The current state of digitization in the German healthcare system
Germany is making progress in digitizing healthcare, but there is still a long way to go. The introduction of electronic health records (ePA) and e-prescriptions are key milestones, but they are not being used across the board. Although digital solutions such as video consultations and health apps are becoming increasingly popular, many practices and clinics continue to struggle with outdated IT systems and inadequate connectivity.
Despite government funding programs and initiatives such as the Hospital Future Act (KHZG), data protection concerns and a lack of digital infrastructure remain challenges that need to be overcome.
At a glance: Milestones of digitization in the German healthcare sector
- 2015: Introduction of the e-health law, which paved the way for digital applications such as electronic health records and e-prescriptions.
- 2021: Start of electronic health records for legally insured persons. Doctors and patients should thus be better connected.
- 2022: Introduction of the e-prescription, but with delays and not yet implemented across the board.
- 2023: Discussions in the Bundestag to accelerate digitization, in particular through the “Act to Speed up the Digitalization of Health Care.”
- 2024: deadline for hospitals, Complete digitization projectsto receive funding from the Hospital Future Act (KHZG).
- 2025: All health insurance companies must provide their insured persons with a provide electronic health records. If you do not want this, you can simply disagree.
What are the opportunities and risks of digitization in healthcare?
Digitalization brings considerable potential, but also some challenges. Here is an overview of the opportunities and risks:
Opportunities for digitization in healthcare
- More efficient processes: Automated processes such as appointment bookings or billing systems reduce administrative costs and create more time for patient care.
- Improved diagnostics: Artificial intelligence and big data enable more precise diagnoses by identifying and analyzing disease patterns more quickly.
- Personalized medicine: Through data analysis, individual treatment plans can be created that are better tailored to patients' needs.
- Expanded access to care: Telemedicine enables patients to receive medical advice regardless of where they live, which is particularly beneficial in rural regions.
- Faster communication: Networked systems facilitate the exchange of information between different departments and institutions.
- Prevention and education: Health apps and wearables motivate patients to adopt a healthier lifestyle and help them identify illnesses early.
Risks of digitization in healthcare
- Privacy and data security: The increasing storage and processing of sensitive health data increases the risk of hacker attacks and data leaks.
- Technological dependency: Severe dependence on digital systems can impair supply in the event of technical failures.
- High implementation costs: The introduction and maintenance of digital infrastructure involves significant investments, which poses challenges for smaller practices in particular.
- Inequality in access: Less tech-savvy people, older patients, or those with limited access to digital devices could be disadvantaged.
- Staff overload: Integrating new technologies requires training and adjustments, which can mean additional stress for employees.
- Lack of standardization: Different digital systems are often not compatible, which can limit efficiency and interoperability.
The most important laws for digitizing healthcare
These following laws form the basis for digitization in healthcare and promote both technical infrastructure and data protection. They create incentives for the use of digital innovations and help improve the quality and efficiency of medical care.
Digital Act (DigiG)
The Digital Act (DigiG) was adopted to speed up the digitization of the German healthcare system. It aims to simplify processes such as the introduction of electronic health records and e-prescriptions. A key point is the mandatory use of the ePA for legally insured persons until 2025, unless they object. Telematics infrastructure and IT security are also to be further expanded.
Health Data Use Act (GDNG)
The Health Data Use Act is intended to facilitate access to anonymized health data in order to promote research and development of new therapies. It creates legal bases for data protection-compliant use of health data and establishes security mechanisms to prevent misuse. The aim is to improve medical care through big data analyses.
E-Health Act
The e-health law, which came into force in 2015, laid the foundation for many digital applications in healthcare. It regulated the introduction of telematics infrastructure, electronic health records and e-prescriptions. Important milestones include the promotion of video consultations and the availability of emergency data in digital patient records.
Appointment Service and Supply Act (TSVG)
The TSVG was introduced to improve access to medical services. In addition to the introduction of appointment service centers, it promoted digital applications such as video consultations and online reconciliation of insurance data. The aim was to make patient care more efficient and accessible.
Drug Supply Safety Act (GSAV)
The GSAV strengthened safety in drug supply by introducing digital verification systems. It created the basis for better traceability of medicines and required pharmacies to introduce modern IT solutions to prevent counterfeiting and ensure quality.
Digital Supply Act (DVG)
The DVG For the first time, it enabled doctors to prescribe digital health applications (DIGAs) on prescription. It established a new framework for reimbursement of such applications by health insurance companies and pushed ahead with the integration of digital solutions into everyday care. The aim is to make it easier for patients to access innovative technologies.
