Stress test for the healthcare sector

"Our healthcare system has demonstrated its adaptability during the coronavirus crisis, despite existing deficits," said Professor Carsten Schultz, innovation researcher in Kiel. And suddenly telemedicine is also possible.

The healthcare sector in Germany has withstood the crisis resulting from the spread of the new coronavirus (SARS-CoV-2). And this is not just because German hospitals are better equipped with intensive care beds and ventilation machines, or because the political measures led to a slower rise in the number of cases compared to Italy or Spain. "In my opinion, our healthcare sector passed the stress test because it reacted flexibly to problems," emphasised Professor Carsten Schultz from the Institute of Business and Innovation Research. Although many hospitals only partially provided for the necessary care beforehand in their pandemic plans, they then adapted their internal processes well to suit the new situation and coordinated with other hospitals. Schultz also finds the innovative strength of the hospital staff remarkable. "At the UKSH, too, from one day to the next a new job rota was introduced. This meant that nurses from less busy areas helped out in other departments. Interdisciplinary teams were formed, containing doctors from different professions, who produced solutions with the nurses."

One lesson to learn from the crisis is that the cooperation between different professional groups at the hospitals generally needs to improve. "There is a large separation between doctors, nurses and other service personnel, like the cleaning staff. Our studies also show that overcoming these functional silos is the key to successful innovation."

In spite of a shortage of nurses and overworked doctors and other hospital staff, Schultz said it shows that "when necessary, like now, they all work effectively and with great motivation." However, this must not belie the fact that the general mood is bad, as employee surveys in many hospitals throughout Germany have shown. Politicians will need to consider better working conditions for hospital staff in future, too.

The regional cooperation between outpatient doctors, the health authorities and hospitals has structurally been positive in the crisis. According to Schultz, "these structures led to flexible solutions. Hospitals were confronted by the situation of not having enough protective equipment nor the transparency of available medical capacities. Economic competitors exchanged capacities in their time of need, short, efficient information channels were set up and work was done for others in order to maintain the medical service." One plus point in Germany was also the strong position of university hospitals. The close interlinking between research and hospitals, together with the scientific approach related to this, really proved themselves.

Happily, from the expert in innovation in the healthcare sector's point of view, is the fact that modern, technical solutions like telemedicine and the digital transfer of data, which have been overlooked for ages, are now suddenly possible. The pandemic has given digitalisation in the healthcare sector a leg up. Developments have been accelerated which, despite evidence proving their benefits, were mostly rejected by medical service providers just a few weeks ago, said Schultz. "Supervising the state of health from home, i.e. telemonitoring and telemedicine, will be standard practices in future, just like interdisciplinary digital consultations, for example on nursing those in need of care or multimorbid patients (those suffering several different illnesses at once)." He hopes that the acceptance of this exchange and the linking of health data from the different sectors (clinical and outpatient care, rehab facilities and non-medical healing professions) will increase, so that "artificial intelligence can be used to benefit the patients."

One of the biggest weaknesses of our healthcare system, according to Schultz, is the intersectoral separation. Each economic unit optimises itself, medically and economically, but only partially coordinates with other stakeholders, plus the quality of information between the sectors is poor.

In Schultz's eyes, the coronavirus pandemic has shown that an interdisciplinary approach can solve problems in healthcare. The working group is therefore trying to make a contribution towards overcoming the current problems, in several research projects funded by the Federal Ministry of Education and Research (BMBF). According to Schultz, "In the Audio-PSS project, for example, we are looking at tele-audiological care for those with a hearing impairment, and in the Living Smart project, we are working on building up a digital service provision platform for mutual support in residential quarters. And in the Q-Aktiv project, we are solely concentrating on the question of organising interdisciplinary research and development to overcome the pandemic."

Author: Kerstin Nees