Digital Health International: Different Countries Have Different Customs


The digitization of healthcare in industrialized countries is unstoppable but it moves faster in some nations than others. The "An international comparison of digital health strategies" session ("Digitale Gesundheit im internationalen Vergleich") at the MEDICA ECON FORUM by TK examines the opportunities and challenges of digitization and what we can learn from its pioneers. Professor Britta Böckmann, Dortmund University of Applied Sciences and Arts, Department of Medical Informatics, jumpstarts the conversation.

"Digital health" is a very broad term and covers many areas such as electronic health records, telemedicine, and medical apps. The fact that they support patient care regardless of location in digital form is something they all have in common. "At this point, I use the term xHealth instead of eHealth," says Professor Böckmann. "The 'x'  in this case stands for 'eXchange', meaning application interoperability."

Image: Britta Böckmann during her lecture at MEDICA ECON FORUM; Copyright: beta-web/Dindas

Prof. Britta Böckmann gives the impuls to the session "An international comparison of digital health strategies"; © beta-web/Dindas

Still a long way to go: Germany

If you compare the individual countries with each other, and especially the industrialized nations, it reveals lots of heterogeneity or variation. In some areas, digitization has rapidly progressed and is implemented comprehensively. However, other countries only have isolated projects that are not linked with one another.

Germany, in particular, is only slowly progressing towards digitizing its healthcare sector. "Germany does not have a national ehealth strategy. Even though there are many sponsored pilot projects and regional initiatives, the concept has not made its way into regular health care, leaving digitization in a patchwork state. It is left up to chance whether a patient with cardiac insufficiency is able to participate in or is actually even just informed about a telemedicine program for example and depends on where he/she lives, which doctor he sees or where she is insured", Böckmann explains.

The reason for the varying speeds of implementation in the individual countries is primarily attributed to heterogeneous healthcare systems. Having said that, motivation also plays a role, according to Böckmann. "Both Austria and Germany have a federal system. Yet Austria is progressing with digitization – strongly driven by the country's Federal Ministry of Health and a clear strategy and consistency across the various ministers."

Learning from others: Estonia, Austria and the United States

"From a German perspective, Austria can teach us how a national strategy for implementation of digital healthcare systems can work", says Böckmann. She adds that Austria was at a similar level ten years ago as Germany is still today. There were numerous isolated applications but no national strategy. Ultimately, however, a strategy was being developed and consistently implemented. "Austria is now introducing the electronic health record ELGA for every citizen who doesn’t opt out. Wherever there is a data exchange, specified international standards like IHE [Integrating the Healthcare Enterprise], need to be applied", explains Böckmann.

Estonia is also among the digital pioneers. Everything has already been digitized here, from public administration to health care – or it will be in the near future. In the U.S., digitization is part of President Obama's strategy under the 'Meaningful use' program. This creates incentives for digitization. "Some other examples of countries that actively implement various areas of digitization are the Scandinavian countries for example or Singapore", Böckmann sums up. Having said that, there is no country that is leading the way in all areas of application to where every country is still able to learn something from the others.

A date to remember

Prof Böckmann will discuss with other scientists the topic in the session "Digitale Gesundheit im internationalen Vergleich" ("An international comparison of digital health strategies").

Thursday, November 17, MEDICA ECON FORUM (Hall 15, G05), 3.00 bis 4.15 p.m.

The article was written by Olga Wart and
translated from German by Elena O'Meara.