platform for this:
- Kick-off event: In September 2022, the Federal Minister of Health, Prof. Dr. Karl Lauterbach, invited relevant stakeholders to Berlin to give the starting signal for the joint development of the strategy.
- Online survey: Stakeholders from the healthcare and nursing sectors had the opportunity to contribute their perspectives and expertise via a digital commenting procedure.
- Expert interviews: The BMG conducted in-depth background discussions with experts from the fields of healthcare, politics, science, business and patient advocacy. In particular, current challenges were addressed so that problems can be more concretely defined and strategically addressed.
- Expert forums: The content from the kick-off event, the expert interviews and statements were finally discussed in greater depth in eight different expert forums (“Care processes health and care”, “Acceptance and enthusiasm of the insured”, “Patient sovereignty and digital competencies”, “Regulatory framework”, “Economy and efficiency, technologies and applications”, “Data, data models, interoperability and architecture”.
International experience is also to be incorporated into the development of the strategy. For this, the BMG looks to the countries of Israel and Denmark and their implementation of data use and establishment of an accepted and used patient record. The findings from the expert forums are summarized in key points, which in turn provide for an opportunity to comment.
At the end of this process, a legislative process will be initiated that actually reflects real-world care requirements. The results of this participation process are to be reflected with all participants and transferred into a common vision as well as concrete goals.
Where are we right now?
At this point in time, both the online survey and the expert forums have been successfully completed. Now the challenge is to evaluate the diverse results and impulses. Finally, the strategy is to be presented to the public in spring 2023.
What do we want from the digitization strategy?
In March 2022, the German government’s Commission of Research and Innovation Experts once again acknowledged the great potential of digitization in the healthcare sector with regard to higher-quality and more efficient healthcare, which has not been nearly exploited to date.
It is well known that digital technologies and health data utilization improve the quality of healthcare and that modern digital analytics offer far-reaching opportunities for personalized diagnosis and therapy. This potential has been wasted in recent years due to a lack of digital structure. Corona became a burning glass for the digital weakness of the German healthcare system.
Our own experience over the past two years as a software company in the field of Corona digital test management has shown us how simple, digital and automated processes can make a big impact. Thanks to the use of technology in test management, we were able to ensure timely test delivery and reduce the risk of contagion on site for all parties involved.
The reduction of manual data entry increased safety and reliability in the testing process. In doing so, the use of contact points can also reduce the risk of new infections as much as possible. In this way, Probatix was able to contribute to the protection of the population and vulnerable groups in particular.
It is to be hoped that the digitization strategy can close existing gaps and lay a foundation for an optimized healthcare system in which digitization potential is fully exploited in the interests of patient welfare. Above all, the issue of data protection must be rethought for this purpose. This must not be used as an excuse in the German healthcare system to prevent important and useful applications.
Therefore, the added value of collecting and using data, e.g., in care and research, must be brought to the fore and implemented in a patient-oriented manner along the digitization strategy. Convincing the population of the benefits of applications such as the ePA is also elementary for the implementation of the goals set by the government and will present us with a task for society as a whole.
