At the “Hauptstadtkongress“ event for medicine and healthcare in Berlin, digitalization and artificial intelligence are the main topics of discussion. But Is Germany holding itself back?
Photos: WISO / Schmidt-Dominé
The keynote speakers at the opening of the “Hauptstadtkongress” (Capital Congress) event held in Berlin in early June were all united: they called on the medical profession, politicians, and industry to show more courage regarding innovation and change. They also agreed that this is the only way to counteract the trends towards rising costs and a shortage of skilled labor. “We should aspire to more space travel and not get bogged down in discussions about the General Data Protection Regulation,” was how the new Federal Minister of Health Jens Spahn put it.
The “health cloud”
The whole assembly appeared impressed when the moderator of the discussion, Erwin Böttinger, Professor for Digital Health and Personalized Medicine at the Hasso-Plattner-Institute in nearby Potsdam, introduced a smartphone app that saves all his doctor's visits, treatments, and medical results on his phone – something that is now standard in the United States. He can access his data at any time – and also make it available to the doctor at his next appointment. In the United States the main concern is improving quality, cutting costs, and patient satisfaction. In Germany the aim must mainly be to raise the quality of medical care, said Markus Müschenich, co-founder of Flying Health Incubators and Chairman of the German federal association of internet medicine.
According to Böttinger, in the United States the Health Information Technology for Economic and Clinical Health Act 2009 has led to investment of 36 billion US-dollars so far. However, in Germany, tighter regulatory conditions have hampered the development. Yet at the same time 70 percent of Germans are requesting the electronic health record, says Annette Grüters-Kieslich, Chairwoman of the Board of Heidelberg University Hospital. But the question of where the money will come from still needs to be answered. “University medical centers and registered doctors have no money for this,” she says.
The correct diagnosis thanks to symptom analysis
“Every day we get a call from a Chinese company that wants to buy us,” says neuroscientist Martin Hirsch, founder of ADA Health GmbH, a leader in the field of artificial intelligence (AI), which has developed an app whose algorithm helps the patient and doctor analyze symptoms and reach the right diagnosis, in particular in the case of rare diseases. Although only available since 2017, the app has almost four million subscribers worldwide, but in Germany the legal situation is still problematic. “Eventually the pressure will become too great and our shareholders will give in,” says Hirsch. This means that Germany will lose unique competences to other countries.
Friedrich von Bohlen, Managing Director of Molecular Health GmbH, added that in China, artificial intelligence is already part of the curriculum for all medical students. “If we wait too long, others will get in ahead of us,” he said.
Medicine as a key sector in Germany
Bernd Montag, CEO of Siemens Healthineers, remarked that the medical industry with its 800,000 employees – as many as the automotive industry – is a key sector in Germany. But to take advantage of the opportunities the country needs a new way of thinking. “Not that we need to or we should, but rather that we want to seize the opportunities of digitalization,” he stressed. For that to happen, however, everyone from the radiologist to the laboratory physician to the industry itself needs to reflect on how their own roles are changing. “We need to ask ourselves who we are,” says Montag. The laboratory physician is no longer the one who knows every test, but is instead "the leader of a complex factory that generates knowledge”. Montag sees the role of Siemens Healthineers in “developing the GPS of healthcare”.
Users as the most important driver
Speakers like Hirsch were convinced that at the end of the day the most important driver of change will be the users themselves, who are accustomed today to organizing their lives using their mobile phone and for whom the current state of the health system is often anachronistic. “For the user, the health system starts with his or her smartphone and not in the waiting room,” says Hirsch. Using patient data generated in the course of digitalization will lead to fundamental discussions, such as over whether the data ultimately belong to the patient, because pharmaceutical companies and universities in particular are naturally very interested in this. There are already some companies that offer patient data, according to Müschenich.
End to the power dispute
So why is it taking Germany so long to drive digitalization forward, notably the electronic health card where a good decade passed between the decision to introduce it and its implementation? Frank Ulrich Montgomery, President of the German Medical Association, called for an end to the power dispute between beneficiaries, healthcare providers, and insurance companies.
It took a similarly long time to implement telematics infrastructure, said Markus Müschenich, who called for the process to be accelerated. Because if it is not clear how money can be made on something, no one will become involved in it, he said. The state has to create the “digital highway” and then industry and academia will create the “cars” for it: “That way we will again be medical pioneers.”
The overturning of the remote treatment ban by the German Medical Assembly in May was unanimously declared a step in the right direction. However, Medical Association President Montgomery said it should be kept in mind that this will never replace doctors: telemedicine mainly concerns remote diagnostics. Treatment will continue to take place primarily in the doctor’s practice.