A frequently heard assessment of Germany’s healthcare system is that it continues to lag notably behind other countries in terms of digitization. But in which areas, exactly, does it lag behind the most? What strategies are other countries pursuing? What can we learn from the experiences of those countries? In the coming months, our goal is to undertake a comparative international study that provides insights into exactly what characterizes a successful national digitization strategy. We are therefore targeting an analysis of the framework conditions, major advancements and success factors in 17 different healthcare systems. Our basic thesis going in to this analysis is that fully leveraging digitization’s potential in the realm of healthcare involves developing a tenable national strategy with long-term objectives that features a clear vision and is advocated by political leadership – regardless of a country’s size or political system.

“Our goal is to make Germany a pioneer in terms of the introduction of digital innovations in the healthcare system” – this statement is found on page 35 of the government coalition agreement entered into this week by the CDU/CSU and SPD. This is a welcome assertion – and an ambitious goal. There is no doubt that Germany has much catching-up to do in terms of digitizing its healthcare system, especially when we compare it to other countries across the globe. In fact, there is no need for a (new) study to establish this – we can see it already in the various progress reports emanating from countries such as Denmark, Sweden and Estonia. Indeed, a critical look at the status quo in Germany shows a sorry state of affairs. However, the question remains as to which areas are furthest behind. To what extent is it even possible to compare other nations’ healthcare systems with the situation in Germany? What kinds of strategies are being pursued by the most successful countries? What can and should we learn from them? These are the factors we’re most interested in examining in the coming months.

A comparison of digitization strategies in 17 countries

In our study, which we carried out together with empirica Communication & Technology Research, we are analyzing digitization strategies in 14 European states and an additional 3 OECD countries. Our aim is to go beyond a mere description of each nation’s precise level of digitization and instead develop a deeper understanding of the conditions and factors contributing to each country’s success in this area. For example, we take a look at each country’s legal framework, whether they pursue explicit strategies and what governance structures are in place. We then link this to tangible infrastructures and actual digital application usage. The questions we ask include: Are there such things as digital patient files? Are electronic prescriptions used? Are there video consultations between doctors and patients? Are new opportunities for data analysis used in research? One of our most important priorities is to analyze and portray the sheer variety of international variants.

The study examines 14 European countries as well as Australia, Canada and Israel.

For this reason, our study initially examines Germany but also all large EU member states, including France, Italy, Poland, Spain and the United Kingdom. Although these countries have healthcare systems that are in many ways very different, they nevertheless face geographical and regional challenges that are similar to those faced by Germany in terms of their size.

In addition, we want to examine how countries with healthcare systems relatively similar to Germany’s are handling digitization. Our study thus takes a closer look at Belgium, the Netherlands, Austria and Switzerland, countries with insurance-based healthcare systems. The picture is rounded off by those countries in the far north of Europe that are generally recognized as being progressive and include Denmark, Estonia and Sweden. And, finally, we venture beyond Europe to examine two geographically large, federally organized OECD countries, namely Canada and Australia, as well as Israel, a smaller country with a reputation as a high-tech hub.

Two study sections: Digital Health Index and “Lessons learned”

In order to understand the strategic approaches of these countries, the first part of the study will have an international panel of experts develop a comprehensive, standardized questionnaire focusing on policy activity in each country, on their “readiness” for connectivity and data usage and on actual levels of data usage. We will present the findings of this analysis in a “Digital Health Index” that ranks the countries according to their progress in the areas specified.

In the second part of the study, we will take a closer look at five countries – undertaking on-site research. In Denmark, France, the Netherlands, Switzerland and Israel, we investigate why digitization strategies lead to success in some countries, but not in others. Our examination will take into account various healthcare policy framework conditions, but also political preferences, economic factors and cultural features.

Underlying thesis: Long-term strategy and political leadership are critical to success

As a whole, our study is based on the idea that digital transformation in healthcare systems succeeds when countries have a clear vision and pursue a long-term national strategy. Another factor is the degree to which policymakers and other political stakeholders work together with resolve and take on a leadership role – regardless of a country’s size or political system. This thesis draws on existing studies and the collected experience of our colleagues in the context of their research underpinning the 2017 Reinhard Mohn Prize: “Smart Country – Connected. Intelligent. Digital.” The prize in 2017 was awarded to former Estonian president, Toomas Hendrik Ilves, a pioneering political thinker and a leader who recognized early on the opportunities inherent to digitization.

The political parties that form Germany’s latest grand coalition government also recognize the need for a healthcare strategy, even though the key impulse for such a strategy is found in a sub-chapter (Research and Innovation) of the coalition agreement’s treaty rather than in its “Healthcare” section. On page 35 of the coalition agreement, they state the following: “We will create a roadmap for the development and implementation of innovative E-Health solutions.” Our hope is that the findings of our study will help in this endeavor. Of course, we will also be taking a look at the extent to which this goal is achieved.

Follow us as we take a closer look at e-health developments in various countries for our study throughout the course of 2018.

We will publish the full results of our international study in November 2018. Until then, we will be highlighting thought-provoking insights and best practices from other countries here in our blog. If you are interested in keeping up-to-date with our latest analyses, we recommend that you sign up for our email newsletter: