Germany’s digital health efforts are failing. Is a Lauterbach strategy the ticket? – POLITICS


This article is the result of a POLITICO working group.

Germany may be known for its efficiency, but that’s not the case when it comes to the digitization of its healthcare system.

Since 2019, Germany has introduced three major new digital health laws covering everything from electronic patient records to digitizing its hospitals. But in hospitals and GP wards, significant progress is anyone’s guess.

While the pandemic has helped crystallize the importance of digital tools such as virtual consultations, in many areas Germany is years behind other countries in the bloc. About 95% of communication between outpatient physicians and hospitals is still done on paper; patients don’t even use their electronic health record; and only about two dozen digital health apps have been approved, according to a McKinsey report.

Health Minister Karl Lauterbach knows the change has been chilling – he was one of the initiators of a proposal to create an electronic patient record during a meeting in a Berlin hotel. It was 20 years ago.

Speaking at the country’s annual digital health show in April, Lauterbach said he “never imagined” that 20 years later he would be standing in front of an audience with the electronic patient record still not fully introduced. . “That thought would have blown me away,” he said.

What is missing according to Lauterbach is a new strategy.

The country has a lot of “tactics, a lot of technology and a lot of innovation, but we don’t have an overall strategy,” he said.

A key problem is that Germany is fragmented with different software and standards used across the country, said Matthias Mieves, a member of the Bundestag and a social democrat. “You don’t have to compare us to Israel. We are also years behind Denmark and Sweden.

This means that the rollout of e-prescribing has again been delayed and electronic patient records are still being implemented in some facilities. Germany has some catching up to do on the arrival of the European Health Data Area, setting a deadline of 2025 for the country to be able to share this data with the rest of the EU.

In Bertelsmann Stiftung’s digital health ranking, Germany is in 16th place, second to last of the countries compared. It shouldn’t be like this.

Eye on the price

“Germany is sitting on one of the greatest troves of healthcare data,” Stefan Biesdorf, partner and member of McKinsey Digital and McKinsey Analytics, told a POLITICO working group on the digitization of Germany in April. “The public health system has comprehensive, longitudinal data for 88% of the German population.”

Different software interfaces and administrative procedures across the country mean that the data of millions of patients cannot be easily used.

Markus Leyck Dieken, CEO of gematik, the agency that manages the platform for digital applications in the health system, is determined to make a difference and to fight against the fragmentation of the German health system, unique among European countries .

Although there are big plans underway in Germany, they are carried out by regions, companies or individual health insurers, he said. Even the systems hospitals use to collect data vary.

“Who has the guts and the guts to say that although we are torn apart by vested interests, we have to overcome them because otherwise no one will have anything?” he said.

Henning Schneider, CIO of the private hospital group Asklepios, describes the problem: they have archived data of millions of patients in local information systems, but in the end they cannot extract much information from the data, because each hospital collected the data with different processes, with different purposes and in accordance with the guidelines of regional data privacy regulations.

What’s left is a “graveyard with a lot of data that you can’t use to improve patient treatment.”

Bring in new blood

The new coalition government led by Chancellor Olaf Scholz has promised to cut bureaucracy, speed up the introduction of electronic patient records and e-prescriptions, and draft a new health data law.

But the reality was a little different.

“We haven’t seen too much action from [the federal government] over the past six or seven months,” said Georg Muenzenrieder, who leads digitization in healthcare at the Bavarian Ministry of Health and Care and is also chairman of the board of gematik.

“We’ve lost time – and not just a few weeks, but over six months now.”

The task of the new government has been made more difficult by the sheer complexity of the health system, said Muenzenrieder. “[Germany has] these different layers of legal framework and decision-making, and they make the system very slow,” he said.

While patients support digitization, less than 1% of respondents actually use it.

“We need a communication campaign,” said Anne Sophie Geier, managing director of the German Association for Digital Health. The aftermath of a pandemic is a good time to convince people, she said.

Lauterbach also seems to understand this, describing himself not only as the “health minister”, but also as the “digitalization minister”. The aim is for the new strategic process to be rolled out after the summer break and for a plan to land this year.

If additional impetus was needed, it comes from Brussels. On May 3, the European Commission proposed a European Health Data Space to promote the digitization of the sector.

“We now have a window of opportunity, we can learn from the past,” Muenzenrieder said.

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