Читать книгу DiGA VADEMECUM - Jörg F. Debatin - Страница 23

Prior to the Digital Healthcare Act (DVG), providers of digital health tools could only obtain payment for their products through niche programs, such as ‘selective contracts’ (‘Selektivverträge’)—that is, contracts with individual health insurers, e.g., in the area of preventative care solutions. With ‘selective contracts,’ health insurers are freer to set budgets, however, uncertainty around the future of digital tools remained high. DiGA could not be meaningfully assigned to an existing category, such as medical aids, drugs, or therapeutic methods of non-physician providers (e.g., physiotherapy, speech therapy, [see chapter 5 Pathways for digital solutions to enter the statutory [regulated] healthcare market], for a good summary, see: Thelen 2018).

As a result, there was no consistent approach to digital applications in Germany, as has also bene the case in most of the world’s healthcare systems. Only the Scandinavian countries, Israel, Singapore, the UK, and parts of the USA already use digital applications for patients care in a structured way. In these countries, however, digital applications are mostly used only in small subsets of the healthcare system, thus impacting only relatively small populations and subject to very different authorisation processes and reimbursement models.

Why is the German healthcare system concerned with DiGA at all? Why are they medically relevant? To date, ambulatory physicians have essentially acted only in the short time in which they can see and examine their patients. On average, a patient visit lasts 7.6 minutes in Germany (Nier 2017). Only the information that is provided, explained, and understood by patients in those 7.6 minutes can resonate with patients, and thus impact an individual’s health. Whether medications are taken, prescriptions for physiotherapy are utilized, aids such as orthopaedic insoles are actually used—physicians can only learn about all of this by skilfully asking questions during subsequent visits—and only if they have the time, recall, and patience to do so.