“A year and a half ago, we began the process of establishing a new legal framework and innovation-friendly healthcare ecosystem. Since then, many digital solutions for patients and physicians have been implemented, and are now bringing benefits. Apps and telemedicine services can, at least to some extent, support medical workers and carers in what they do as well as provide patients with reliable information regarding COVID-19,” says Professor Jörg Debatin, head of the Health Innovation Hub (hih) in Germany. The think-tank, established by the Ministry of Health (Bundesministerium für Gesundheit, BMG), aims to accelerate the digitalisation of healthcare in Germany and help to translate new laws into practical solutions. Debatin was the guest during the 'Talking Points' webinar, hosted by the HIMSS D-A-CH Community on 17 March 2020.

Until 2018, remote consultations in Germany were not allowed. But a lot has changed since the legal restrictions were lifted. Some of the health insurance funds (Krankenkassen) reimburse telemedicine services that are certified by the National Association of Statutory Health Insurance Physicians (Die Kassenärztliche Bundesvereinigung). While digital health solutions have not been disseminated fully among doctors, stable regulations are now essential.

TOOLS READY TO IMPLEMENT

In response to the COVID-19 pandemic, Health Innovation Hub has published a list of trusted telemedicine services (including costs, reimbursement policy, functionality and prices) that can be easily integrated into a doctor’s practice without technical know-how or hardware investments. Most of them are available for free.

 “We see growing interest. Before the COVID-19 pandemic, only a few hundred doctors were interested in telemedicine solutions for teleconsultations. In the last few days, the number has increased to several thousands,” says Debatin. The secure digital platforms that facilitate doctor-patient interactions are helpful, especially nowadays – with citizens worried about their health when they are cut off from healthcare services by remaining at home. Remote consultations can be offered not only by family doctors but also by specialists, such as psychotherapists and psychologists. They also have to continue seeing their patients, and telemedicine is sometimes the only possibility.

Debatin hopes that, in the long-term, digital health services will settle into the healthcare market. Follow up appointments for chronic patients or prescription renewals can be done remotely, without compromising the quality of the health services. It also leads to a reduction in the workload of clinics. “Doctors gain more time for patients who really need a personal meeting and medical examination at the clinic. This is what digitalisation is about,” emphasises Debatin.

CHATBOT FOR RISK ASSESMENT

Is it a simple cold, flu or maybe coronavirus? A German startup, DOCYET, has created an application that helps to clarify whether a patient has the symptoms typical of a SARS-CoV-2 infection. This so-called Corona-Bot is updated daily, following the latest scientific publications and data provided by the government’s central scientific institution, the Robert Koch Institute, and the Federal Centre for Health Education. The free chatbot ask questions about symptoms and other factors that determine the probability of coronavirus infection. Ultimately the patient receives a clear risk assessment and further advice, including a telemedicine consultation with a chosen doctor.

“The crucial factor is that the bot offers patients access to relevant information from a trusted and evidence-based source. In using it, you can be sure you get the best advice. Such tools protect citizens from fake-news that can mislead,” says the chairman of Health Innovation Hub.

WE ARE BETTER PREPARED

 “We couldn’t manage the epidemic this well if we had not already digitalised the clinic,” says Debatin, recalling another crisis. Between 2011 and 2012, hospitals started to record rising numbers of patients infected with EHEC – a pathogen that can cause life-threatening intestinal inflammation with bloody diarrhoea and kidney failure.

Debatin stated that “a clear situation overview wouldn’t be possible without digital technology,” during the 'Talking Points' webinar. Even seemingly simple tools like electronic health records help create a firm basis for reporting the current epidemiological situation with high accuracy. Access to transparent and reliable information is vital for coordination and effective resource management in healthcare, not only in an emergency.

Much more can be done to prepare for population health monitoring. Since precise mapping of the epidemiological situation is crucial for preventive measures, data donated by the users of wearables could reflect even more precisely the current state, broken down by zip codes.

“We have not gone far enough with the digital agenda in Germany to respond fully to the COVID-19 crisis. Many innovations that could help are planned, but not yet implemented,” says Debatin. He adds that “this pandemic is showing us that we dramatically need to empower the European Centre for Disease Prevention and Control ECDC.” Apart from extracting the power of digital technologies, we should rethink a few issues in healthcare as well as strengthen the European health authorities. It is only when we take this approach that healthcare systems will be able to respond to epidemiological and other health threats in a coordinated and efficient way.

The 'Talking Points' webinar with Professor Jörg Debatin, head of the Health Innovation Hub (HIH) was moderated by Armin Scheuer, VP  of Business Development, HIMSS International. The full recording (in German) is available here.