Roadmap for the Digitization of Healthcare

The digitization of the healthcare sector is not making much progress. The players involved should step on the gas to benefit from the advantages of a networked healthcare system. It is time to move into the fast lane. The following digital strategy will make it happen.

The German government's interdepartmental digital strategy cannot be transferred to the healthcare sector. The five fields of action - digital competence, infrastructure and equipment, innovation and Digital Transformation, society in Digital Transformation, and modern state - are too unspecific for that. But a different strategy for this sector does not yet exist.

Yet it would be so urgent and to the benefit of all involved to strategically plan the Digital Transformation of the healthcare system so it can then be implemented efficiently and purposefully. After all, it is not an end in itself. The point is that

• digital processes and technologies improve healthcare everywhere and provide optimal support for all stakeholders, as well as
• ensuring that the correct information is available in the right places, securely and without delay.

How should such a strategy be structured? What framework do conditions need to be taken into account in its implementation? Where do the responsibilities lie? 

When it comes to who is affected by the digitization of healthcare, many people first think of doctors in private practice, hospital staff, and pharmacists. This is not surprising, as they represent huge user groups with 120,000 doctors' practices, almost 2,000 hospitals, and around 20,000 pharmacies. However, the players in the healthcare sector include many other parties, such as:

• Physiotherapists and psychotherapists
• Spa facilities
• Medical supply stores
• Professional associations
• Health insurance companies
• Health authorities

Not to forget the patients, who form the numerically most robust group, which is also very inhomogeneous. This includes, for example, the fact that in addition to digitally savvy individuals, numerous people are less proficient in modern communication technologies. Therefore, it is imperative to ensure a high level of user-friendliness when implementing digital solutions so that technical hurdles exclude no one.

However, the networking achieved in this way must take place between the people involved and include the specialist services. These are the electronic prescription, insurance master data management, and the electronic patient file. Currently, many of these services exist independently of each other. Not only is it impossible to exchange data, but the various applications also do not even "know" which data or data sources are available to the other specialist services. The reason: the technologies used are currently not interoperable. This can only be changed if they are subject to the same standards.

To illustrate this with an example: For specialist services to be able to exchange data reciprocally, it is irrelevant how the system's internal data processing takes place. In the future, this will be different for e-prescriptions than for digital patient files. The interfaces, the so-called system outer edges, are crucial. These must be standardized according to internationally recognized procedures. Only then will the data be mobilely exchangeable between the various specialist services and serve as the basis for smart processes and systems.

The aim is to establish a "seamless digital patient journey". With a view to optimal care, the patient can share relevant data at any time, already during the first contact with his general practitioner, but later, for example, with the specialist providing further treatment, the rehabilitation facility, or the medical supply store.

The organs of self-government have always been responsible, among other things, for improving healthcare and preventive care. In the digital age, knowledge transfer takes on even greater importance. There is an acute need for action, particularly in training. After all, it will become increasingly important for healthcare workers to be able to handle digital technologies.

The professional associations, but especially gematik, which is responsible for developing the electronic health card and coordinating its infrastructure in Germany, have other tasks to perform. These include,

• ensuring that there are no state-specific, isolated solutions, but relatively uniform solutions across the country,
• that not only the data but also the process interfaces are standardized,
• that only internationally established standardization procedures are used and that the standards are mandatory for each system interface so that all applications are interoperable,
• that all participants throughout the EU, both university hospitals and research-based companies, have access to a shared data pool in the area of "research and development",
• that gematik maintains a standard and interop registry available to all stakeholders.