Digital conversion costs hospitals billions

Tablets that send signals for correct intake after dissolving in the stomach, or contact lenses that constantly measure eye prere to prevent glaucoma: In the medicine of the future, many things are conceivable that today sound like dreams of the future. The art of healing, so far little upended by digitization, is about to undergo a transformation. It offers opportunities for patients, facilitation for physicians, business for corporations, but also risks in data protection.

Worldwide, the digital healthcare market will more than double to a good 200 billion dollars (170 billion euros) by 2020, reports dpa, citing estimates by the consulting firm Roland Berger. Investors put vast sums into growth companies developing health apps for smartphones. They could record blood prere and body temperature, make initial diagnoses and recommend that owners visit a doctor. And electronic patient records could improve treatments and reduce costs in healthcare systems by $80 billion in the medium term, says Thilo Kaltenbach, Partner at Roland Berger.

The evaluation of patient data is one of the most important future projects in the German healthcare system. Lushly funded with 150 million euros from the German Federal Ministry of Research, an initiative is underway that could one day allow university hospitals to share patient data. So far, billing data from health insurance companies has been analyzed, but not medical data.

Clinicians and researchers are already producing a lot of data, the ministry says. "More and more X-rays, doctor's letters or laboratory values are being recorded electronically". But the data would not be linked enough. Patients therefore often went through an odyssey with doctors until they received the right treatment. Often there is a lack of comparable medical cases or long-term experience.

A bridge is now to be built between patient care and research. He said the project helps researchers gain a better understanding of diseases, which is "urgently needed for new prevention, diagnosis and treatment methods". In the end, clinics and doctors should be able to access patient data via interfaces and rely on all the data that is important in the healthcare system.

The United Kingdom has had good experience with the integration of patient expertise, says Susanne Mauersberg, health expert at the Federation of German Consumer Organizations (Verbraucherzentrale Bundesverband). "Meanwhile, more patient experience is urgently needed in research, even with Big Data".

Physicians' representatives also welcome the use of anonymized treatment data. For research, it would be "real progress" if patients could determine whether their treatment data could be stored in "secure and state-controlled" databases, says Peter Bobbert, federal executive at the Marburger Bund. But for that, high scientific and ethical standards would have to apply, and patients would have to remain masters of the process. "Data protection must not be set aside."

A common position of all federal states for patient consent is still missing. Mauersberg promotes a practical solution. If sick people have to give their consent for each purpose individually, this is not very practicable. "We also need contemporary and dynamic data protection."In her view, the USA is a negative example: patient profiles are traded there.

But it's not just the federal government that's testing the economic and medical opportunities of patient data; the private sector is, too. Germany's largest hospital operator, Fresenius Helios, is conducting initial trials, and software company SAP is working with Berlin's Charite Clinic on a project to improve treatment of the chronically ill by using patient data. "Hospitals have tons of data that they can't even use on their own," said SAP expert Kai Sachs at a conference in Frankfurt.

If data could be linked and made available to doctors, this could improve therapies for the chronically ill, according to the vision. Data could warn of heart damage if patients' resting pulse was regularly too high or data fluctuations indicated harmful water retention. It is a prototype project, SAP emphasizes. All data protection laws would be respected.

Economic benefits of digitization that would benefit the healthcare system as a whole are welcome, says Marburger Bund. The vast majority of employed physicians believe that digitalization can improve work in hospitals. However, economic aspects should not be the primary consideration. "We must prevent financially strong companies from developing a business model from personalized medical data to increase their own profits," says Bobbert.

However, digital future projects cost a lot of money – and that is scarce in hospitals. According to the German Hospital Association (DKG), a quarter of the 2,000 or so clinics in this country are making losses. Ten billion euros needed for digital upgrade, Marburger Bund estimates. He calls for a "special government program.

So far, however, the money has been slow in coming. Of the six billion euros needed annually for investments, the German states paid only about half, criticizes the DKG. Money for modernization is lacking at all corners and ends. A lot still has to happen before digital showcase projects become established in clinics, he said.

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