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Interview with the Gematik boss : "Many doctors do not yet recognize the benefits of the electronic patient record"
Mr. Leyck Dieken, the health policy year 2020 was originally supposed to be all about digitization. As is well known, things turned out differently. Has the Gematik been thrown back by the Corona crisis?
No - on the contrary: the crisis has given us wings. We've actually become more productive with the products we're working on because our developers and testers had more peace of mind. One example of this is the e-prescription that we will be launching in July 2021. Here we are making faster progress in development than we had planned. Another very positive effect is the digital equipment. We have invested a lot in the equipment so that our employees can work securely from home.
So has Gematik now reached the digital level that it needs? You were brought in a year ago with the assignment to make the semi-public company fit in this regard.
We have come a long way in the past few months, but we are still far from the end of the road. For us, it's about making the big leap from the past into the future now. The Association of Private Health Insurance, which has just joined Gematik as a partner, also helps us here. There are obvious reasons for this: The PKV wants to get into the digitization of the health system with the latest developments.
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And what didn't go so well in the last few months during the crisis?
Unfortunately, numerous on-site events at which we wanted to enter into dialogue with a specialist audience - especially with doctors - have been canceled. We carried out many formats virtually. But of course that is far from being compared to a direct face-to-face exchange. I very much hope that we can make up for that soon.
There seems to be widespread reservations about digitization, especially among doctors. The National Association of Statutory Health Insurance Physicians recently complained to Health Minister Jens Spahn that they feared additional bureaucracy. Will the residents in private practice take part when the electronic patient files (ePA) arrive on January 1, 2021? These are provided by the statutory health insurances, but must be filled by the doctors.
I take the concerns raised seriously. It must now be a matter of making the practical benefits of the EPR clear. So far, many doctors have not yet recognized it, often because they have not yet been able to experience the EPR in everyday practice. If we show in our demonstrations how well it works and what practical benefits it offers - for example when communicating findings to colleagues - that usually changes very quickly. In addition, we exchange ideas with our shareholders, among other things, about the digitization of medical processes in order to improve them.
What is it about?
For example, documents that doctors use are filled in automatically as far as possible. We asked the medical partners to show us what they wanted. Above all, we want to create a practical benefit with the EPR in order to increase acceptance.
The Gematik was recently discussed again and again because there were significant problems with the connectors with which the practices are connected to the digital infrastructure and without which the EPR would not work. For weeks there were problems in 80,000 practices, so that not even the master data of the insured could be processed. Is the problem now out of the world?
Yes, it is. We take the disruption as an opportunity to bring about changes on many levels. This concerns, for example, the control and access rights of the connector providers and IT service providers commissioned by us. Gematik did not have this before. Since the connectors have so far been ultimately under the control of the doctors, this means, conversely, that they have to help resolve technical problems. But no doctor has to be an IT expert. Therefore, practice owners should be able to commission others to ensure the safety of the connectors and their maintenance.
How important is it to you that Jens Spahn is Minister of Health? He is digitally euphoric, that's why he brought you to Gematik and previously wrote a 51 percent majority of the ministry into the law. Can you even implement your plans without him behind you?
I never saw that as an indispensable factor. But of course it's good to have him as minister. No one before him has pioneered so many digitization laws. As far as the 51 percent rule is concerned: The digitization of the healthcare system should not be determined solely by the particular interests of the shareholders. For us, the guidelines decided in the democratic area of the Bundestag will be the orientation in the future, because digital health applications are best legitimized with them. The shareholders bring their expertise to the table.
The German EU Council Presidency began in July, during which Spahn wants, among other things, to advance the European health data space, which allows health data and patient files to be exchanged across the EU. This is relevant for tourists, but also for research with health data. How far are you here?
We now have a concrete 7-point plan with our European partners of what we want to achieve during the presidency. This includes, for example, establishing the “National Contact Point” as a German point of contact with the European data space by 2023. These contact points are necessary to be able to send e-prescriptions from one country to another, among other things. In addition, Gematik is working with the EU Commission on the standardization of the European “Patient Summary”, i.e. cross-border electronic patient letters. We will be able to outline the first results in November. The European data space is a win for Europe, but also for patients.
Data donations should also be exchanged in the health data room; according to the plan, such donations will be possible via the ePA from 2023. How can the more fearful Germans be convinced to donate data to help medical research?
With the Corona-Warn-App you have seen how trust can be gained: With the greatest possible transparency about how the application works, what it can do and how data is protected. I am convinced that more and more people understand that medicine is limited when there is a lack of data - this is all too clear with the current development of a corona vaccine.
Your request to leave the donated data to the pharmaceutical industry was not taken into account in the Patient Data Protection Act, only research institutions are allowed to access them. Is this a mistake?
Indeed, I see it differently. The development of a corona vaccine is a good example of the fundamental role the pharmaceutical industry plays in accelerated research and development. This makes it clear that research in science and industry will only provide the solution. At the same time, it must be ruled out that non-research companies can use data purely for commercial purposes.
Mr. Leyck Dieken, how confident are you that there will be a run on the ePA of the individual cash registers on January 1st?
I am sure that the interest will increase day by day as soon as the EPR is actually available. People will experience the EPR as an asset to their health care. It will be even faster with the e-prescription: The benefits of this application will be immediately clear to everyone.
The Gematik (society for telematics applications of the health card) was founded in January 2005 by the top organizations of the German health care system. It is intended to further develop the infrastructure of the healthcare system. 51 percent of the shares are held by the Federal Ministry of Health. Markus Leyck Dieken has been managing director of Gematik for a year.
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