Dentro de: “Thought Leaders : connected health”: p. 66-70
Reinhold A. Mainz
Commissioner for Telematics
National Association of Statutory Health Insurance Physicians
nformation and communication technology (ICT) and the establishment of a legal and economic framework form the two mainstays of Germany?s medium-term strategy for healthcare telematics. The situation is best understood by comparing the position of the Federal Ministry for Health and Social Security
(?Bundesministerium für Gesundheit und Soziale Sicherung ? BMGS?) ? principally a policy-making body ? with that of the independent sector, which actually provides the services on a contract basis and is therefore at the sharp end of the industry.
This comparison throws up a clear distinction between the short term objectives and targets of the federal ministry and those of the service providers, who operate under the umbrella of federal or state law. The differences between the two parties are outlined in this essay.
In the field of health telematics, independent contractors at the federal level work together within the ?Aktionsforum Telematik im Gesundheitswesen ? ATG? (Action Forum on Telematics in the Health System; atg.gvg-koeln.de). This body was founded in 1999 to get the various parties around the same table, introduce some transparency to the proceedings, assist in arriving at a consensus and ? finally ? prepare recommendations for action. The latter now constitutes an important point of reference for all service providers in the
German healthcare system as well as the relevant government departments.
The ATG?s objective is to improve the quality of medical care and to create
opportunities for increased efficiency, largely by promoting the exchange of
information through the use of ICT in specific areas. Particular attention is paid to those areas where operational efficiency is compromised by existing
practice, or where there are many different parties involved.
While the federal ministry is responsible for legal matters and for building a
framework for statutory health insurance and healthcare delivery, the regional
authorities (German states or ?Länder?) are mainly involved with setting guidelines for physicians and other healthcare workers. They are also responsible at the same strategic level for hospital healthcare provision.
At the sharp end, however, the minutiae of day-to-day operations are laid down
contractually between the various parties, which include insurance funds and
statutory healthcare associations.Mainz, Reinhold A.