Digitalisation in the health sector

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, there is the ability to assign the data, to retrieve the data, and to use the data in any direction. Whether it's automated writing of doctors' letters, or whether there is some form of data evaluation in the scientific sense. All of these are, of course, successes of digitization and the 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 as few sources of error as possible. possible.

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

Prof. Dr. Bernd Wolfarth: I think in the healthcare sector, the first thing that is important is that we need digitization. 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 indeed succeeded. 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 sports, in competitive sports, there is a very heterogeneous landscape as far as medical care is concerned. But we are certainly a long way from having digitization in all areas. Especially since this heterogeneity poses additional problems: There are many areas that are served by a wide variety of institutions, i.e., people from practices, people from clinics, and people who are on the road as "free agents" come together, and of course it's a real challenge. So there is still a lot to do in the future to provide continuous digital data storage. In my eyes, that is still quite a long way off.

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 sports 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 Center, we also look after individual athletes - we have their medical files, at least as far as the findings were collected here, which we have just digitized. I was lucky that I only came here in 2015 and that this department didn't exist at that time. So I was able to 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 up a system right from the start, which was already very largely digitized at the outset and which was then really organized digitally within 2 or 3 years. For me, it was simply important to set up a process that had a good workflow. We have an order entry system 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, to benefit the patients, in this case also the athletes, and 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 has to 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 can be implemented. Of course, this also includes the appropriate 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 various stress parameters, lung function, all possible functional measurement stations that we then had to integrate), was of course that we looked from the outset to ensure that they are intelligent systems, modern systems, and also forward-looking systems, where we have 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 digitization? I believe that if it's an optimal system that works well, there are few to no reservations. I think the main problem is always change management/conversion. And of course the main reservation is that it's something new, that I'm 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, and that, ideally, well-established and sensible workflows - that's why I say workflow plays a major role - can be mapped, and that requires flexible systems. If these flexible systems exist and are also well adapted to requirements, there are actually no legitimate reservations about digitization.