The German healthcare system has learned a lot from the pandemic. With digitization, which is lagging behind, and the outdated hospital landscape, which urgently needs a new structure, there are still major tasks to be solved. Nevertheless, the hospitals are "prepared" for a possible new corona wave in winter if the number of cases does not explode, says the head of the Essen University Medical Center, Jochen A. Werner, ntv.de. Something else worries him: that society might not be sufficiently prepared for the vaccination procedure. It is possible that they have not prepared enough "acceptance" who will get the vaccination "when and why".
ntv.de: The race for a vaccine is in full swing. Once a vaccine has been approved, will you get vaccinated immediately?
Jochen A. Werner: Of course, I will be vaccinated as soon as possible if an effective and safe vaccine developed in accordance with the valid and proven criteria is available. In addition, I will be vaccinated against the flu again this year – this prevention is also very important, especially against the background of still unexplained reinforcement mechanisms with the coronavirus.
How well we get through this winter depends very much on a vaccine. Will we have one soon?
Nobody can give a serious answer to this question. Many companies are currently working flat out and with various processes to develop a vaccine. I think it is likely that at some point we will have multiple vaccines with different modes of action. That would also be a good thing to give all people with different personal and genetic dispositions access to the vaccination against Corona. But I think it is rather unlikely that vaccines will be sufficiently tested by the winter season, which will begin in a few weeks, and, above all, will be available in the required quantity for a relevant number of people. Here we are talking about billions of units of vaccination doses, at least on a global scale. So in real everyday life we will have to live with corona for some time without a vaccine. It is therefore all the more important to adhere to the AHA rules – keep your distance, observe hygiene and use an everyday mask.
Do we have to worry if the vaccine is a long time coming?
Of course, in many areas, the situation will not get any easier if a vaccine were not available for some time. In my opinion, we should be particularly concerned if we lose control of the virus and the result is drastic upheaval in society and the economy around the world. I continue to assume that the fight against Corona will not be won in hospitals, but in society. I am concerned about whether, after our not unproblematic experience with the introduction of masks and tests, we are sufficiently prepared for the start of the introduction of vaccinations and whether we have prepared acceptance of who gets them, when and why, and how to deal with them again communicating group of anti-vaccination opponents.
How long will it be before everyone is vaccinated?
That is difficult to say and depends largely on the vaccines that are available. It would be ideal if vaccines from different companies were available, because then the required number of vaccine doses could be produced more quickly. But we certainly have to reckon with several months, depending on the efficiency of the state health systems.
At the beginning of the corona pandemic, hospitals were hopelessly overwhelmed. Are the clinics in Germany better equipped for a possible new wave?
The corona pandemic exposed the weaknesses of the German health system, especially the lack of digitization. But our strengths – motivated and well-trained nurses and doctors, a good infrastructure and the comparatively high proportion of intensive care beds – have also become clear. Against the background of this experience and a now largely uncritical inventory of protective materials, we are prepared for increasing numbers of cases – if they don't explode.
The sickness information law amounts to a total of 4.3 billion euros, if one adds the participation of the federal states and / or carriers. With this money, a hospital future fund (KHZF) is set up at the Federal Social Security Office, through which these funds can be accessed by the federal states. Ten percent of the total is earmarked for university hospitals. Investments in modern emergency capacities and a better digital infrastructure, for example patient portals, electronic documentation of care and treatment services, digital medication management, IT security measures and cross-sectoral telemedical network structures are to be funded. The KHZF can also finance necessary personnel measures.
The so-called Hospital Future Act was passed last week. There is a good four billion euros to be distributed. Does that help?
From my point of view, the sum can only be start-up financing and an innovation accelerator, since the investment required for the fundamental digitization of the healthcare system is definitely significantly higher. Politicians with Federal Health Minister Jens Spahn have clearly recognized that we have a lot of catching up to do with digitization, even in an international comparison. In this respect, the Hospital Future Act is undoubtedly a positive signal, but it also makes it clear that the federal government is thus getting involved in hospital financing for the federal states.
Where do you see risks in the system?
I see the greatest danger in the fact that the money actually earmarked for digitization and innovation is invested in preserving traditional structures and safeguarding vested rights. Because the hospital landscape also has to change in the medium term, towards larger specialized units that treat complex cases of illness. The fact that everyone does everything, as is often the case today, not only limits the medical quality, but also hinders digital progress, because small houses cannot afford many investments, either financially or in terms of personnel.
You rely on digitization and robotics in the care sector. The aim is to create time and space for humane care. But who guarantees that the patient will not only be looked after by robots in the end?
Prof. Dr. Jochen A. Werner, Medical Director and Chairman of the Board of the Essen University Medical Center.
Digitization will not de-soul medicine, on the contrary, it will make it much more human. We are already recognizing today that the introduction of the electronic patient record relieves nursing of activities away from the patient and that slots are slowly opening up again for more time with the patient. You can certainly sense my cautious formulation, because of course this can only be an approach to relieve the nursing care. For example, we also have to deal with which documentation obligations we can do without. And of course nothing speaks against using robots in the future, for example, to support the nursing staff with heavy physical work or to take food orders, especially when there are no service staff to relieve the care.
Is there anything on your wish-list that isn't necessarily about money?
Yes, and that would be courage, determination and the will to put particular interests behind. Medicine, with its divergent groups of influence, is unfortunately adept at preventing and talking to projects. Digitization in medicine as in society is a large, overarching, long-term and challenging project. We will only achieve this if we overcome egoisms and pull together. I think that the focus on the well-being of the patients and the employees in the hospitals and not on one's own interests is the right guideline. And then we still have to think about the next step: the necessary information and training on the changes associated with digitization. We all have to work intensively on education.
Diana Dittmer spoke to Jochen A. Werner
. (tagsToTranslate) Economy (t) Corona crisis (t) Coronavirus (t) Vaccination (t) Health policy (t) Hospital (t) Pandemics (t) Jens Spahn