Table of Contents

The eHealth Keep an eye on 2020 is the very first of a sequence of annual position reviews on the digital maturity and infrastructure of German healthcare. Drawing on 30 indicators, our two-portion report analyzes where Germany’s health care program at the moment stands in digital infrastructure, source and need for electronic solutions amongst healthcare suppliers, and the urge for food for electronic health care amid sufferers (see sidebar, “Notes on methodology”). We also define the quantitative positive aspects that e-health has shipped to date by reviewing the hottest health-related literature, and we examine the road blocks and opportunities for the amplified adoption of telemedicine.





In the previous two many years, Germany’s healthcare technique has built a great deal of development, driving forward the legislative framework for the digitization of healthcare—especially in electronic patient records, telemedicine, and e-prescriptions. That do the job was urgently needed in perspective of Bertelsmann Stiftung’s 2018 Electronic Wellbeing Index ranking, which positioned Germany next to last amid 17 nations.


Germany has also performed a groundbreaking position in e-health: it was the world’s initially nation to set up a mixed regulatory and reimbursement procedure for electronic e-wellbeing apps (“apps on prescription”).





Outcomes from the latest study of healthcare players and industry experts by the German Managed Care Association (BMC) health supplement this report (see sidebar, “BMC Innovation Panel Survey”). We also contain exterior views: insights from a digital-roundtable dialogue on the outlook for telemedicine and an write-up featuring the Federal Ministry of Health’s outlook on the upcoming of e-health and fitness in Germany.
Part a person: German e-health—insights and evaluation
The to start with element of the report gives its most crucial insights on e-wellbeing in Germany. It focuses on four main regions: technological infrastructure and electronic maturity, digital source and demand from customers, the acceptance and use of digital healthcare options by sufferers, and the advantages of e-wellness as documented in the literature.
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Specialized infrastructure and digital maturity. Whilst more than 8 in 10 doctors are already connected to the telematics infrastructure, health care amenities however largely share professional medical facts in analog variety. In 2019, 93 % of medical professionals communicated with hospitals on paper, and significantly less than half (44 p.c) of all healthcare services (these as hospitals, outpatient professional medical practices, and healthcare centers) exchanged health care data by digital implies.


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Digital offer and need. German health care services use a wide variety of electronic systems, tools, and providers and give them to their clients. Furthermore, well being insurers present a diverse vary of electronic companies, from the online marketing of health and nicely-remaining to on the internet merchants to health-related info dispensed by way of movie chat. By distinction, somewhat number of techniques of outpatient medical practitioners give digital offerings: for case in point, just 15 p.c of the techniques that participated in the 2019 KBV PraxisBarometer survey described that they supply an solution for reserving appointments on-line or make it achievable for a affected person to order prescriptions by using their internet websites. Fifty-9 p.c provided no electronic providers at all.


Lots of outpatient health professionals and pharmacists stay skeptical of digital solutions. Surveys advise that 43 per cent of health professionals in outpatient configurations hope doctor–patient associations to deteriorate as digitization progresses, and only 14 percent expect them to increase. Nearly 50 % of all pharmacists be concerned about getting rid of their regular shoppers once e-prescriptions are extensively available.
In a 2018 examine, Bertelsmann Stiftung described on regional and picked telemedicine tasks.


As a outcome of the COVID-19 pandemic, telemedicine companies are now in higher desire. In the spring of 2020, 52 percent of all outpatient medical practitioners ended up offering movie consultations—a 50-share-stage maximize from the finish of 2017.


