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How German health care is set to become more digital in 2020

From video chats with doctors to accessing patient files online, here's how German health care is slated to digitalize in the coming year.

How German health care is set to become more digital in 2020
It will get easier to arrange doctor's appointments and access medical information online or via smartphone in Germany. Photo: DepositPhotos/WrightStudio

Booking holidays, buying tickets, making bank transfers on your mobile phone: For millions of people living in Germany, much of their everyday life has long occurred online. 

After years of wrangling between politicians and health care service providers, digital services are set to pick up speed in the healthcare system as well, bringing concrete improvements for patients. 

As part of a major healthcare overhaul project by Federal Health Minister Jens Spahn, German residents will be able to access their electronic patient files by January 1st, 2021.

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

The statutory health insurance companies (GKV) and the consumer advice centres are also counting on doctor's practices to offer more digital services – from video consultation hours to online appointments.

“We need a modernization push in the medical practices,” said Stefanie Stoff-Ahnis, board member of the GKV-Spitzenverband, to DPA.

Stoff-Ahnis emphasized that doctor-patient consultations should remain the core of health care. Photo: Depositphotos/photography33

This is important in order to be able to utilize the opportunities offered by digitalization to improve patient care, she added. In recent decades, the reality of life has changed for many people.

“They shop online, work on the move and 24/7 has become the standard of service in many cases. In order to be able to meet increasing demands in this environment, digitalization is an opportunity for doctors and not a risk.”

The following is a look at how technical and digital services are likely to change over the next year in Germany's health care system.

READ ALSO: Patients in Germany to be given speedier doctor's appointments

Video consultation hours

“At the moment, doctors tend to regard this as an additional service,” said Stoff-Ahnis.

Video consultation services have long been taken for granted, yet this is slated to change, with doctors expecting 20 percent of treatments to occur through video consultation hours in five years. 

“Many parents would be happy if – when their child has diarrhoea and is vomiting – they didn’t have to go to the doctor's office, and could instead talk to their doctor via video,” said Stoff-Ahnis.

Online appointments

Lots of patients don't want to be dependent on telephone hours or answering machines when it comes to making doctor’s appointments.

Online appointments are a modern and patient-friendly offer, said the head of the Federation of German Consumer Organizations (vzbv), Klaus Müller, to dpa. 

But not everyone wants to click through digital calendars to set up an appointment. “That's why it depends on the combination,” said Müller.

It would be practical if patients could book appointments online in the evening after work, said the head of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen, to dpa.

“Practices are certainly happy to offer such services, but they must also function technically,” he said.

Waiting room

“Digital notifications can also help with waiting at the doctor’s office, so that patients can go out for a while,” said Gassen. 

But long waiting times can be unavoidable.

“For example, one patient might come to the family doctor with a cold, another will be there seeking a follow-up prescription, and the next is looking for something more complex,” said Gassen. “This can't be planned for in advance.” 

READ ALSO: How Germany plans to revamp emergency care to beat hospital overcrowding

But waiting times should be kept to a reasonable amount, he said.

“Nobody complains if they leave the practice after five minutes if they were sitting in the waiting room ten minutes before,” said Gassen. “But waiting two hours for three minutes of a doctor's time is stupid.”

A man at a doctor's appointment in Hartha, Saxony in January 2019. Photo: DPA

Overcoming technical gaps

Other digital services generally depend on functioning technology, questions of liability and high data protection. 

“The speed is not so bad,” said Gassen. He added that most practices are now connected to an encrypted “data highway” – despite all the difficulties in getting the approved encryption devices.

Legal clarity is also necessary. Doctors take the protection of health data very seriously, and patients know that too. 

“It is understandable that no doctor wants to jeopardize this trust lightly with technology in which he doesn’t fully trust the data protection scope,” said Gassen. 

Consumer advocate Müller said that an increasing number of patients are seeking to use digital health services. 

“As long as no one can access the data who is not allowed to do so, this is a way forward for modern medicine,” he said.