Patient Data Protection Act (PDSG)
The PDSG attaches great importance to protecting sensitive health data in electronic health records. It prescribes strict data protection guidelines and regulates which actors can access the data. At the same time, it facilitates the interoperability of various digital systems in order to make supply more efficient.
Digital Care and Care Modernization Act (DVPMG)
The DVPMG expanded the Digital Supply Act to include applications for care. It made it possible to prescribe digital care applications (DiPAS) and created incentives for the development of innovative technologies in the care sector. It also promoted the introduction of telephare and digital communication in home care.
Examples of digitization in healthcare
We have already mentioned some elements of digitization above, such as e-prescriptions or electronic health records. Let's take a brief look at these and a few other components of digitization here:
1. Electronic health records (ePA)
The electronic health record enables patients to centrally store their health data and make it accessible to doctors when needed. This makes communication between different specialists easier and duplicate examinations can be avoided. At the same time, ePA reduces duplicate investigations and thus saves time and money. Patients also retain full control of their data and decide who can access it. In the long term, ePA can help personalize medical care and better tailor it to individual needs.
2. E-prescription
The electronic prescription replaces the classic paper prescription and enables patients to digitally send prescriptions directly to their pharmacy. This saves time and reduces prescription errors. In addition, patients can easily manage their prescriptions via apps, which provides a better overview of current and past prescriptions. The e-prescription thus promotes modern and barrier-free healthcare and is an important step towards paperless administration in healthcare.
3. telemedicine
Telemedicine applications enable patients to use medical consultations via video or telephone consultations. In rural regions in particular, this facilitates access to medical care and reduces waiting times at the same time. In addition, telemedicine platforms can also be used for monitoring chronic illnesses or aftercare, providing patients with continuous care. These applications therefore contribute to making healthcare more efficient, flexible and patient-oriented.
4. Health apps and wearables
Health apps and wearables help patients actively monitor and improve their health. Examples include blood sugar meters, fitness trackers, and apps that help treat and manage chronic diseases such as diabetes. These technologies make it possible to collect health data in real time, track progress and react to changes at an early stage. They also promote health-conscious behavior by motivating patients to be active regularly, sleep better, or follow a balanced diet. They play a central role in preventive and personalized medicine.
5. Artificial intelligence (AI) in diagnostics
AI-based systems analyze medical data such as X-ray images, MRIs, or laboratory data to help doctors diagnose and plan treatment. These technologies often identify disease patterns faster and more precisely than humans, leading to early and more accurate diagnoses. In addition, AI systems can evaluate large amounts of data to identify complex relationships that are decisive for individual treatment strategies. In the long term, the use of AI in medicine helps to reduce physicians' workload and significantly improve the quality of patient care.
6. Digital health applications (DiGA)
Digital health applications are medical apps or web applications that help patients treat, monitor, or prevent diseases. They are tested by the Federal Institute for Drugs and Medical Devices (BfArM) and can be prescribed by doctors or psychotherapists after approval. Statutory health insurance covers the costs, making DiGA accessible to all insured persons.
Examples of DiGA include apps to help with mental illnesses, pain management programs, and digital companions for managing chronic diseases such as diabetes.
7. Digital care applications (DiPAS)
Digital care applications (DiPAS) help people in need of care to better organize their everyday lives and maintain their independence. They offer functions such as reminders to take medication, coordination of care services, or documentation of health values. Relatives and caregivers also benefit, as they can use the applications to communicate more easily and make care plans more efficient. DiPAS thus promote individual and networked care that meets the needs of patients and at the same time makes the work of nurses easier.
8. Robots in surgery
Surgical robot such as “Da Vinci” robot revolutionize surgery by helping surgeons perform high-precision procedures. These systems offer exceptional accuracy by eliminating tremors and being able to perform the finest movements that would hardly be possible with the human hand. This not only reduces the risk of complications, but also reduces the recovery time for patients. Robots in surgery are used in particular for minimally invasive procedures and, thanks to their advanced functions, enable a new dimension of patient safety and efficiency.
9. Smart Hospitals
Smart hospitals rely on networked technologies to make procedures and processes in clinics more efficient and patient-oriented. Networked systems enable optimized patient management, dynamic bed occupancy, and faster and more precise diagnostics.
Automated logistics solutions ensure that medicines and consumables are always available as needed. In addition, smart hospitals use digital communication systems to improve the flow of information between medical staff and take patient care to a new level.
These innovations promote better use of resources and improve the quality of medical services. You can find out more about smart hospitals read it here.
