Failures of the past
The electronic health records (EHR), which was launched in 2004 with the GKV-Modernisation Act, is still not in use. Why? Patients were understandably concerned about their data and were not sufficiently informed about the advantages of electronic health records. Physicians, too, continued to work in the same way as before for lack of convincingly communicated visions of the future. Politicians failed to present the opportunities of digitisation and ways of implementing it pragmatically.
Since then, digitisation in Germany’s healthcare system has been slow to gain momentum. New technologies such as virtual reality, blockchain and artificial intelligence have not been constructively integrated, the groundbreaking possibilities of digitisation remain largely unused. Securing the digital sovereignty of every user through the use of technical innovations such as blockchain could, however, contribute to resolving the problem. If technology could make one thing easier, it should be the communication between doctors, patients and politicians.
Time is of the essence when it comes to implementing electronic health records, especially as Germany has long since missed the boat; in 2018, the Bertelsmann Foundation analysed and compared the status of digitisation in 17 countries in the Digital Health Index. In terms of political strategy, technical implementation and actual data use, Germany ranks 16th out of 17.
Learning from the frontrunners
Since January 2018, so-called data integration centres have been set up, amounting to more than 150 million euros, with the goal to network physicians from all fields and to provide the necessary information for every application. This is an important first step, but its implementation will continue into the next decade. In order to finally make noticeable progress, a cleverly moderated discourse, a concerted strategy and concrete measures are needed to come closer to the goals of personalised cancer therapy, the treatment of Alzheimer’s disease or more intelligent intensive care solutions.
It is worth taking a look at the top-ranking countries in the aforementioned Bertelsmann Foundation Digital Health Index. After all, if there is one positive outcome of the fact that Estonia, Canada, Denmark, Israel and Spain are far ahead of Germany, it is that we can learn from their success.
Three decisive factors of success are an effective strategy, political leadership and a national coordination unit. Politics provide a clear framework, promote acceptance among the stakeholders and promote dialogue. Successful countries are also taking a pragmatic step by step approach by first introducing the digital prescription.
Implementing digital sovereignty – and communication
The vision of personalised medical care will only be possible in the future by using the personal data of each user. Data is the key to the success of any solution. The goal of every development must be, to clearly demonstrate the immense benefits of using this data and to address any possible concerns. Security is crucial, the digital sovereignty of each user must be preserved. The end here does not justify the means, but rather it must be made as transparent as possible what is to be expected and what is not. Transparency and self-determination of the user must be maintained at all times – especially if the user is the patient.
Systematic integration of wishes – and worries! – from patients, nurses and doctors
In the above-mentioned milestones and in the development of eHealth products, we must seek dialogue with actual users. UX researchers are experts at identifying the fears and oppositions of users and are able to transform them into quality features of an optimal solution during further development. A major obstacle for digitisation in healthcare is the concern of ” dehumanising medicine ” through eHealth products. UX experts can leverage these concerns, by placing the users’ everyday reality at the centre of the development of technology based services. Such services are experienced as human if they offer a direct personal advantage, for example, to enable a physician to bring relevant information together intelligently and professionally. Whenever this happens, the patients’ fear of a product that is allegedly intended to replace a physician disappears.
Technological innovation also requires innovative and empathic implementation processes in order to really gain the users’ trust.
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