{Appointment} Quality in health management through efficiency: Federal Minister Jens Spahn on current trends

Ob Companys or private individual: Quality is important in the healthcare system. Federal Health Minister Jens Spahn agrees - and thus reveals the societal dilemma between digitization, efficiency and market regulation.

Healthcare Efficiency: Does Capitalism Improve Quality?

Health is a human right and should ideally not function according to the laws of the free, capitalist market at all - at least that is the position of business ethicists such as Prof. Dr. Giovanni Maio, Director of the Institute for Ethics and History of Medicine at the Albert-Ludwigs-University Freiburg, at the 15th National Health Industry Conference in Rostock.

Federal Minister Jens Spahn, on the other hand, did in his Rede on 15.06.19/XNUMX/XNUMX in Rostock clearthat it is not that easy: He announced a discussion about the quality of health care, especially with regard to quality measurements in the inpatient area in hospitals, but improvements in the care sector are also extremely important.

The Efficiency Dilemma: Between Regulation and Competition

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With regard to regulation and legislation, however, Spahn finds himself in a dilemma between efficiency and necessary regulation: On the one hand, he finds laws and regulation important: for example, for everyone People to provide access to medical care everywhere, including in the countryside.

"Without needs planning, we would simply have no doctors in the country because everyone wants to work in the cities." It is also efficient to put care products on the doorstep of old people for six months in advance, but that is just as inefficient useful like Combination from assisted living and short-term care. According to the Minister of Health, sensible regulation must be carried out here in order to create a framework for competition.

Federal Minister of Health: Overregulation hinders innovation

Because over-regulation is particularly harmful to the innovative power that is so important in the health care system, not only because competition helps to make processes more efficient and thus also Costs to save. “If we regulate too much, start-ups will migrate with new ones ideas to the USA,” said Spahn.

Because that in other countries, especially in the digital field is much further, was apparently recognized in the Federal Ministry of Health. Spahn referred to current developments of large digital companies such as Apple or Google in the health sector.

Digitization as a marginal topic in German politics

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Nevertheless, the important and future-oriented topic of digitization for all other areas was only mentioned in a few sentences fast dealt with. This gives reason to fear that it has still not been recognized to what extent digital Technology will affect all areas of society, including quality in hospitals and care.

How far this could change socially is shown by a thesis that I base on a Lecture just two days later at the University of Witten-Herdecke: specialist knowledge is available in the context of digitization Significance verlieren – and with it, for example, the importance of the medical profession. Much more likely to be in a digitized Welt interpersonal, empathic skills, for example, from nurses, are much more in demand. This could completely reverse the importance of the corresponding workers on the labor market.

Privacy, German fear and the look abroad

After all, Spahn was looking at the German Anxiety-Theme Privacy firmly: "We have to actively shape this if we don't want to suffer anything in the end". If you now look at countries that are already much further ahead in digital development, it quickly becomes clear that a number of steps are still necessary in practice to actively shape this.

The best example of this is of course Estonia, which I clearly had in mind when I visited a few years ago Eyes showed how old-fashioned and inefficient administrative processes in Germany really are. And how much more efficiently everything could be designed - but also that the issue of data protection will be the sticking point, especially in the critical health sector.

When health data is managed digitally

An average Este, for example, needs 15 minutes for a tax return. The record for starting a business is 18 minutes. With an electronic signature you can conclude contracts in a few minutes. The parliamentary election can be done in five minutes by mobile phone from the sofa. And a Cabinet meeting lasts only about 45 minutes - because the ministers no longer have to dig through piles of paper.

It goes without saying that Estonians can also view all of their health data digitally and transparently online, which is not passed on on outdated storage media, as it is in Germany - and above all not only among doctors and health insurance companies. You can't get married and divorced there yet Internet.

Efficiency as a panacea for more quality?

In fact, alongside efficiency, this is the most important argument in favor of digital administration: transparency and making one's own data accessible to every individual citizen. That should be safer System also be as paper management, even if there have already been hacker attacks that successfully were fended off.

If you think about how much time and Money you waste in Germany with postal voting or for the tax return. Or for contracts, can only be enthusiastic about the Estonian system – right?

Digitizing hype vs. digitization frustration

In any case, the Estonians I met were all enthusiastic about their efficient, digital administration. This efficiency to save both time and money is also the reason why Estonia's administration since Foundation of the country relies entirely on electronic data processing.

If you then look at their representatives on the ones that are constantly discussed in this country Problems When we address data security and data protection, they are happy to answer the question: whether we shouldn’t also use Google or Facebook use? Or they answer in general terms: there simply cannot be a completely secure system.

How economical may administration be?

Even if that for sure That's right, this mass of well-done self-PR irritated me a bit. What I found almost even more irritating, being used to German civil servants, was the extent to which economic thinking went hand in hand with e-government services, even from government agencies.

Since this also concerns the digitized health administration, here we are quickly back to the question of medical ethics raised above: How economically should administration be organized, and especially in the health sector?

When the state does marketing

After all, the whole thing has long since become a marketing topic: the digital signature has already been successfully exported to other countries, including Switzerland and Azerbaijan. Taavi Kotka, secretary-general for ICT at the Estonian Ministry of Economic Affairs, stated in a speech and later in a video interview, quite openly, that it should be allowed to buy together citizenship rights in different countries.

On the one hand, of course, it's great when citizens can benefit from a leaner state. On the other hand, it is a bit strange for me to publicly think about how to market these efficient structures in other countries as well.

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