Berlin After many attempts, this should now be the last: Federal Minister of Health Karl Lauterbach (SPD) wants to achieve the digitization of the healthcare system with a digital “restart”. The plan includes projects such as the electronic patient file by 2024 and the question of how companies can get data for research more easily.
A corresponding law is being drafted. When Lauterbach presented the plans a few weeks ago, the reactions were mostly positive to euphoric. With some distance, however, leading experts and institutes are now also expressing concern that the project – like that of Lauterbach’s predecessors in office – will fail.
The chairman of the Commission of Experts for Research and Innovation (EFI), Uwe Cantner, explained at the research summit in Berlin earlier this week that the digital turnaround is only possible if the Minister of Health works closely with the other departments. The ministries would have to coordinate the various strategies in concrete terms and also clarify responsibility for the individual sub-steps.
So far, Lauterbach’s own digitization strategy, the general digital strategy of the traffic light and its future strategy are still “unrelated”. In addition, there are no structures in the government for coordination. The EFI had previously called for this to be located in the Chancellery.
In a digitization roadmap of the EFI, which is available to the Handelsblatt, it is said that Lauterbach’s strategy formulates many goals and measures. “However, you are missing information on how the implementation should take place.”
The EFI makes concrete suggestions using the example of the so-called health data room. In an international comparison, Germany is in last place when it comes to making health data available to research. This is not only a significant locational disadvantage, but also makes research into new medicines and therapies more difficult.
Germany falls behind
Lauterbach wants to change this with a so-called Health Data Utilization Act. “Cooperation with other departments at federal and state level will be necessary for implementation,” says the roadmap. For example, the Federal Ministry of Justice must be involved in the “legal adjustment”.
The health ministries of the federal states would also have to play a role, for example by involving the hospitals in data collection. In addition, the planned goals would have to be backed up with “detailed timetables and budgets”.
EFI boss Cantner demands that Lauterbach present such a health data usage law as soon as possible in order to regulate the standards. “Otherwise it will peter out.” Denmark, Finland and Austria have shown that a law without a conflict with the European data protection regulation GDPR is possible.
The basis for this should be the “opt-out rule” planned by the traffic light, according to which health data is stored in an electronic patient file as long as there is no explicit objection. The fact that this rule is controversial, for example with the Federal Data Protection Agency, causes great concern in the industry.
The head of the Berlin Charité, Heyo Kroemer, was outraged. “It can’t be that it’s being questioned again, even though it’s five to twelve,” he said at the research summit.
In the worst case, Germany is threatened with “Teslaisation” of the health economy: because if Germany does not manage to digitize everything in the health care system that does not necessarily have to be done by people on people, there is no chance of maintaining the level. “Then the big Chinese and US companies will take over.” Kroemer is a member of Lauterbach’s government commission for future hospital care.
He sees another hurdle in data protection. This is precisely why “a very strong political will is necessary,” urges Kroemer. Lauterbach plans to curtail the veto right of the Federal Data Protection Commissioner and the Federal Office for Information Security (BSI) in health digitization. In the future, they will be part of a committee in which representatives from medicine and ethics will also discuss such decisions.
Dependent on data from abroad
The economic importance of the health economy, including care, research, pharmaceutical and medical technology industries, is enormous: It accounts for 17 percent of the labor market, twelve percent of gross value added and a good nine percent of Germany’s exports, said Stifterverband President Michael Kaschke. If rapid digitization succeeds, “the importance of 2040 could be greater than that of automobile manufacture”.
According to a McKinsey study, the digitization of the healthcare industry could create a benefit of 42 billion euros, half due to lower costs, half through better care.
The digitization of the industry is therefore about much more than just the electronic patient file. Digital economist Irene Bertschek from the Mannheim ZEW criticized that the Mainz-based company Biontech could not be moving to Great Britain because it would get the necessary data for its cancer drugs there.
During the corona pandemic, researchers and politicians had to rely on data from Israel to measure the effect of the corona vaccination. Meanwhile, there is no data at all for the evaluation of vaccine damage.
More: Lauterbach’s digitization plans in detail