This is what a digitized practice can look like
In a modern digitalized medical practice, the patient's process starts from the comfort of their own home. The patient books their appointment online via an intuitive booking system that immediately shows free time slots. Before visiting the practice, he fills a digital anamnesis on their smartphone, which means that practice staff already have all relevant information available.
If they have not yet done this at home, the patient will contact the front desk using a QR code on the day of the appointment. Waiting times are minimized through digital patient management, which efficiently coordinates appointments. During treatment, all previous findings and reports are available to the doctor in the electronic patient record.
After the appointment, the patient receives his prescription directly as E-prescription to the smartphone, which he can easily redeem at a pharmacy of his choice. He can also use a practice app to view his results or be reminded of follow-up appointments. In addition, patients can pay their bill for a private service with a click on their own smartphone — as easy as when shopping online. All communication — whether with the doctor or the administrative team — is simple and secure digitally.
With providers like Nelly You too can develop your practice in exactly this direction. More details about this here:
How to digitize your medical facility with Nelly
Digitalizing your practice doesn't have to be complicated! With Nelly, it's efficient and tailor-made. Here are a few examples of how Nelly helps you to optimize everyday practice:
- Digital anamnesis: Let your patients conveniently fill out their medical history online at home. This saves valuable time in practice and enables better preparation for the appointment.
- Automated reminders: Avoid open documents: With Nelly, you can remind patients of pending tasks, such as documents or signatures, via SMS or email.
- Invoicing and factoring: With Nelly's digital invoice management, you can create and send invoices automatically. Patients can view their bills online and pay them directly while you receive a notification that payment has been received. In cooperation with banks as your contractual partner, Nelly also offers factoring so that you do not have to worry about outstanding receivables.
- Improve reviews: Nelly helps you improve your online review score. After treatment, patients receive an automated invitation to review their practice — positively rated patients can be redirected directly to a public Google review.
Make your practice more modern and efficient with Nelly. Find out more here and start digitizing your facility today!
For those interested: The state conference on the future of digitization in healthcare
The state conference on the future of digitization in healthcare is an important platform on which experts from healthcare, science, research, politics and business exchange views on current developments in the digital health sector. A central topic is digital care and networking in healthcare and care, including innovative product ideas and their effects on the working world and on patients. Other focal areas include strengthening digital competencies, ethical issues of digital supply and cyber security.
The conference also offers well-known companies in the digital healthcare industry the opportunity to exhibit their products in order to promote a practical transfer between science and practice. In 2024, the conference was held under the new format “Connected Health Brandenburg 2024" on February 28, 2024 at the Griebnitzsee Campus of the University of Potsdam. More information about the upcoming Connected Health Brandenburg 2025 can be found here.
Common questions
Why does digitization play a central role in healthcare?
Digitalization plays a central role in healthcare, as it makes processes more efficient, speeds up diagnoses and treatments, and facilitates access to medical care. It enables innovative approaches such as telemedicine, AI-based diagnostics and personalized therapies that sustainably improve the quality and efficiency of healthcare.
What is digital healthcare?
Digital healthcare includes the use of digital technologies such as telemedicine, electronic health records, and apps to support prevention, diagnostics, and treatment. The aim is to facilitate access to medical care and make processes more efficient.
What is a digital medical device?
A digital medical device is software or app that serves medical purposes, such as diagnosing, monitoring, or treating illnesses. Examples include apps on recipes or devices with embedded software that are approved by competent authorities such as the BfArM.
What is the e-health law?
The E-Health Act promotes digitization in healthcare and creates legal frameworks for digital applications such as electronic health records (ePA) or e-prescriptions. It aims to improve medical care through secure and efficient digital communication.
Why is digital health literacy important?
Digital health literacy empowers patients and professionals to use digital tools effectively and safely. It is crucial for understanding health information, operating applications such as apps or patient records, and making informed decisions.
By when do hospitals have to be digitized?
Hospitals must commission digitization projects by the end of 2024 in order to receive funding from the Hospital Future Act (KHZG). However, the implementation of these projects can be completed beyond 2024. This flexibility was made possible by an agreement between the German Hospital Association (DKG) and the National Association of Statutory Health Insurance Funds. Digitalization includes patient portals, IT security and electronic documentation.
How is AI being used in healthcare?
Artificial intelligence is used for diagnostics, therapeutic support and personalized medicine. Examples include the analysis of medical image data, the identification of disease patterns, or chatbots for patient advice.
What are digital health applications?
Digital health applications (DIGAs) are certified apps or programs that help patients with treatment or prevention. They are prescribed by doctors and usually reimbursed by health insurance companies, such as apps for treating back pain or depression.
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