Health insurance companies continue to emphasize that the conversation between patient and doctor is the core of medical care. 

Stoff-Ahnis said: “When we can overcome physical distances through modern technology, many more people can be helped.”

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Health: Doctors in Germany allowed to prescribe digital apps for first time

Germany is not known for being digital friendly. But the country's health system is moving forward – and it's become the first in the world to prescribe insured health apps.

Health: Doctors in Germany allowed to prescribe digital apps for first time
Now doctors can prescribe downloadable apps. Photo: DPA

As part of the new Digital Healthcare Act, Health Minister Jens Spahn (CDU) has made it possible for some health applications – apps and web-based programmes – to be prescribed by doctors. And the costs are to be covered by the statutory health insurance (GKV) in what is thought to be a world first.

The health apps, which will be downloadable to phones or computers, are aimed at supporting patients, particularly with chronic diseases such as diabetes, high blood pressure or anxiety. The hope is also to have apps to support groups such as pregnant women.

On Tuesday the first apps were unveiled after they made it through the test procedure from the Federal Institute for Drugs and Medical Devices (BfArM). They are the Kalmeda app, which promises to help with tinnitus, and Velibra, a therapy programme for anxiety disorders.

A business opportunity?

Until now, apps have been largely excluded from regular health care treatment. However, this development opens up a market for the software industry, which mainly consists of start-ups.

READ ALSO: German health care – Everything that changes for patients in 2020

“Digital health applications are finally coming into mainstream use and will put health care in Germany on a completely new footing. A completely new market is opening up with new players,” said Diana Heinrichs, board member of the German Association for Digital Healthcare. The association was founded to represent the interests of manufacturers seeking a listing by the BfArM.

According to consulting company Research2Guidance, there are around 100,000 health apps in Google and Apple stores. But many of them are leisure or wellness applications such as pedometers or sleep aids. And most of the truly medical, paid apps are based on insecure business models.

Ralf Jahns, managing director of Research2Guidance, expects that this will change as a result of the statutory health insurance reimbursement.

“Numerous developers in Germany and abroad are showing interest in the opportunities that are now being created in Germany,” he said. “This would not only affect start-ups, but also large corporations, especially from the pharmaceutical industry, or hospital chains.”

Photo: DPA

“Certainly, tech giants like Google and Co. will also discover the potential,” expects Jahns. And German start-ups would have the opportunity to become visible worldwide and become international players. Jahns estimates that “hundreds of health apps could make it into the public health insurance system in the medium term”.

But for that to happen there must be demand. A survey conducted by the Yougov polling institute for the Handelsblatt newspaper showed that only six per cent of respondents have used health apps so far. However, 59 percent could imagine doing so if their doctor prescribed them and the costs were covered.

READ ALSO: How German health care is set to become more digital in 2020

Which apps have been approved?

Although only two have been fully approved so far, a total of 27 applications for health insurance reimbursement have been received by BfArM. Uso Walter, founder of the start-up company Mynoise, was one of the first with the Kalmeda app. It aims to help patients suffering from tinnitus through behavioural therapy.

The app counteracts the “ringing in the ears” with a multi-level exercise programme. Patients receive an individual therapy plan, for example with aids to help them cope better with stressful situations. Relaxation and meditation exercises complete the offer.

The Innovation Office of the Federal Institute is also to hold advisory meetings with developers of 75 other apps. In total, the institute has received around 500 enquiries from manufacturers

How do apps qualify?

They have to demonstrate that the treatment process is effective within a year.  The effectiveness of Kalmeda, for example, will now be tested within the next 12 months in a study with 150 test patients.

However, the measures also attract criticism. “The rules as they are designed could create a gold-rush atmosphere,” fears Stefanie Stoff-Ahnis, board member of the GKV-Spitzenverband: “And that cannot be the point of healthcare.”

It also remains to be seen if doctors accept the apps and prescribe them.

Under the healthcare act, Germany wants to see more video appointments for patients plus electronic sick leave notice, and e-prescriptions, as well as improvements to IT systems for doctors and dentists.