Germany steps up race to catch up with innovation in digital health
Germany’s recent Digital Care Act is set to bring new opportunities for the biggest healthcare market in Europe to accelerate efforts to digitise and innovate.
Below, Dr Jens Baas [pictured on the right], CEO of one of the country's largest statutory health insurers, Techniker Krankenkasse (TK), tells us what it means.
This interview has been edited for clarity.
Healthcare IT News: Over the past couple of months, I think it’s fair to say that the European digital health space has been buzzing with excitement following the German parliament’s passing of the Digital Care Act. With this, it’s clear that Germany wants to make a big leap forward. However, until now, it has not known to be at the forefront of digital health. Why is that?
Baas: The German healthcare system still is one of the best worldwide and that's the reason for the slow progress. The system works and many players profit from it. It is part of human nature to only start tackling the problems when they become obvious and the old system is no longer tenable. In Germany, we have realised in the meantime that an increased degree of digitalisation in health care is required.
HITN: From TK’s perspective, what does the Digital Care Act bring new to the table?
Baas: The act will lead to a [sic] significant progress in digitalisation of the healthcare system in Germany. It's the basis for a fundamental modernisation of the system. From the view of the health insurance funds, the act is, above all, significant, because it offers us more possibilities to promote digital innovations and to ensure a quicker implementation of digital health applications into health care. It is also a bedrock for the future electronic patient record, because it aims at including more healthcare providers into the healthcare telematics infrastructure. Of course, we also appreciate that the act fosters the implementation of telemedicine, streamlines administrative processes and makes it possible to use health data for research. These are crucial factors for Germany to begin its race to catch up with digitalising the healthcare system and avoid falling behind by international standards.
HITN: One of the aims of the Act is to ensure that patients are able to use healthcare apps quicker and with ease. These tools, which doctors will be able to prescribe, will be tested against several requirements by the Federal Institute for Drugs and Medical Devices, and will be reimbursable by statutory health insurers for one year. How will this work in practice? What metrics would you say are important for insurance when deciding to incorporate or cover a certain digital health product?
Baas: The possibility of getting apps on prescription is a real innovation. Insurees are thus entitled to cost reimbursement when using digital health applications for which a fee is charged if they are prescribed by a doctor. The quality of the apps has, of course, to strictly and regularly be checked just as with medication and medical consumables and assistive products. The catalogue of criteria is still being developed. We as health insurance funds focus on the efficacy and data security. In addition, a health app has to have a high degree of functionality. The user must be able to use it intuitively and it must offer reasonable support from prevention up to the therapy of illnesses.
HITN: Reimbursement has traditionally been a major hurdle for digital health. What do you see as insurance's role in digital health reimbursement in the future?
Baas: The Digital Care Act and the possibility for insurees to get apps on prescription actually also changes the roles of health insurance funds. We as health insurance funds are able to more actively shape the health care system and to more actively support our insurees with regards to their health.
HITN: The new Act also shows a push to create a vibrant digital health startup ecosystem in Germany - stating that health insurance companies will be able to provide funding and work with venture capital funds focusing on health innovation. What is TK’s view on this, and have you already started doing so?
Baas: Already today, we are closely cooperating with start-ups and will continue to do so as well as further develop these relationships. The Digital Care Act offers new possibilities and important rules of the game to improve that cooperation. What is important: As a health insurance fund we will not act as a mere capital provider. Health insurance funds are not merely interested in yields but act in the interest of their insurees to offer them the best possible care. Our added value is not to earn money in the first place but our knowledge of the insurees' needs and the mechanisms to integrate new ideas into standard care.
HITN: As the deployment of new digital tools transforms the delivery of care, how will the role of insurers change?
Baas: Germany currently is at an important waypoint along the path to digitalisation of the healthcare system. New digital tools such as the electronic patient record are important steps to implementing a modern and patient centred health care. The health insurance funds were assigned a central role here, since they do not consider health to be an area to gain profit from in contrast to commercial enterprises. Therefore, sensitive insurance data are in good hands with them.