Doctors prescribe apps, treat their patients in video consultation appointments and can access digital healthcare networks for this purpose. This is the German healthcare system in 2020, made possible by the Digital Care Act (DVG), which largely came into force on 9 December 2019.
The digitization and innovation team at the Federal Ministry of Health led by the department head Dr. Gottfried Ludewig has achieved great things. In 18 months of intensive work under the leadership of Minister Jens Spahn, they have established the legal foundation for a first digital breakthrough in healthcare.
Apps by prescription
Starting in 2020, health apps will become part of the standard care provided by statutory health insurance. Many patients already use numerous health apps. These are used, for example, to monitor the intake of medication, to record vital parameters such as heart rate or blood pressure or to document blood sugar levels. In the future, such „healthy“ apps can be prescribed by doctors. The statutory health insurance will bear the costs. This will significantly boost the digitization of the (German) health care system.
When does the insurance company pay?
In order to enable patients to use the apps quickly, manufacturers are provided with a dynamic path for reimbursement. If the safety, function, quality, data protection and data security of the products have been tested by the Federal Institute for Drugs and Medical Devices (BfArM), the insurance company pays the costs for one year. During this period, the app providers must also verify an improvement in supply in order to remain part of the regular supply in the long term. The manufacturer itself negotiates with the National Association of Statutory Health Insurance Funds (GKV) regarding how much money it will receive.
Financing and capital
In the future, health insurance companies can specifically promote the development of digital innovations. Manufacturers of health apps, providers of telemedical procedures or IT companies can cooperate with health insurance companies in a targeted manner. However, to promote the development of digital innovations, health insurance companies can also acquire shares in investment funds. In particular, funds specializing in health technologies can be considered. They have a broad overview of the national and international market environment. The acquisition of shares in a venture capital fund in combination with cooperation in terms of expertise and content is intended to promote the development of innovative approaches in the health sector.
Digitization is not analogous. So far, resistance, among other things, has been preventing progress. For this reason, the DVG is making it mandatory for health care players to be integrated into a digital network. For doctors who still do not want to connect to the telematics infrastructure, an increased fee deduction of 2.5 percent is planned as of 1 March 2020. Up to now this was at 1 percent. Pharmacies will be required to be connected to the telematics infrastructure by the end of September 2020 and hospitals by 1 January 2021. Midwives and physiotherapists and nursing and rehabilitation facilities may participate on a voluntary basis with a reimbursement of the costs for the voluntary connection.
It is hard to believe that since mid-2018 doctors have been allowed to offer online consultation appointments but are not allowed to advertise them. If they did, they had to expect warnings, actions for injunctions or fines. This prevented patients from accessing this innovative and convenient form of treatment. To ensure that video consultation appointments finally become a normality, physicians may in the future provide information about the video consulting appointments they offer. The disclosure for a video consultation appointment can now also take place online, i.e. during the video consultation appointment itself. This was previously only possible in advance.
For all of us as patients, the DVG will facilitate access to digital medicine. The obligatory networking of health care providers will finally provide a networked and meaningful use of individual health data. Hopefully this will also result in better medicine and faster, more accurate diagnoses. For the digital healthcare industry, it opens up unprecedented financing opportunities for its developments and ideas. Uncertainties will arise, of course. There will be improvements and further developments in order to progress towards a well functioning system.