From lockdown to lock-in: warning about software dependency in healthcare
During Corona, the federal government concluded a pact to digitize the health authorities. But crisis-proof, interoperable IT was not procured, say experts.
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Even with the ongoing digitalization of the healthcare system since the coronavirus pandemic, it is still far from crisis-proof. Nicolai Savaskan from the Neukölln health authority and Mesut Yavuz from the Nuremberg-based company Yes Automation criticize this in an essay on lessons from Covid-19 available online at heise. According to them, the lockdown threatens a lock-in, i.e. a dependence on proprietary software manufacturers for hospitals and health authorities. The CrowdStrike disaster has shown how great the dangers are.
As a result of the pandemic, the federal government put together an 800 million euro pact to digitalize the public health service (Ă–ffentlicher Gesundheitsdienst, Ă–GD). Considering the previous work with paper, fax and at best Excel, as well as the associated paperwork for contact tracing during the first corona wave, the technical upgrade of health authorities for the 21st century "was a necessity", the practitioners write. The first tranche of the Ă–GD pact in 2021, amounting to 260 million euros, was mainly spent on hardware such as whiteboards, cell phones and laptops. This means that at least the technical prerequisites for digitization are in place, but this is not yet the case.
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Warning against dependence on Microsoft
Just 5 percent of the total funding amount went to cross-state digitization solutions, while 41 percent went to individual projects and 54 percent to non-cross-state measures, the duo calculates in another paper on the Ă–GD funding programme. For example, the federal states applied for funding eleven times for the same application - software for all state health authorities with numerous duplicate structures. In general, the measures to date have "mostly focused on short-term solutions instead of long-term, crisis-proof interoperable systems", the insiders complain. Incidentally, millions are being spent "redundantly and ultimately inefficiently".
At the same time, health authorities and ministries "made themselves too dependent on Microsoft", Savaskan and Yavuz give an example. As a result, they no longer have any room for negotiation when it comes to the pricing of license fees. The researchers counter this with the "numerous advantages" that open source offers. These include elements such as interoperability and shared data exchange, scalability, simple collaboration with all stakeholders, data protection, security and transparency as well as "permanent procedural learning". It is long overdue to use this open approach to pave the way "for a digitally sovereign Ă–GD in Germany".
According to the experts, the "digital health authority 2025" mission statement contained in the Ă–GD Pact already aims to achieve interoperability across all levels. Unfortunately, however, this was not considered in the BMG's call for funding. In contrast, the associated guidelines stipulate that open source licenses should be prioritized. However, this requirement is still not sufficiently observed in practice. It is therefore also necessary to strengthen digital skills in the Ă–GD and establish a digital global "One Health Platform". In an interview with heise online in 2022, Savaskan criticized shortcomings not only in the digital reporting system. (rme)
