Digitalisation in the health sector

In the discussion about digitalisation, especially in the health sector, it is easy to get the impression that this is about something abstract, almost metaphorical. A pity really, because the absolute opposite is the case!

As a developer of software solutions for the healthcare sector, we have had our finger on the pulse of digitalisation for 40 years. We have been experiencing its usefulness for just as long. We had the opportunity to ask our client Prof. Dr. Bernd Wolfarth, Head of the Institute for Sports Science and Sports Medicine at the Charité in Berlin, what effect digitisation has on him and his team.

What effect do you notice from digitalisation at your institute at the Charité?

Prof. Dr. Bernd Wolfarth: First of all, we are paperless. This is something quite banal: we pushed to become paperless because we have grown steadily with the department and after 2-3 years the archive capacities were more or less overfilled. That is a first, very tangible advantage.
And then, of course, it's the assignability of the data, the retrieval of the data, the use of the data in any direction. Whether it's automated writing of doctors' letters or whether it's a form of data evaluation in the scientific sense. All of these are, of course, successes of digitalisation and quality assurance plays a very important role. On the one hand, of course, in data storage, but of course also in data collection, so that there are as few sources of error as possible.

What is your general assessment of digitalisation in the health sector?

Prof. Dr Bernd Wolfarth: I think in the health sector it is first important that we need digitalisation. A lot has happened in recent years, but not nearly as much as we would have liked. If I break it down to my department, which I have here in Berlin, it was an early request of mine to try to map processes digitally. And we have actually managed it. In our department we have been paperless for three years, so we have a digital file for our patients. But of course, Germany as a whole still has a lot of catching up to do in this area. In sport, in competitive sport, there is a very heterogeneous landscape as far as medical care is concerned. But we are certainly a long way from having digitalisation in all areas. Especially since this heterogeneity poses additional problems: there are many areas that are served by the most diverse institutions, i.e. people from practices, people from clinics, people who are on the road as "free agents" come together, and of course it is a real challenge. So there is still a lot to do in the future to provide continuous digital data storage. In my opinion, there is still a long way to go.

In the discussion about digitalisation, especially in the health sector, it is easy to get the impression that this is about something abstract, almost metaphorical. A pity really, because the absolute opposite is the case! The core question we ask ourselves in all digitisation projects is where can we support, facilitate or even make possible in a very practical way?

Prof. Dr. Bernd Wolfarth: Well, at least in the regional competitive sport that we now represent here in Berlin: We simply look after many competitive athletes here, we look after some clubs, we look after the Olympic Training Centre, we also look after individual athletes - we have their medical files, at least as far as the findings were collected here, which we have digitised. I was lucky that I only came here in 2015 and that this department didn't exist at that time. So of course I could start from scratch, which is always a bit of a curse and a bit of a blessing. I saw it more as a blessing and was able to build a system right from the start, which was already very largely digitalised at the beginning and which was then really organised digitally within two or three years. For me, it was simply important to set up a process that had a good workflow. We have established an order entry system, we have all the important findings that are collected digitally. We then have the possibility, on the one hand, for the benefit of the patients, in this case also for the benefit of the athletes, but on the other hand, of course, also in the sense of scientific evaluations, to access all data. And for me, that is an extremely important requirement that we also have in the university care situation. And overall, it must be said that it is also a question of quality assurance in this context. We also try to reduce as far as possible all human factors that can cause errors, so that automatic data allocation and automatic data collection are realised. Of course, this also includes the corresponding hardware beyond IT. But here, too, the premise in the selection of all the measurement functionality that we have (in our case, this is a wide field from ECG to ultrasound to different stress parameters, lung function, all possible functional measurement stations that we had to integrate) was that we made sure from the outset that they were intelligent systems, modern systems, forward-looking systems, where we have the appropriate interface access to connect them to our core system.

However, despite all the economic advantages and technological progress, we repeatedly experience that a decisive factor for the success of digitalisation is ultimately its acceptance. Do you encounter reservations about digitalisation?

Prof. Dr Bernd Wolfarth: Reservations about digitalisation? I believe that if it is an optimal system that works well, there are few to no reservations. I think the main problem is always change management / the conversion. And of course the main reservation is that it is something new, that I am changing something, that perhaps work processes are changing. And that's why I believe that the most important requirement must be, in addition to the functionality in the backbone, that the frontend also functions well, that the people are taken along, that, ideally, already well-rehearsed and sensible workflows - that's why I say workflow plays a big role - can be mapped, and for that you need flexible systems. If these flexible systems exist and are well adapted to the needs, there are actually no legitimate reservations against digitalisation.

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