How will the healthcare system change in 2020? We have prepared a forecast of the most important digital health trends for you.
The eHealth and mHealth Trends 2020 include the app on prescription, smart medical things, telemedicine, medical deep learning and data protection in medicine. Some of these Digital Health Trends are really picking up speed this year, others will only be ready for the market in the coming years, and yet others such as data protection are up to date every year. It is therefore worthwhile to follow the development of all trends.
eHealth Trend 1: App On Prescription
It is expected that from the second quarter of 2020, doctors will be able to issue prescriptions for health apps to their patients. By March 31, 2020, the National Association of Statutory Health Insurance Physicians must therefore develop a security concept and, together with the Federal Office for Information Security (BSI), certify manufacturers of such apps. Once CE-certified, the tested apps will then be listed in the directory for digital health applications (DiGA directory), in which all health apps subject to compulsory health insurance are listed. In addition, the Federal Institute for Drugs and Medical Devices (BfArM) must have tested the app according to criteria such as safety, functionality, quality, data security and data protection and as a medical device.
If these requirements are met, the app is provisionally reimbursed by the statutory health insurance for one year. During this time, the manufacturer must prove to the BfArM that its use improves patient care. How much money the manufacturer receives is then negotiated with the central association of the statutory health insurance. The German Medical Technology Association (BVMed) has presented a position paper on the inclusion of digital health applications in the reimbursement of health insurance companies. In it, BVMed proposes seven measures for the implementation of the Digital Health Care Act (DVG) through the Directory for Digital Health Applications, which is maintained by the Federal Institute for Drugs and Medical Devices (BfArM).
eHealth Trend 2: Telemedicine
Now that the German Doctors’ Day has paved the way for telemedical consultations, even at the initial contact, this market is now slowly developing. A current example is the market entry of KRY at the beginning of December. The company offers a platform for doctors to conduct and bill video consultations in the respective health care system. Just like KRY, TeleClinic, a start-up from Munich, cooperates with doctors who are licensed in Germany and have their own practices here, and so far relies heavily on the telephone for patient contact. In addition, there is Medgate Deutschland, a Rhön Klinikum subsidiary in cooperation with Medgate Switzerland, and Zava, which previously operated as a DrEd for selective indications from London. Recently, the Professional Association of German Dermatologists (BVDD) also started to get involved in the highly competitive telemedicine market. Its Swiss platform OnlineDoctor is aimed exclusively at self-pay patients.
Within the framework of the telemedicine project TELnet@NRW, 10,000 patients have already been treated. For smaller hospitals in particular, such telemedicine-supported care networks ensure high-quality care close to home. Televisits enable the 17 hospitals currently participating in the project and their physicians to exchange views with experts from the University Hospitals of Aachen and Münster on how to optimize treatment.
InSight Telepsychiatry and Regroup Telehealth announce their merger to become the largest and most comprehensive provider of telepsychiatry in the United States. The merger will leverage the collective partnerships, expertise, leadership, network of providers and resources of both companies to improve access to care for those who need it most. This year’s Philips Future Health Index shows that telemedicine is not yet an integral part of the daily work of healthcare professionals in most countries surveyed, including Germany. When it is used, it is primarily for professional exchange with colleagues rather than for communication with patients.
eHealth Trend 3: Electronic Health Record
Bitmarck, a managed service provider working for various statutory health insurance companies, has commissioned the Viennese company RISE as a partner in the development of a standardized, electronic patient file. RISE delivered a BSI-certified connector for the telematics infrastructure on behalf of Gematik in 2018. In view of the legislator’s tight time schedule to introduce the electronic patient file on a mandatory basis on January 1, 2021, both partners are under time pressure and have already started work on the project.
With regard to the electronic health record (ePA), 62 percent of those surveyed by the Philips Future Health Index said they would like to see their data, although they currently have no access or knowledge of such access. In contrast, 24 percent reject the ePA and 14 percent are still undecided in this regard.
eHealth Trend 4: Smart Medical Things
In future, an intelligent implant will monitor the healing of bone fractures after surgery and warn in case of incorrect loading. If a bone grows together incorrectly, the smart helper will even counteract this with movement. A group of researchers at Saarland University plans to develop such an implant, which should allow complicated fractures to heal faster and better, within the next five years.
3D printers are also increasingly being used in medicine. The UKM (University Hospital Münster) also relies on the procedure. With the 3D-printed models, surgeons prepare themselves optimally for an operation and thus not only improve the result but also reduce the operating time by 10 to 15 percent. CT images are used as the basis for 3D printing, which are processed by software. Researchers at ETH Zurich and the South African company SAT developed an artificial tailor-made heart valve made of 3D-printed silicone. In the future, this could help to meet the growing demand for replacement heart valves in an ageing society.
Experts agree that the number of medical robotics applications will increase over the next few years. For example, doctors can use the robot-supported Sculptura system from Sensus Healthcare to irradiate tumors in the body during an operation. And with the lightweight robot LBR Med from the automation and robotics specialist Kuka, several application scenarios are conceivable at the same time: e.g. performing ultrasound examinations independently and with constant pressure or assisting the doctor during spinal surgery.
eHealth Trend 5: Medical Deep Learning
More and more research projects and start-ups are dealing with artificial intelligence in medicine. The TrueBrainConnect research project at the Charité Universitätsmedizin Berlin, for example, systematically investigates non-invasive connections between brain regions in order to draw conclusions about possible disease patterns. In the future, dementia or Parkinson’s disease will be detected at a very early stage – thanks to an improved evaluation of brain waves measured by electroencephalography (EEG), in the future even without surgical intervention. Scientists at LMU, Helmholtz Zentrum München and TUM have developed an algorithm that automatically detects metastases. The new technology even finds single scattering cancer cells in the entire body of mice. In order to make such innovations accessible to doctors and hospitals, there is, among other things, Telepaxx MarketPlace, a marketplace for medical products.
According to the Philips Future Health Index, 41 percent of medical professionals in Germany today use AI-based technologies in their daily work. This puts them roughly on a par with their US counterparts (33 percent). Only Italy (59 percent), France (54 percent) and China (85 percent) are ahead of their German and US counterparts. One field of application for AI, for example, is diagnostics, where it is used to improve image quality or automatically detect abnormalities in findings.
eHealth Trend 6: Data Protection In Medicine
The Techniker Krankenkasse (TK) has terminated its cooperation with the Berlin-based company Ada Health. As a reason, TK refers to the data protection shortcomings in the health app of Ada Health, which were reported by security expert Mike Kuketz and the computer magazine c’t. Shortly thereafter, the AOK Nordost also terminated its cooperation with Ada Health due to data protection concerns.
The Federal Commissioner for Data Protection has announced to focus more on the protection of health data. In addition, Ulrich Kelber, as he told the Tagesspiegel, is concerned about attacks on hospitals. Health care facilities should not work with expired operating systems or insecure cloud services. Health apps would have to be better examined with regard to data protection. Therefore, the topic of data protection remains a perennial issue, which still occupies a large place in the health care system and should not be neglected by any health care provider.