Medical practice digitalization: stable IT, financing & data protection required

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Digitalization in medical practices could improve patient care and relieve the burden on doctors and practice staff – thanks to greater drug therapy safety, telemonitoring, video consultations, AI, etc. However, the sluggish expansion of digitalization and an investment backlog are a burden on practices. This is why the National Association of Statutory Health Insurance Physicians is calling in a position paper for, among other things, a Practice Future Act to finance digitalization, similar to the Hospital Future Act.

Internet and healthcare network must be up and running

In particular, a stable telematics infrastructure (TI), the “health data highway” of the healthcare system, and user-friendly applications – for both doctors and patients are needed. Disruptions to the telematics infrastructure occur time and again, most recently last Friday and Saturday. According to the Federal Ministry of Health (BMG) and Gematik, however, these were only short-term or partial disruptions.

According to Gematik, only a few health insurance companies were affected by the ePA disruption on Friday. The BMG emphasized that, for reasons of transparency, even “very brief disruptions” are often reported. Gematik is also in close contact with all providers and is implementing “further technical and organizational measures to increase operational stability”.

The National Association of Statutory Health Insurance Physicians does not believe that the TI disruption has hindered patient care. Nevertheless, there were delays due to the switch to the paper process, explained KBV board member Dr. Sibylle Steiner. She also conceded that it is also detrimental to digitalization if doctors do not have an up-to-date infrastructure and, for example, do not have a valid health professional card or do not have connectors with up-to-date software.

Regular TI disruptions are reminiscent of the e-prescription launch

Nevertheless, Steiner also sees that TI malfunctions occur regularly and recalled the nationwide introduction of e-prescriptions. According to Dr. Petra Reis-Berkowicz, also a KBV board member, it is noticeable that TI-induced crashes of TI applications are becoming more frequent, sometimes lasting several minutes, sometimes several hours. Reis-Berkowicz hopes that the disruptions will become fewer, that the “whole circus” will work and no longer have to be discussed in press conferences.

Reis-Berkowicz is optimistic that all of this — AI and well-functioning technology, practices that have to care for significantly more patients than 30 years ago — will be shouldered. However, according to the position paper (PDF), the sluggish expansion of the network is also a burden for practices: “Without fast internet, doctors, and psychotherapists cannot work digitally. This must change.”

Digitalization can only be successful if it eases the burden, says Dr Christian Messer, member of the KBV's Assembly of Representatives and specialist in psychosomatic medicine and psychotherapy. However, there is currently a lot of anger about its functionality. The ePA is “dimensions away” from being of use to doctors. He also emphasized that billing data should not be stored on central servers.

More data protection for electronic patient files

Another of the KBV's demands is that billing and diagnostic data, which health insurance companies enter into the ePA and which can have stigmatizing effects, should only be visible to the insured people themselves. It also emphasizes that health insurance companies, industrial companies and third parties must not be provided access to the data and that the ePA must not become an instrument for health insurance companies to intervene in patient care. In its position paper, the KBV calls for an opt-in model for minors.

End of sanctions

For the future, the KBV is calling for the involvement of medical and psychotherapeutic expertise in the development of digital solutions. There is regular criticism of the fact that the people who use the applications are not or barely involved in the development of products for state digitalization.

Other demands include the expansion of the 116 117 patient hotline, the associated online portal including the “medically validated and algorithm-supported initial assessment systems” for patient management when making appointments. This should take place “according to medical necessity and urgency – based on medical and psychotherapeutic expertise” and “not be determined by economic interests”.

The Westphalia-Lippe Association of Statutory Health Insurance Physicians supports this demand, as it “serves as an important point of contact for medical concerns, especially outside practice opening hours” and can manage care according to “medical urgency”. “The 116117 patient hotline is the key to modern and efficient patient management. The 116117 route relieves the burden on surgeries and ensures that increasingly scarce resources are used where they are most urgently needed,” explains Dr. Dirk Spelmeyer, Chairman of the Board of the Westphalia-Lippe Association of Statutory Health Insurance Physicians.

(mack)