Data exchange in the healthcare sector: Countries are working on own projects
The electronic patient file aims to provide essential data. However, this is not fully possible yet, prompting individual efforts by the federal states.
Presentation of Health Harbor Hamburg at the 9th Interoperability Day.
(Image: heise online)
Although the electronic patient file (elektronische Patientenakte, ePA) is a beacon of hope for politicians and healthcare stakeholders in the growing healthcare crisis, it is unlikely to be at the heart of the digitalization of the healthcare system by early 2025. The goal and hope of the delegates at the German Interoperability Day 2024 continues to be the benefits of functioning digitalization.
Efforts are underway in the various federal states to establish interoperable communication platforms in the healthcare sector. Project manager Dr. Anna Daub presented the Rhineland-Palatinate healthcare platform and Gudrun LiĂź, eHealth department head at Asklepios Service IT GmbH, the Health Harbor Hamburg HÂł initiative. There are similar projects in other federal states, for example in Bavaria, Baden-WĂĽrttemberg and the NRW Virtual Hospital.
Bavaria, Hamburg, Rhineland-Palatinate and Co.
Prof. Siegfried Jedamzik, general practitioner and founder of the Goin e.V. practice network, which has existed since 1999, spontaneously presented various projects in Bavaria –, such as the interoperable patient portal "Mein Krankenhaus Bayern". The data is often only available regionally and the lack of interoperability throughout Germany is problematic. However, with demographic change and the increasing shortage of doctors, digitization is an opportunity, for example to avoid medication errors.
Jedamzik has particularly high hopes for the electronic medication plan planned for 2025 together with the ePA. However, many doctors are not yet sufficiently familiar with the technologies. Experts are therefore repeatedly calling for digitalization to be anchored in medical training.
Daub presented the project to implement an interoperability platform (IOP platform) in the healthcare sector in Rhineland-Palatinate using the example of the participating state hospital in Andernach. The state hospital in Andernach, which specializes in psychiatry and neurology, wants to improve the quality of information, diagnosis and treatment and uses a cross-institutional Master Patient Index (MPI) for the automatic assignment of patient data to a unique patient identity.
Patients must give their prior consent
The Health Harbor Hamburg initiative consists of hospitals, the Hamburg Medical Association, health insurance companies and the Association of Statutory Health Insurance Physicians. It was founded in 2019 and aims to improve data exchange for 21 hospitals so far, but also to involve medical practices in the project. The current focus is on transferring structured data to the electronic patient file and creating a telemedicine network.
The exchange of images in the DICOM standard is also planned. This is easier with an IOP platform including MPI. LiĂź also sees the securing and financing of the continued operation of the central platform after the end of the funding period and the standardization of processes in the various clinics as a challenge. Follow-up financing is often a problem, especially for service support and maintenance contracts.
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Joint exchange platform desired
All participants at the conference were open to cooperating with other federal states if they were not already doing so. The participants also stated that they were also considering a connection to the telematics infrastructure, the data highway for the healthcare sector.
However, promising projects such as the electronic patient file are not yet delivering the desired added value for hospitals in particular, even though doctors would like an interoperable exchange platform to be able to transmit documents to medical practices quickly and securely, as well as to communicate with patients. All this is supposed to happen, but the deadlines keep getting pushed back.
Insanely complex
"To be honest, you do it because you have to," said Andreas Hempel, Solution Architect at Asklepios Service IT GmbH. Hospitals are being faced with more and more obligations, but the resources are lacking. He also described processes relating to information security, such as PDF/A-1, as "incredibly complex". In his opinion, the ePA was built more for doctors' surgeries and not for hospitals.
Keeping airplanes on the ground
Medical IT specialist Prof. Sylvia Thun was impatient that interoperability has not worked in Germany for 25 years. At the Charité, she already has experience with software manufacturers that adhere to international standards. She would "ground any aircraft" that does not adhere to the standards that have been in place for a long time. She is a little angry about the whining.
"We are putting patients at risk if we carry on like this," said Thun. For her, it is inconceivable that some of the providers of hospital information systems nicht once five FHIR resources can implement the standards laid down by Gematik in the ISIK specification (for information technology systems in hospitals). Other countries would also be able to implement the specifications.
According to Heike Diebler, from the German Association for Interoperability in Healthcare and deputy chairwoman of the Saxony SME and Economic Union, more clarity is needed across the federal states, as otherwise there is a risk of a standstill. With reforms in the healthcare sector, such as the upcoming hospital reform, a lot will also happen in Saxony.
(mack)