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Acceptance and use of electronic health care solutions by individuals. The greater part of clients are open up to the digital options out there in Germany’s current healthcare program. A person in three of the respondents to an on the internet study documented that they have scheduled a doctor’s go to on-line. Two in 3 Germans welcome the introduction of digital wellness information and e-prescriptions—including much more than 60 percent of folks in the 65-plus age group. The pandemic has further increased the willingness of Germans to use electronic healthcare solutions. A McKinsey survey in August 2020 unveiled that far more than two-thirds of respondents are much more open to these products and services now than they were prior to the crisis.
The start of apps on prescription, and with it the remuneration of digital wellness applications, will probably raise patients’ demand from customers for electronic health and fitness applications. In the 2018 research, Bertelsmann Stiftung determined that the use of cellular programs in German health care was restricted at that time but confirmed substantial prospective for the foreseeable future. Currently, about 59 per cent of Germans say they can visualize utilizing apps that are only readily available on prescription—even practically 50 % of men and women in the 65-additionally age team. This common acceptance of e-wellness is anticipated to travel significantly greater utilization in the upcoming: for illustration, at the begin of 2020, less than 5 percent of people who endure from common ailments this sort of as continual back agony, substantial blood strain, or migraines had downloaded applications that assisted aid the treatment for their situations.
The dynamic mother nature of the advancement in Germany’s health and fitness-application marketplace is shown by McKinsey’s eHealth App Barometer, which steps app use by the amount of downloads. At the to start with peak of the COVID-19 disaster, all through the very first quarter of 2020, health applications and expert services ended up downloaded virtually two million times—twice as several as all through the similar period in the past 12 months.
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Benefits of e-health documented in the health-related literature. From 2000 to 2020, PubMed registered 158 professional medical articles or blog posts exploring the advantages of e-health and fitness answers in Germany for 5 therapeutic places: diabetic issues, cardiovascular condition, respiratory disorder, melancholy, and rehabilitation. About this interval, the full selection of publications on these five therapeutic regions in Germany achieved 14,468, so e-health and fitness has not been a concentrate of scientific research. However, the amount of e-health studies will in all probability rise, due to the fact the government’s acceptance process for electronic wellness purposes calls for companies to meet increased-than-standard criteria for scientific evidence of the positive aspects made available by e-well being options.
About 80 percent of analyzed German study papers that bundled quantitative assessments of e-health and fitness purposes affirm their optimistic benefits—mainly improvements in the patients’ well being (79 percent of the reports analyzed), but also bigger personal savings in costs and time.

At the very first peak of the COVID-19 crisis, health apps and providers have been downloaded pretty much two million times—twice as a lot of as throughout the exact same period in the earlier calendar year.


Component two: Concentrate on telemedicine
The nascent market place for telemedicine has exploded as a end result of the COVID-19 pandemic and may nicely provide as a position model in the digitization of healthcare. All of the 2nd aspect of eHealth Observe 2020 is hence devoted to telemedicine.


The major report seems to be at the evolution of telemedicine more than the previous few years and explores its importance in the German health care technique. Our conclusion: in Germany, telemedicine providers (this kind of as online video consultations) are nevertheless a very long way from crossing the end line. To achieve it, the place ought to, very first of all, deliver economical incentives and regulatory assistance for telemedicine and, second, broaden the electronic infrastructure and increase interoperability. In a guest attribute, Ulrich von Rath, an internist and standard-drugs practitioner, stories that “Telemedicine will make perception because it enriches the treatment we offer.” He delivers insights into the use of telemedicine in a healthcare apply and reveals what will be wanted to push digitization in outpatient configurations.
In a virtual-roundtable discussion, 3 telemedicine providers—Katharina Jünger from TeleClinic, Claudia Linke from Zava, and Florian Weiß from jameda—share their views on wherever telemedicine is headed and what could possibly pace up its enlargement. They believe that that the upcoming of health-related-care delivery in Germany will be “blended care”: a hybrid of digital and in-human being visits. Even so, for that to transpire, telemedicine ought to be embedded deep in the countrywide wellness ecosystem.
The eHealth Keep track of 2020 report closes with the outlook of the Federal Ministry of Wellbeing on the upcoming of e-health in Germany. This post handles what has been achieved to date from the ministry’s standpoint and what will have to take place to aid the broader provision of digital healthcare in Germany. Initially and foremost, this will imply opening up the healthcare method to innovation, the improvement of a thorough communications network with the digital client history as a central system, and the creation of a European Overall health Details Space


for the good processing and use of health care information.
Download the whole report in German.
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