Germany

Citation

(2006), "Germany", International Journal of Health Care Quality Assurance, Vol. 19 No. 4. https://doi.org/10.1108/ijhcqa.2006.06219dab.003

Germany

Germany

The action programme information society Germany 2006 and the healthcare reform

Keywords: Information technology, Quality assurance, Patient involvement

Germany has a healthcare system using sophisticated technologies. But the sector-oriented service structures and pillars of our healthcare system are also reflected in the area of ICT. In the German healthcare system every institution in itself is an isolated solution, partially in line with the latest scientific research, but singular.

As a rule, the limits of information technology are reached where the economic and business capacities of one’s own institution are exhausted.

Therefore, the existing solutions regularly have to cope with the problem of incompatibility, only in exceptional cases there is a well functioning interoperability.

Consequently, the essential advantage of telematics, which is in particular the use of synergistic benefits, is given away. Also the advantages offered by disease management programmes which do not focus on the structures of services but on persons, could still be consolidated by digital documentation covering and connecting a broad range of institutions.

Therefore, both the infrastructural conditions for the use of telematics have to be improved and also important key applications such as the electronic prescription have to be boosted. By introducing the new electronic health card, the nationwide use of health telematics in Germany can be promoted. The activities of the Federal Government and the legislation initiated within the scope of the Act on the modernization of the statutory health insurance (Health Reform, 2003) serve these improvements.

The Federal Government is striving for a nationwide and cross-institutional networked use of information technologies.

The resolution unanimously adopted at the 75th Conference of Health Ministers in 2002 showed that nowadays the stakeholders consider telematics to be generally indispensable. For the first time the provision of quality-assured health information, e.g. by establishing health information portals for the general public is formulated as a public function of the Federal Government and the Laender.

The Working Group of the Federal Government and the Laender on Telematics in Health Care has been commissioned to develop, in co-operation with the Federal Ministry of Health and Social Security, a national strategy for the nationwide and interoperable use of health telematics applications, connected with a binding plan describing the steps of implementation. This is a joint task of the Federal Government, the Federal Laender and the self-governing bodies in the healthcare system (Selbstverwaltung).

To this end, the basis of the Federal Government’s work will be the agreement reached with the central organisations in the healthcare system on a joint action for the further development of telematics. In their declaration of 3 May 2002, the Federal Ministry of Health (and Social Security) and the central associations of self-administration committed themselves:

... to develop a new infrastructure for telematics on the basis of a general framework architecture, to improve and/or introduce the electronic communication (electronic prescription, electronic discharge letter by the physician) and to introduce the former health insurance card as an electronic health card in the future.

The stakeholders agreed that they wanted to find joint solutions to further details, functionalities, standardization, and financing because of the common benefit to be expected.

For this purpose, a Steering Group on Telematics has been established where all stakeholders involved are represented, ranging from the Federal Government Commissioner for matters related to disabled persons via the Data Protection Commissioner, the self-governing bodies, the patients’ representatives up to scientists. Its tasks include the formation of political consensus and the development of a national strategy for the use of health telematics.

In view of the increasing relevance of IT applications in healthcare, adequate framework conditions for introducing further applications of telematics have to be developed and stipulated. Prior to the selection of concrete telematics applications and systems, they have to be evaluated on a technical, economic and medical background (HTA).

Surveys on procedures applied in practice or still being developed have to be elaborated and assessed systematically (determination and selection of best practices). As a basis on the way to this end, the “TELA” database is currently being established in co-operation with the Federal Laender and harmonized with the corresponding European activities of the eEurope 2002 Action Plan. It shall be made available to the general public and accompany the development of evaluation procedures for telematics applications.

With the increasing use of the internet, the patients can be given opportunities of information connected with a rapid, simple and low-cost access to medical knowledge, in the interest of an improved health promotion and preventive healthcare. At the same time, however, the risks of health information imparted via the web are growing, since to a large degree its quality and reliability are beyond any regulatory influence. Top quality information as well as dubious publications, useful pieces of advice as well as dangerous recommendations can be found there. At the same time, the web technology serves as a basis for new forms of commercial offers (e-commerce) and new possibilities for the arrangement of product-related advertising (interactivity, linking, combination of advertising messages with reliable health information).

Well-established methods of quality controlled publication are working to an only very limited extent on the internet. The more important are those procedures of quality assurance which develop efficient quality seals for the orientation of web users. In the interest of the patients, the origin of recommendations has to be transparent on the one hand, and their medical reliability has to be ensured on the other hand. The “eEurope 2002” Action Plan has created a European framework by elaborating a key set of common quality criteria.

At the same time, the Federal Government initiated the Action Forum for Health Information Systems where in the meantime more than 150 suppliers of health information services, bodies responsible for health education as well as institutions and organisations in the fields of consumer and patient protection as well as of quality assurance have joined to build up a quality network. In this way, reliable health information on various topics is available to both, the health professions and also to the patients.

For more information: www.dimdi.de