Berlin Digital offers for patients are playing an increasingly important role in Germany. “Some progress has been made in the past twelve months,” says the e-health monitor 2022 from the management consulting firm McKinsey, which will be presented on Tuesday and is exclusively available to the Handelsblatt in advance.
The study measures the digitization of the healthcare system in Germany using 30 indicators. “It remains a mammoth task, but there is noticeable progress,” says study author and McKinsey partner Tobias Silberzahn. The report lists the so-called apps on prescription as an example. These are approved digital health applications (DiGA) that are reimbursed for patients by statutory health insurance companies.
33 such apps are currently available on prescription, including therapies for depression, diabetes and tinnitus. In the first half of 2022, there were 62,000 prescriptions for an app on prescription, which represents a fraction of the total number of prescriptions of around 500 million. “However, the apps on prescription are very popular with patients,” says Silberzahn.
The McKinsey report expects 125,000 apps to be prescribed for the coming year. At an average price of 458 euros per app, this corresponds to a market volume of around 57 million euros.
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The offer is apparently well received by the insured. According to a survey by Techniker Krankenkasse, 86 percent would use a DiGa again if they fell ill. The statutory health insurance companies, on the other hand, are critical of the apps on prescription because of the expenses. Other digital health services are also being used increasingly, such as online pharmacies or apps for prevention and diagnosis.
The e-health monitor cites video consultations as another positive example. According to the National Association of Statutory Health Insurance Physicians (KBV), 61 percent of general practices now offer digital services. The video consultation is by far the most widespread at 37 percent, followed by online appointments, which 21 percent of the practices offer. A total of around 3.5 million video consultation hours were billed last year, an increase of 29 percent compared to the previous year.
“The patients have retained habits such as the video consultation hours from the corona year 2020 and continued to use them,” said Silberzahn. However, it remains unclear how long the pandemic effect will last, as many practices reduced their range again as part of the relaxation of the corona virus. In addition, the video consultation is not worthwhile for many providers. The Swedish company Kry leaves the German market in December.
Patient record and e-prescription with problems
At the same time, the study shows what challenges Health Minister Karl Lauterbach (SPD) still has to face when it comes to digitizing the healthcare system. Less than one percent of those with statutory health insurance currently use the electronic patient file (ePA), one of Lauterbach’s most important digital projects. In addition, most files are still empty and are therefore not used.
The opt-out procedure that the federal government launched in November is intended to change this. Only those who object should no longer receive electronic files. “This is an important step, but it will also be crucial to quickly expand the functionalities of the ePA,” says Silberzahn. “The electronic health record must deliver real benefits to citizens and healthcare professionals and must be easy to use.”
He assesses the electronic recipe in a similar way, a similarly important digital project for Lauterbach. It’s supposed to be available across the board since this year, but the introduction is faltering. Only a few weeks ago, the only pilot region withdrew from the project.
>> Read more: Setback for Lauterbach’s digital project – pilot region stops e-prescription test phase
Lauterbach’s ministry is now planning the nationwide start in mid-2023 with a rudimentary solution via the electronic insurance card, on which the prescriptions are to be stored. “Personally, I would have preferred a more contemporary solution without a plug-in card,” says Silberzahn. “The e-prescription can only be successful if we reconcile safety, speed and ease of use.”
Countries like Denmark, Sweden and Israel showed how it’s done. In Sweden, 99 percent of prescriptions are redeemed digitally, in Germany the proportion is in the per thousand range. “Similar to Denmark, the e-prescription in Sweden is linked to the national electronic patient file, in which the medication plan is also stored – another success factor for the almost complete market penetration,” says the e-health monitor.
The e-prescription apparently already had an effect in Germany. 99 percent of the pharmacies were connected to the telematics infrastructure (TI) in June 2022. Last year it was 75 percent. The TI forms the technological basis for data exchange between pharmacists, clinics and medical practices. The latter group was 96 percent affiliated with the TI.
More: Everyone should automatically receive e-patient files: Lauterbach is launching opt-out procedures