Digital technologies have certainly played an important role in addressing the current pandemic. In times of ‘social distancing’ and home office, they have not only become crucial tools for the continuation of our everyday lives, but instrumental in contact tracing and in containing the virus’ spread. And while Germany has never been known for being a leader in digitalization, its recent launch of the worlds largest crowd-based infection monitoring app shows quite the opposite. As supporters of this initiative, I’d like to look at how German authorities may not only have changed their global reputation, but also showed how in every crisis, innovation can be found.
Since the establishment of the health innovation hub in 2019, Germany has certainly been making first steps towards a more digital health care system. However, the Corona pandemic has put German public authorities under unprecedented pressures to innovate. Beginning with GP’s who urged patients to do online consultations in case of a suspected COVID-19 infection, increasing restrictions also led other healthcare professionals such as psychotherapists to offer video consultations and free digital health applications are being offered to patients who want to continue rehabilitation or physical therapy.
Most notable however, is the recent and highly untypical collaboration between Germany’s public health authority, the Robert Koch-Institute and the Berlin-based digital health startup Thryve. Launched with the support of the health innovation hub (hih) and built on research conducted by Eric Topol’s Scripps Research Translational Institute on American influenza waves, the “RKI Corona Datenspende” app became available to the public last week and has already shown large signs of success.
Besides using innovative technologies, one of the things that makes this approach remarkable in the German health care context, is its bottom up approach. With the slogan “Hände waschen, Abstand halten, Daten spenden” (Wash your hands, keep your distance and donate your data), the app relies on donated data from individuals that is gathered through wearables like smart-watches and wristbands. By measuring vital signs like pulse, sleep and levels of activity, it helps detect signs of a COVID-19-like infection, which, combined with basic sociodemographic data and users’ postal code can help model the prevalence of the COVID-19 and offer a real-time sample of the population.
The “RKI Corona Datenspende” app also poses a breakthrough in terms of both its unusually fast execution as well as scope. Launched in a span of only two weeks (that’s lightning speed for a field that usually takes months to launch any new product!), the app counts over 300 000 active users to date, making it the largest health care data scale any federal Government has succeeded in gathering thus far. And this is certainly significant in terms of its use. For the large numbers are what allows for heat maps to be created, and delays in infection registering related to the reporting chain to be overcome.
Of course, as for any digital project in Germany, apps like “RKI Corona Datenspende” also raise discussions about data protection and infrastructure. Germany’s Informatics Society criticized the fact that the app was not open source while Germany’s Federal Commissioner for Data Protection and Freedom of Information considered the term “data donation” to be misleading. However, it’s worth noting that users of wearables in Germany opt into this app on their own accord, and remain pseudonymous throughout the process and decide to stop sharing data at any point. Nevertheless, as numbers show, the immense support shown from the usually more sceptical German public has not only exceeded our expectations but shown that a voluntary and data-minimising approach can work, even in a place like Germany, where integrating technology into healthcare has proven difficult in the past.
As much as COVID-19 has plunged Germany into a crisis, it has also arguably opened up the German healthcare system to the gates to many new digital services, as laid out in this overview by hih’s Managing Director, Dr. Henrik Matthies. Of course, Germany still has a lot of work ahead in digitizing its healthcare system, and solutions like establishing a personal electronic health records, e-prescriptions and a national health data research infrastructure that remains yet to be implemented. However, the fact that within only weeks a German federal authority joined forces with a startup to launch the largest crowd-based research project is a noteworthy achievement the health innovation hub is proud to have been part of. It marks a significant step towards more bold digital innovations in healthcare in Germany.
Julia Hagen is Director Regulatory and Politics at the health innovation hub (hih) of the German Federal Ministry of Health. As a neutral platform, the hih fosters the dialogue of all relevant stakeholders and bundles innovative forces in the healthcare sector – for the benefit of the patients. The task of the health innovation hub is to further explore the possibilities of digitization and to develop ideas and concepts for the design of care and for the digital transformation.
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