Warken promises to reduce bureaucracy and wants to stick to ePA timetable

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In her first speech at the Doctors' Conference, Health Minister Nina Warken stated, among other things, that she wanted to take the issue of reducing bureaucracy seriously. The planned measures ranged “from the introduction of a de minimis limit for recourse checks for doctors in private practice to the review and simplification of administrative procedures in hospitals”.

The President of the German Medical Association, Dr. Klaus Reinhardt, had previously called for an urgent reduction in bureaucracy, which had already been promised several times, instead of creating more bureaucracy. He said that “more than 50 million net working hours per year are spent on bureaucracy” in the statutory health insurance sector. On average, this means 61 days of work for each practice; in the inpatient sector, the time required is three hours per day.

Major reform plans

In addition, patient management should be improved, and a primary doctor system should be introduced, in which patients with health problems should always contact a GP practice first and this would serve as a point of contact for faster “appointment referral for further specialist treatment”, said Warken. The aim is to provide sustainable outpatient and inpatient healthcare. This is a complex reform project.

Regarding the hospital reform, people should not just “mistakenly think” that it is about “closing their local hospital”, but about improving the quality of care. Nevertheless, it could still be the case “that a longer journey will be necessary for a specialized, plannable operation”, said Warken. Ultimately, it is about achieving the best possible outcome for health.

Improving data availability for AI

She also emphasized how important it was to use the “opportunities of artificial intelligence for better care” in the coming years and “at the same time consider possible concerns associated with the use of this tool” because AI also offers “great opportunities” to relieve the burden on doctors. To achieve this, data availability in the healthcare sector must be improved, the issue of data security must be kept in mind, interoperability in the healthcare sector must be strengthened and “everyone must be prepared to be open to good solutions”.

Stability and security to be improved

The same applies to the electronic patient file: “I know that the topic is still controversial, but the ePA not only creates added value for patients, but especially for you [the doctors, editor's note] in the practices”. The ePA is still in its infancy, but can do more and more. “We are therefore sticking to our timetable. I know that not everything is running smoothly in some practice management systems currently, but please don't be put off, help us to make the project even better and try out the ePA. It is the future,” says Warken confidently. The more the ePA is used, the faster it will become the standard, with all its advantages. At the same time, Warken promised to “pay particular attention to the security and stability of operation”.

What role should AI play?

Medical Association President Reinhardt also expressed his conviction that AI will ease the burden. AI will “profoundly change society, but also medicine”. It offers “great opportunities for research, for more precise diagnostics and for more individualized therapy”. AI will “disruptively change” knowledge generation and decision-making. It could accelerate processes, which would be helpful in times of skills shortages and demographic change.

Doctors need to ask themselves what role AI can play in medical care and whether it can replace medical services. This question will be explored at the Doctors' Conference. To this end, Reinhardt referred to the papers of the German Medical Association: From medical art with artificial intelligence (PDF); the statement “Artificial intelligence in medicine” and the statement of the central medical association at the German Medical Association.

It is important to seize the opportunities and take the risks seriously. This requires “clear regulations and binding guidelines”. The responsibility for decisions should not be transferred to algorithmic systems alone. Responsibility cannot be shared, “not even between humans and machines”. This socio-ethical obligation is part of the medical profession.

AI is increasingly finding its way into practices

In practices where AI systems are used, they help to make diagnoses and simplify practice processes, such as documentation and appointment scheduling. “Artificial intelligence offers enormous opportunities to improve the quality of care and reduce the workload in practices and clinics. If 78% of colleagues see AI as a great opportunity for medicine, and it is already being used in one in seven practices and almost one in five hospital teams, then this shows that the medical profession is ready for this transformation – provided it is ethically reflected, medically responsible and technically reliable,” says Reinhardt, who is also the Federal Chairman of the Hartmannbund, about a survey initiated by Bitkom. For the non-representative survey, Bitkom interviewed more than 600 doctors from the Hartmannbund.

According to Wintergerst, the ePA is a prime example of “delayed digitalization”. According to the survey, 86 percent of doctors are not of the opinion that working with the ePA is technically smooth. According to the survey, 66 percent fear data misuse and 62 percent fear high technical costs. When asked about the advantages of the ePA, most doctors cited the possible insight into medical history, the avoidance of duplicate examinations and drug therapy safety. A minority see no advantages, and less than half (41 percent) are looking forward to working with the EPR.

Electronic patient file: Doctors not prepared, but open

Two thirds of doctors are open to the introduction of the electronic patient record (EPR), although 77% do not feel well-prepared. “Only if we make the electronic patient record suitable for everyday use, compatible and easy to use and consistently take medical staff with us will it really be a step forward in practice operations,” said Reinhardt. While the ePA offers opportunities such as the avoidance of duplicate examinations, there are concerns about technical challenges such as security and data protection.

Digital technologies such as robotics and virtual reality (VR) are also widespread. VR is used by a tenth of respondents, for example for training purposes or during operations. More than half do not yet use VR, but consider it useful (54%). Telemedicine is used by 28% of doctors, for example to monitor vital signs remotely or in the form of video consultations.

According to the survey, however, digitalization is being held back by structural and technical hurdles as well as an “overly strict” interpretation of data protection. “The will to digitize is there – but the structural hurdles remain high. 81% of colleagues see the complexity of the system as a key obstacle, 72% even see data protection as a brake on innovation. Clear political decisions are now needed: for transparent procedures, sustainable infrastructures and consistent data protection – for the benefit of patients,” emphasized Reinhardt.

(mack)