Removing Dust From the German Health Care System by Introducing Health Apps Into Standard Care: Semistructured Interview Study

BACKGROUND

In 2019, Germany launched the Digital Healthcare Act. The reform enables physicians to prescribe health apps as treatments to their statutory-insured patients.

OBJECTIVE

We aimed to determine the extent to which the integration of health apps into standard care could be considered beneficial and which aspects of the regulation could still be improved.

METHODS

We conducted a semistructured interview study with 23 stakeholders in Germany and analyzed them thematically. We used descriptive coding for the first-order codes and pattern coding for the second-order codes.

RESULTS

We created 79 first-order codes and 9 second-order codes following the interview study. Most stakeholders argued that the option of prescribing health apps could improve treatment quality.

CONCLUSIONS

The inclusion of health apps into German standard care could improve the quality of treatment by expanding treatment portfolios. The educational elements of the apps might additionally lead to more patient emancipation through a better understanding of personal conditions. Location and time flexibility are the biggest advantages of the new technologies, but they also raise the most significant concerns for stakeholders because app use requires personal initiative and self-motivation. Overall, stakeholders agree that the Digital Healthcare Act has the potential to remove dust from the German health care system.

[Digital health applications and date protection]

Digital health applications represent a new form of care. The basis for the approval of digital health applications is the Digital Healthcare Act. In order to be included in the directory, the digital health applications must undergo an extensive evaluation process by the Federal Institute for Drugs and Medical Devices. The focus is on proving added value for care, but also on the technical aspects. This strictly differentiates the digital health applications from the health apps. Cutting-edge apps enable a simple output of collected data to make doctor-patient interactions efficient. Appropriate remuneration and education could increase the acceptance by the medical profession and thus accelerate implementation; however, such instruments and incentives are not currently provided for in the system.

[Digital health applications (DiGA) on the road to success-the perspective of the German Digital Healthcare Association]

The approval of the first digital health applications (DiGA) in October 2020 resulted in a lot of buzz - not only in the healthcare sector but also beyond. The integration of DiGA to the public healthcare system was seen as a significant innovation and stakeholders worldwide were looking to Germany. How did the start of the DiGA innovation project go and what is the current standing? The first months of DiGA becoming part of standard care brought new experiences and knowledge to manufacturers, doctors and patients as well as to health insurance companies and associations. More than six months later, it is time for a preliminary review.This article looks at the achievements so far as well as the status quo of DiGA in the market as of March 2021. It also focuses on current and upcoming challenges that the various stakeholders face on the way to integrate DiGA into standard care in a widespread and sustainable way.