Bureaucracy: doctors demand relief and sensible digital processes

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Doctors have been complaining about the excessive bureaucracy in surgeries and hospitals for years. To send out a visible signal, the Lower Saxony Hospital Association (NKG) has therefore erected a five-metre-high symbolic wave of bureaucracy in front of the New Town Hall in Hanover. It is intended to show how doctors and other medical professionals are being overwhelmed by bureaucracy. "The oversized wave consisting of cardboard boxes, folders, forms and legal texts symbolizes the ever-increasing burden of documentation and reporting obligations that have piled up in the healthcare sector in recent years," says the NKG.

More and more time is being spent on paperwork, less and less on patient contact. Even more bureaucracy is feared as a result of the hospital reform. According to the NKG, without changes to the law, "in Lower Saxony alone, more than 500 additional full-time employees would be working solely on bureaucracy for documentation obligations, medical service audits and reserve funding as a result of the reform and would therefore be absent from patient care". "Doctors and nurses now spend almost as much time at their desks as they do at patients' bedsides or in operating theaters. Instead of countering the shortage of specialists with structural changes, bureaucracy is causing increasing frustration among our employees. The need for documentation continues to increase without offering any added value for patients," complains Dr. Alexander Poppinga from the Evangelical Hospital in Oldenburg. The German Hospital Federation had already criticized in the past that bureaucratic duties take up three hours a day.

"If the bureaucratic work was reduced by just one hour, there would be an additional 1,700 full-time doctors and around 4,000 full-time nurses available," says the NKG. The association's director, Helge Engelke, presented the Lower Saxony Minister of Health, Andreas Philippi, with concrete proposals for reducing bureaucracy. Philippi therefore promised to reduce documentation requirements, simplify application procedures and continue to campaign for this at federal level. Like the German Hospital Federation, the NKG is also campaigning for the abolition of the hospital atlas published in 2023 – as well as for fewer reporting obligations, less redundancy and a critical review of existing documentation obligations.

Practices also in favor of reducing bureaucracy

A few days ago, the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, KBV) also presented proposals for reducing bureaucracy in 21 areas. "Politicians must simplify and reduce bureaucratic processes as quickly as possible," said Dr. Stephan Hofmeister, Deputy Chairman of the KBV Executive Board. Practices must also be provided the opportunity to transmit information to health insurance companies digitally. "A lot of time could be saved if it were possible to process an informal request via the respective practice management software," said KBV board member Dr. Sibylle Steiner. Although digitalization could help in many areas, processes would often have to be revised.

Electronic patient records as a central element?

Politicians frequently refer to the electronic patient file as the heart of the digitization of the healthcare system, which is intended to serve as a central element of data exchange, especially between practices, pharmacies and hospitals. However, many practices and health insurance companies criticize the fact that many hospitals are not yet using the electronic patient file. According to the German Hospital Federation, hospitals are "in the process of implementing the ePA – provided the corresponding updates have already been made available by the HIS manufacturers". From October, doctors will be obliged to fill in the ePA, but there are still a few issues. However, the electronic medication list contained in the ePA has already proven to be helpful.

Concerns about cyber attacks

One concern of hospitals is that malware could be infiltrated via the ePA. Although those responsible assure hospitals that security is a top priority for the ePA, security gaps have repeatedly emerged in the past. Hospitals already have to deal with cyberattacks regularly. Data protection officers from various countries are currently investigating whether there have been any breaches of data protection at the Ameos hospital network. According to dpa, around 1.5 percent of all data at the Ludwigslust and Hagenow hospitals was leaked at the beginning of the year –, but the main system was spared.

(mack)