The so-called Lipobay scandal can be considered a trigger for a political decision: As early as 2003, the German federal government at the time initiated the development of the electronic health card. The card was intended to help improve healthcare and to make it safer – possible drug interactions were to be identified before they can occur. It was hoped that the German healthcare system would then receive a modern IT infrastructure and become an international pioneer in e-health. Today, we have to say that this project has not been successful. At least not for the time being. While in other countries, the most important patient data is stored in electronic health records and prescriptions already have been digitally transmitted for several years, Germany is still working on the basics of digital health networks and is mainly exchanging information on paper. While we are talking about the application of intelligent algorithms on a theoretical level in Germany, these have long been in use in Israel for the early detection of cancer, for example. Not surprisingly, the Digital Health Index developed in the context of this study shows that the German healthcare system is lagging far behind in terms of digitalization: In an international comparison, Germany is ranked 16th out of 17 countries surveyed. For the newly developed index, experts from the analysed countries gave their assessments on more than 150 individual items – on the political-strategic approach, on the technical readiness and on the actual use of the available technological possibilities. But the findings should not be a reason to bury one’s head in the sand – on the contrary. The study report shows that the digital transformation of healthcare systems is hardly a straightforward process in any country, and it is not always a successful story. We can see that countries like the Netherlands or the NHS in England, which have changed strategy after setbacks, are today on a good or at least on a better path. The report contains countless examples of successful and less successful digital health initiatives and approaches. For five of the 17 countries, we have analysed the development lines in more detail. The German health system can and should learn from these examples. At the political macro level, our analysis shows a clear pattern: digital transformation needs political leadership and coordination. Successful countries are characterised by a trio of effective strategy, political leadership and coordinating national institutions, i.e. “agencies for digital health”. The process of digitalization in successful countries is health benefit-oriented and is implemented in pragmatic steps. Politicians in these countries see the promotion of acceptance among patients, doctors and other health profession4 #SmartHealthSystems Uwe Schwenk Director “Improving Healthcare – Informing Patients,” Bertelsmann Stiftung Dr. Brigitte Mohn Member of the Executive Board, Bertelsmann Stiftung als as a central strategic task. Moreover: the end users of digital technologies, not (only) their professional representatives, are systematically involved in co-designing strategies and applications. From the empirical findings, we derive the recommendation that German health policy must continue along the path it has recently taken. Politics must act more decisively than in the past and expand its leading role in the design of digitalization. Finally yet importantly, we need to pick up speed. Not as an end in itself, but for the patients and their physicians, who in Germany still cannot fully benefit from digital health because of missed digital opportunities. There is no need for a new “exogenous shock” like the Lipobay scandal as further justification to advance digital health. We wish you an interesting read and look forward to exchanging views on the results of the study.
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