Increasing efficiency in healthcare through digitalisation
Digitalisation can fundamentally change healthcare: faster processes, better data availability and more time for patients. But despite the technical possibilities, there are obstacles that slow down progress. How can digitalisation be designed in such a way that it does not remain a technological toy, but brings real improvements to the everyday lives of doctors and patients? And what lessons can be learned from international role models in order to successfully drive forward digital change in Germany? Prof. Sylvia Thun, Director of Digital Medicine and Interoperability at BIH, provides answers in this interview.
What are the biggest hurdles in digitizing healthcare, and how can they be overcome?
The main hurdles are less about lacking technology and more about lacking binding regulations. Responsibilities are fragmented, standards are often only recommended, and valuable information too often ends up in unstructured PDFs. To make progress here, clear rules are needed: mandatory standards that ensure different IT systems in healthcare can uniformly interpret and exchange data (such as via HL7 FHIR, SNOMED CT, LOINC, or UCUM), mandatory conformity testing before use in the market, as well as governance that creates transparency over roles and responsibilities. Digital transformation will only be effective when interoperability is no longer treated as an optional extra but rather as a prerequisite for procurement, reimbursement, and approval.
What is already working well in the digitization of healthcare, and where can progress be seen?
In fact, the last few years have seen clear progress. With the e-prescription, electronic sick note, secure communication in healthcare (KIM), and the first digital doctor’s letters, a new era beyond fax and paper is beginning. At the same time, FHIR-based data spaces are being created at university hospitals through the Medical Informatics Initiative and the University Medicine Network (FHIR stands for Fast Healthcare Interoperability Resources, an open standard for exchanging health information), linking care and research. Electronic patient records and digital identities are also developing further, creating a solid foundation.
Which international models are there - where is it worth looking for Germany, and what can possibly be adopted?
A look at Scandinavia or the Baltic states shows that national minimum services such as electronic medication, vaccination status, or sharing images and findings can be implemented consistently when standards are binding. Projects like the Estonian e-Health Record illustrate how regional data platforms can seamlessly connect care. What can be transferred to Germany are especially clear terminology and profile specifications, interoperability clauses in procurement, and patient-centered transparency solutions. The key factor is the courage to define and enforce minimum standards here as well.
How can digitization provide noticeable relief in everyday life for doctors and patients?
Digitization must not be an end in itself. It must give back time. This works when data is structured from the beginning and can then be reused multiple times—a principle that can be described as “document once, use many times.” Physicians thus benefit from clinical decision support at the point of care, which can automatically provide alerts on medication interactions or guidelines and help avoid duplicate examinations. Patients benefit from digital education, electronic consents, or remote monitoring. Routine tasks such as findings or discharge management can be automated. And last but not least, the benefits must be measurable—in saved time, avoided readmissions, or improved data quality.
How can we achieve faster roll-out and application of digital innovations, and what contribution does the BIH make?
Germany does not have an idea problem but a scaling problem. So that innovations are not stuck in pilot projects, we need nationwide accepted FHIR reference profiles with test cases and sample data, proof of conformity as a prerequisite for award and approval, and open-source reference architectures that clinics can implement directly. Equally important are training and implementation programs for IT departments and industry partners, accompanied by funding that focuses on measurable outcomes. The Berlin Institute of Health (BIH) makes a significant contribution to this: We develop FHIR-based data platforms with clear quality indicators, maintain terminology links and implementation guides that feed directly into clinical practice, and implement lighthouse projects such as „Senology on FHIR“ in gynecology or in rare diseases, serving as blueprints. We also promote the translation of paper-based standards into clinical reality through interoperability consulting hours, test events, and participating in international standardization committees - with the overarching goal of ensuring that digital innovations arrive quickly and effectively in patient care.