No medicine without a patient

In our highly efficient, highly specialized healthcare system, we often forget what it’s really all about at its core: providing high-quality care to patients. With digitization and the KHZG, we now have the chance to redesign processes. And Mina Luetkens, with her Patients4Digital initiative, wants to ensure that patients can take a self-determined and sovereign role in this process.

Ms. Luetkens, it’s a bit of a paradox: On the one hand, the digitization of healthcare is about the patients, who should thus also be the focus of the implementation of the KHZG funding facts. On the other hand, their opinions and wishes have hardly been heard so far. Is that one reason why you founded Patients4Digital?

When you talk to players in the industry, few seem to see it as a paradox. Many people claim to work in a patient-centric way and to focus on the wishes and needs of patients. But if you take a closer look, it quickly becomes clear that the standard answer you get is empty. Often, there is simply no understanding of what it means to actually involve patients. For some, it is enough to have thought about the patient’s perspective and only a few have actually asked directly. Actually, however, you would have to consistently start with the patient and also keep coming back to them if you want to involve them in the treatment processes in a meaningful way. This is precisely why we founded Patients4Digital, as you rightly suggest. 

Yet the equation is quite simple: no patient, no medicine. What do you think is the reason why too little attention is paid to the patient voice?

In principle, it’s a natural process of responsibility becoming independent. Because at a certain point in time, we decided socially that our healthcare system – unlike in the U.S., for example – should be linked to the idea of a welfare state. And with this decision, the state has a responsibility. The difficulty lies in regulation that is able to adapt to the spirit of the times, which can be vividly illustrated by the example of data protection. And even though we call ourselves Patients4Digital, we are not concerned with digitization as an end in itself, but rather with the added value of digital processes for patients and how existing and rigid structures, including regulatory ones, can be reorganized as a result. We can draw parallels here with book printing and its importance for education: Digitization empowers patients, allows them to come of age, and thus – via genuine patient involvement in their own healthcare – offers immense potential for social change.

And the KHZG’s funding criteria are clearly formulated from the patient’s point of view.

Absolutely, for it one must read only the promotion facts two to the patient portals through, which was admittedly broadly seized, but absolutely in the black meets. The formulations of this guideline have been chosen with patients in mind from front to back, as can be seen above all from the overriding goals.

Why does this sound like a big but…?

Because at the end of the day, paper is patient and it is not necessarily clear to most of those responsible in the hospitals what is meant by an overriding improvement in the quality of care. We have had many discussions here and also asked precisely about this. The answers tend to be fragmented and aimed at subordinate aspects such as “appointments are better kept.” Perhaps the workload reduction for the staff is also perceived. However, the great opportunity of a holistic hospital experience is rarely recognized. In the meantime, there are enough results from research that show that a positive overall experience has an enormously positive effect on the patient’s recovery process.

But shouldn’t well-designed patient journeys ensure this?

They should, whereby the decisive aspect is “well thought out”. Patient Journeys are derived from the Customer Journeys of Design Thinking. Many of the Patient Journeys do not deserve their name. With my background as a physicist and with some experience in engineering, they rather remind me of a bad manufacturing process. Patients are the core work piece that gets pushed through the “manufacturing process” on a whim. Then there are ancillary processes where a part is already “pre-produced” and then “flanged”. I’m talking here about laboratory tests or imaging diagnostics that are in no way timed with the processes of the ward rounds. In other words, even the efficiency of the core process of every clinic, namely the treatment of patients, suffers from the lack of a holistic process orientation. Orientation to treatment paths would automatically result in a patient-oriented outcome.

And where do you think this inefficiency comes up again?

This inefficiency is unloaded onto the patients: As long as a patient is in the clinic, he has to function obediently. That’s why it’s annoying if he or she doesn’t want something or questions something. And that is the absurdity: Every real customer journey has several points at which the customer makes a decision, which is the exciting thing for the creators of such a journey. The question behind this is how to ensure that the customer decides in favor of A and not B at precisely this point. What factors can be changed in the product so that the customer decides in favor of A? Patient journeys are still a long way from this, but they absolutely have to get there if they are to offer real added value. Until then, we should talk about treatment paths, if at all, and not about journeys – because a hospital stay is not a “journey.

What do you think it will take for the KHZG to be successful with its funding provisions?

The KHZG is certainly only the beginning. But if we come back to the patient portals we’ve already talked about, for example, I think they can only be successful if not every hospital does its own thing. Otherwise, there is a great danger that digital offerings will not be noticed or accepted at all. If we want acceptance, the hurdles must be as low as possible. Here, the healthcare sector can learn a lot from other industries, such as banking. I think we need the courage today to create uniform solutions, at least regionally. Because then patients will quickly see the added value for them, for example, when they need knee surgery and can look directly in the portal to see which clinics in the region offer exactly this operation. One portal for all my clinic visits, that makes sense. And then, as a patient, I have the choice of whether the well-rated emphatic doctor or the latest surgical technology is more important to me. At that point, I’m no longer just a patient, but also a customer of the hospital.