Rising costs, increasing regulation, crippling bureaucracy: Germany's nearly 2,000 hospitals have to contend with many challenges. The Hospital Futures Act (Krankenhauszukunftsgesetz) now provides funding for digital solutions. But what should a successful digitalization strategy in a hospital look like?
Anyone who still harbored doubts about the enormous benefits that digitalization and networking really offer for our healthcare system should have been convinced by the launch of the digital registry for intensive care beds at the latest. Doctors had called for such a central registry for a long time in order to quickly find the next available bed in an intensive care unit in case of an emergency. But it was only because of the coronavirus pandemic that it was launched in just two weeks. Since then, the information has helped tremendously in making the best use of existing capacity and optimizing patient care.
The healthcare system in Germany is among the best in the world. But the coronavirus crisis shows that the medical system is under strain. The approximately 2,000 hospitals are suffering from ever greater levels of regulation and growing bureaucracy. As a result, the cost of care is skyrocketing, and revenues are lagging. The statutory health insurers (GKV) calculate that spending on hospital treatment rose by another 3.9 percent last year – to EUR 80.9 billion. The bottom line, however, is that hospitals are not necessarily benefiting from this, owing to rising personnel and material costs – a trend that the Corona pandemic has exacerbated: hospitals must keep intensive care beds, doctors and nursing staff free for Covid-19 patients, but the flat rate of EUR 560 per day only partially replaces the actual revenue that facilities generate with an intensive care bed. The result: the economic woes of many hospitals continue to worsen. According to a study by management consultant Roland Berger, almost 60 percent of German hospitals expect to run a deficit in 2020. Sales are also on the decline: while two-thirds of the companies reported rising sales in 2019 (67 percent), just under 30 percent expect growth in 2020.
But how can this negative trend be reversed? Advisors recommend more efficient management, for example through purchasing cooperatives and cooperative supply arrangements. In addition, they are to optimize their medical services, for example by offering more outpatient treatments, for example via video consultations. Basically, the study advises hospitals to digitalize services, invest in up-to-date medical technology and optimize their processes with IT systems. This is because digital services such as electronic patient records (ePA), electronic doctors' letters or closed medication loops reduce costs and increase the quality and safety of treatment.
Sensible, but quite costly solutions, whose financing is now also supported by the federal government: with the Hospital Future Act (KHZG), the federal and state governments are providing hospitals with EUR 4.3 billion for a digital infrastructure and modern emergency capacities. Now each hospital has to take care of itself in order to actually draw down the funding from the Hospitals of the Future program.
First, clinics must set priorities based on their digitalization strategy. In order to benefit from the funding pot, hospitals must cover certain thematic areas, but may not have started implementation until after 02 September 2020. Funding is provided for projects in these fields:
In the second step, the facilities should determine their current digital maturity level – for example, via Check IT now. And based on this, consider concrete measures such as setting up a closed loop medication function. It improves therapeutic safety in the handling of medicines and turns hospitals into digital pioneers. The fact that there are not yet many of these in Germany can be seen by taking a look at the Hospital Report of the Scientific Institute of the AOK: According to the study, German hospitals score an average of only 2.3 out of a possible seven points. Hospitals have to rely on qualified partners in order to quickly improve their performance in this area. Certifications are used to regulate which IT service providers are suitable for hospitals. And be careful: if the implementation deadline passes by without action being taken, sanctions may be imposed.
The Hospital Futures Act also mandates that 15 percent of grant funds be invested in IT security. However, the funding will probably only be allowed to flow into initial projects; ongoing costs are not eligible for funding. From the experts' point of view, however, this is a problem: IT security is not a sprint, but a marathon. Instead of one-off funding, German hospitals would need continuous funding to keep their infrastructure permanently up to date.
TelekomHealthcare Solutions is among the certified hospital service providers. The team supports clinics in developing and implementing their digital transformation throughout the entire process with individually tailored digitalization packages. Together with the hospital management, the company determines the exact need for action and develops concrete recommendations for a digitalization strategy. We list specific digitalization and modernization measures, report the need to the federal state and apply for funding from the Hospital Futures Fund. Of course, we also guide a facility's digitalization project in the long term by taking over the management of project documentation and records management.
German Health Minister Jens Spahn has set a lot in motion through the law for the coming months. For example, the connection of clinics to the telematics infrastructure took effect on January 1, 2021. Also starting in the new year, all insured persons will be able to receive an electronic patient file from their health insurer. This also creates an obligation for hospital operators to keep patient data digitally available and to store it in the ePA on request.
