A survey conducted by McKinsey suggests that 55 to 58 percent of European physicians believe that telemedicine will play a significantly greater role in the future. Governments and insurance companies seem to agree as they create more reimbursement pathways for digital health products and services.

In this article, we’ll take a look at how digital health services are reimbursed in Germany, the second-largest healthcare market in the world with a 374 bn Euro annual bill.

Why digital physiotherapy is important

Remote healthcare hit the headlines in 2020, when the COVID-19 pandemic forced the healthcare sector to provide remote services whenever possible. While physiotherapists were eventually allowed to provide in-person treatment, many patients still think twice before scheduling an eye-to-eye meeting with their physio – after all, the risk of spreading COVID-19 is never zero, no matter what precautions people are taking.

And it looks like remote healthcare is here to stay. While not every type of medical care can be provided remotely, physiotherapy is one of those fields where digital health solutions have enormous potential. According to a systematic review, telerehabilitation can be as effective as face-to-face treatments.

Digital physiotherapy is an excellent option for people who live in rural areas and have no desire to commute to a physiotherapist’s office. It’s also well-suited for exceptionally busy people such as new parents and patients with limited mobility who have difficulties coming to visit their physio.

Germany is one of the first European countries that recognized the importance of telehealth solutions and created a legal framework for them. According to Roland Berger, Germany’s market for digital health solutions will reach a whopping 54 billion euros by 2025.

German hospitals get funding to boost digitalisation

The current German government takes digitalisation very seriously. In September 2020, it started a massive investment program for hospitals aimed at improving data security and introducing digital solutions. Hospitals can use the funds to implement electronic medical documentation systems, telehealth solutions, IT security measures and other digital innovations. The federal budget provided 3 billion euros for these projects and local governments added another 1,3 billion. 

To apply for these funds, hospitals have to submit an application to the government of the respective federated state until the end of 2021. In the application form, all they need to do is describe their project and estimate its cost. Reviewing the application takes up to three months.

But the government is doing more than just giving money. Germany’s Digital Healthcare Act (Digitale-Versorgungs-Gesetz, DVG) is an ambitious law that was passed in 2019 and is still being implemented.

Electronic form of health insurance in digital tablet

The main concepts of Germany’s Digital Healthcare Act (DVG)

The DVG introduces several major changes that have the potential to transform Germany’s healthcare system and boost its efficiency, especially in the light of COVID-19 and possible future pandemics.

First and foremost: healthcare providers (except midwives and physiotherapists) must join a mandatory digital network called the Telematics Infrastructure. The TI lets healthcare providers store and exchange sensitive medical information in a highly secure way.

For physiotherapists, voluntary participation in the TI begins in July 2021. However, it costs quite a bit: we can expect one-time costs of around €2500, as well as around €280 to be paid every three months. Fortunately, these costs will be reimbursed. The exact details will be known by the end of March 2021.

Second: telehealth consultations are becoming the new norm in all areas of healthcare, including physiotherapy.

Third: every person with public health insurance (that’s 72 million people) must have an electronic health record by January 2021. Prescriptions, sick leave notices for employers and other kinds of medical documentation will be issued electronically so doctors can finally say goodbye to time-consuming paperwork.

Last but not least: doctors and physiotherapists will be able to prescribe apps to their patients. They will be reimbursed by all public health insurance providers – we’ll talk about it in more detail right now.

Reimbursement of digital healthcare apps

The ability to prescribe digital healthcare apps is one of the most interesting legal innovations brought about by the DVG. However, even though app stores are brimming with all kinds of health apps, doctors can only prescribe apps that have been approved by the government.

For an app to be officially approved and reimbursed by Germany’s statutory health insurance providers, it needs to fulfil numerous requirements regarding data protection and information security. The app must also be CE-certified as a medical device in one of the EU’s two lowest-risk classes (I or IIa), and its developers must have plans for clinical research that would prove its efficiency.

Developers of apps that match these criteria can apply for the so-called Fast-Track Process, a review conducted by the Federal Institute for Drugs and Medical Devices. When the app is approved, it is added to a publicly available registry of reimbursed apps. The app’s creators then have 12 months to conduct the clinical research they’ve planned before and obtain definitive proof that their product improves patients’ health. Otherwise, the app will get taken off the list. 

This is only one of the many possible reimbursement pathways for digital health solutions.

pathways for digital health solutions in germany

Given the growing need for digital healthcare, we can expect even more reimbursement opportunities for digital health solutions in the near future – so it’s time to jump on the bandwagon and start implementing them in your facility. Even if an app you like isn’t being reimbursed yet, you can still use it. After all, many patients are willing to pay for your services if they need urgent advice and believe in your treatment approach.