First DiGA registrations: Is this the future of medicine?

The race is open, DiGA can be set in motion. More precisely, it is possible to go through the formal application process in order to obtain funding from the health system. Or, in very neat terms: providers of digital health applications (DiGA) can submit an application to the Federal Office for Drugs and Medical Devices (BfArM) for inclusion in the DiGA directory. The first 15 DiGA have been submitted, the overview can be found here (German) and is updated continuously.

At a time when the professionalism of statistical evaluation of studies is discussed and discredited in tabloid headlines, a disclaimer in advance: Of course, the first 15 submissions do not allow a comprehensive and differentiated picture of digital medicine to be drawn. But a first impression is allowed.

What do we see in this DiGA series? Applications on the subject of nutrition, digestion, diabetes. Apps on mental health and stress. Migraine apps, sleep training and mobility analysis. One deals with data communication between doctor and patient. And then there is ADA. Obviously, this technology is the closest thing to the future of medicine in Germany in 2020. This is good news; in the sense of: After all. However, anyone who expected the establishment of DiGA to give a boost to the future of digital medicine does not need a new app, but simply more patience.

What is the categorical difference here? If you have sleeping or intestinal problems, you are sure to find help with the right app. That’s good. The future of digital medicine – and what is meant here is: the true potential of data – will only become visible where the diagnosis has not yet been made. Data takes anamnesis processes to a completely new level. This is where the power of digital medicine lies, in the networking, linking, processing and interpretation of large quantities of the most varied data. ADA can do this. And Scitim certainly contributes to this. End of this list.

It may be that the very applications that were already fully developed and now only want to tap into an additional stream of revenue are in the front row here. It may also be that these very concrete applications are simply faster and easier to develop. Thirdly, they are undoubtedly capable of generating benefits. But when we ask about the future of medicine, we are still waiting for something that is as much – or even more? – The future is as ADA.

Devastating Result of the 2020 EPatient Survey

The EPatient Survey is an at least reasonably representative online study on the state of digital health in Germany and, above all, on the use of digital health services by patients. In other words: customers. That is positive, we can learn something from that. Alexander Schachinger and his team have just presented the 2020 results. Learning: It is a tragedy.

A highlight: The use of online consultation hours with doctors has tripled. Sounds good. The percentage of patients who used the online consultation hour has increased from 0.7% to 2%. So the trivial realization must be: The online consultation does not take place. It is a chimera. The fact that the survey period included the beginning of the corona pandemic only reinforces this interpretation.

The head of the study sees a “large increase” here. The digital entrepreneur and co-founder of the Spitzenverband Digitale Gesundheitsversorgung, Diana Heinrichs, commented on today’s digital press conference: “The result is devastating”.

Julia Hagen from the Federal Ministry of Health reported from workshops with doctors on health tips and their use in consultation and treatment. A formative impression: the doctors were mostly in a positive mood, but feared overtime. The interested observer asks himself: Yes, what else? The example of Amazon and its uncompromising simplicity of operation, which was also quoted in the press conference, is the result of extraordinarily hard work. The EPatient Survey says: “People want simple and useful health apps, but there is currently no relevant use for them, at least not for the apps that the legislator has on the screen.“ One commernt: One must urge the pharmaceutical assistants to address the customers actively on health related apps. Whether we could at least overtake the educational system in terms of digitalisation, the moderator of the press conference asked. The choice of goals also says something about one’s own ambitions.

So what is most saddening here? The findings that have basically only underpinned an unpleasant premonition with new data – or the reaction to it? Please make your own decision.

Transhumanism in times of Corona

The futurologist in me wavers over a message from Zoltan Istvan this morning. Zoltan is one of the most prominent transhumanists in the US and beyond. He pushes the issue forward in terms of content and also knows how to generate the necessary publicity, right up to his own presidential candidacy. At the same time, he is simply a very nice guy who would not easily cause a stir in any pedestrian zone in the world.

On LinkedIn this morning, he makes the following statement:

Those who have supported the corona lockdown in recent weeks bear indirect responsibility for shrinking budgets in medical research outside the field of virology. Therefore: Those who have already reached a certain age today may simply be too late for the necessary breakthrough in the considerable extension of human life. This is the view of transhumanism.

Anyone who likes it may dismiss it as theatrical thunder. But Zoltan has at least one point here: Do we strike the right balance between maximum short-term action and the courage to think big, long-term and visionary? Nobody can want people to become seriously ill because we have not developed a vaccine against the current corona virus quickly enough. But do we want to prolong human life significantly later than we might otherwise have done? However immediate the interactions will be in the end, the call for courage and vision in times of action is necessary.

Corona: Not a lie, … but a trap

Never before has healthcare been so fast. From a local viral infection in China to a multi-billion dollar pan-European donor conference in just a few months. We could almost believe that the future of medicine is being decided in the international competition for the first vaccine against corona. The Corona App will help us to digitize health care. And the ethics committee is dealing with the compulsory vaccination. Everyone is already happy, or at least busy. And trapped.

Systems tend to be self-preserving. This basic truth from the systemic consultation will prove true in the coming months using the example of Corona. The system has set up a simple but tempting trap for us. It follows a simple dramaturgy:

  • We were able to develop, test and produce a vaccine in a very short time. This proves the efficiency of our health system, Research Department.
  • We were able to ensure at all times that sufficient free capacity was available in intensive care medicine. This proves the efficiency of our health system, Department of Stationary Medicine.
  • We now have a health care app, with/without… (please insert any tech company). This proves how flexible and capable of development our health system is, department “Something with Computers”.

The subtext is clear: Everything’s fine. Please do not touch anything. Just keep funding the same.

To counter the cheap counter-attack with the necessary: Whoever has such a well-developed and well-funded health care network in his everyday life can easily stay cool even in pandemics. Of course. But we would fall into the trap mentioned above if we were to conclude that everything is already in order. As if all we had to do was pay a little better for nursing care and there it was, the prototype of a sustainable health system. It is not.

The real digitalisation of the healthcare industry is still in full swing. It goes way beyond fighting a single Corona family virus. Health is ripe for disruption. This will be a place not to think about Corona in the weeks ahead. Health is bigger.