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March 14, 2019

DMEA Dossier on Digitalisation of Nursing

Digitalised nursing: less bureaucracy, more time with the patients

The importance of nursing in healthcare is increasing all the time, due in no small part to demographic changes, with an ageing population. At the same time staff shortages and limited resources are evident in nursing more than anywhere, and this applies equally to outpatients, long term care and hospitals. A systematic and needs-based digitalisation of nursing documentation and nursing processes will not eliminate this nursing crisis but it can ease the pressure on nursing staff and eventually help to ensure that there is sufficient time to provide patients with actual nursing care. The digitalisation of nursing is one of the main topics at DMEA 2019.

The shortage of nursing staff is one of the dominant topics in medicine. The federal minister of health Jens Spahn has made it his task to improve working conditions in nursing. The law to incentivise nursing staff (PpSG) was one of the first major pieces of legislation to be successfully introduced by the minister in the lower house, the Bundestag. Different approaches are currently being discussed and encouraged with the aim of resolving the most pressing problems affecting the nursing sector and hospital nursing. In this respect one of the main headings is that of the lower limit on the number of staff as laid down in the PpSG. The recruitment of nursing staff from abroad is also being discussed.

The crisis in nursing: The potential offered by IT solutions as a way of easing the pressure

In contrast, too little attention is still being given to the systematic use of digitalisation as a means of supporting nursing staff and easing the pressure on them, both in hospitals and in in-patient care facilities and out-patient nursing services. “Replacing paper-based processes by means of a systematic digital representation of nursing services can substantially ease the burdens on nursing staff in all working contexts”, is the view of Sebastian Zilch, chief executive of the German Association of Healthcare IT Vendors – bvitg e. V. 

“The outlay on this transition is significantly lower that the costs of recruiting specialist staff from abroad or for retraining staff from other areas. “However, the digitalisation of nursing processes is not necessarily a guarantee of success. It has to be well planned, carefully implemented and sustainably financed. The statutory conditions have to be created is such a way as to enable nursing-related, paper-based processes to be entirely dispensed with. Furthermore there should be suitable financing arrangements for nursing services that would make it attractive for facilities to set up digital processes. And when digitalisation is taking place in the healthcare sector more attention should be given to nursing staff as independent participants. So far the users of the German telematics infrastructure have consisted solely of physicians and pharmacists. Nursing staff (and other health professions) have not been included.

Avoiding obstacles, developing digitalisation skills

These and other demands were stated by the bvitg in the summer of 2018 in a position paper on digitalisation in nursing. This topic is not only concerned with the political conditions but also with the implementation of digital processes at the level of the individual establishments: “The most important factor in determining the success of digitalisation projects for the nursing sector is the involvement of the nursing staff in all stages of the project, from selecting the products to their implementation”, according to Heiko Mania, who heads the working group for “Digitalisation in Nursing”  that was set up by the bvitg a year ago.

What actual form this will take will be one of the topics of the seminar “Digitalisation in Nursing – Best-Practice knowledge for Successful Projects” which Mania is chairing at the DMEA. In addition to the insufficient involvement of nursing personnel, Mania believes that the biggest stumbling block in digitalisation projects for nursing lies in the less than adequate digital implementation of the nursing process: “In this respect there are often very differing expectations at the start of the project. If, during the advance phase, a shared horizon of expectations cannot be created, there will almost inevitably be disappointment.

It is also important to ensure that the IT skills required for the training for the nursing professions are communicated effectively. Familiarising nursing staff with the necessary skills and relieving them of any concerns they may have are therefore important components of any IT project for nursing, according to Mania. Nursing documentation directly at the point of care will be more readily accepted by nursing staff than working with IT systems at a fixed location some distance away from the patient.

PpSG and the consequences: digital nursing documentation is now indispensable

In general a vastly increased willingness to accept digitalisation in the nursing processes in medical and nursing establishments in the healthcare sector is very much in evidence. At the present time in more than seven out of ten establishments in Germany nursing staff still use pens and paper for documentation purposes. But that cannot be sustained mush longer because of the continuing increase in the volume of nursing documentation in the coming years.

The most important reason for this are the political initiatives for improving care, the most significant of which is the PpSG. Among the aspects covered by this legislation is the complete reorganisation of the financing of nursing care in hospitals. “At the present time it is not entirely clear how this new development will be implemented, but we can be sure that, in the future, nursing services will be presented and recorded differently”, Mania stated. The regulation of minimum staff levels came into force in early 2019 and, hospitals in particular are now required to provide greater clarity about their services, with improved documentation, to enable care ratios to be calculated and to deploy limited staff resources at the right places. This can no longer be done using pencils and paper.

Incentives for digitalising out-patient and long term care

Another provision of the PpSG could also give a boost to digitalisation in the sectors of out-patient and long term care: Nursing services and care homes that invest in digitalisation can take advantage of start-up funding of up to 12,000 euros, provided that they are also prepared to make their own investment. “This provides a good basis for encouraging important digitalisation projects. We can expect nursing facilities and services to make extensive use of this assistance”, said Mania.

However, the bvitg sees such start-up financing as just the first step. “We are calling for increased, long term and comprehensive financing for digitalisation measures in the care of the elderly. One-off, partial financing will not lead to a lasting easing of pressure”, warned bvitg chief executive Sebastian Zilch. The association is also calling for a commitment to convert to electronic processes in the care of the elderly, as well as provisions that, as is the case with electronic patient records, ensure that the industry and standardisation bodies are included when interfaces and terminology for digital care are being defined.

Outline details of timing of events

First DMEA Day (9 April 2019):

• Congress session: Digital Transformation in Nursing – What is the Added Value? (Time: 9.30  – 11 a.m. | venue: _Stage C, Hall 4.2)

• Congress session: Nursing in the Intersectoral and Interprofessional Care Process (time: 11.30 a.m. - 1 p.m.| venue: _Stage C, Hall 4.2)

• Seminar: Digitalisation in Nursing – Best Practice Knowledge for Successful Projects (time: 1.30 – 5.15 p.m. | _Lovelace Room, Hall 1.2)

• Talk: Automation Technologies and Assistance Systems in Nursing (time: 2.30 – 3.30 p.m.; _Hub 2, Hall 2.2)

•  Talk: Health & Care 4.0. Intelligent Assistance Systems in the Healthcare Market of the Future (time: 3.45 – 4.45 p.m.| venue: _Hub 1, Hall 2.2)

Second DMEA Day (10 April 2019):

•  Workshop: Electronic Patient Records – Expectations for Physicians, Nursing Staff and Patients (time: 11.30 a.m. – 1 p.m.| venue: _Box, Hall 1.2)

•  Congress session: Is Progress Being Made? Telemedicine and Homecare in Germany (time: 11.30 a.m. - 1 p.m.| venue: _Stage B, Hall 2.2)

•  Excursion: Excursion to an in-patient care facility (time: 11.30 a-m – 2.30 p.m., venue: South Entrance

•  Talk: From 0 to 100: IT in Nursing Practice (time: 1.15 – 2.15 p.m.| venue: _Stage B, Hall 2.2)

•  Talk: Digital Health: Success with User Orientation and Participation (Time: 5 - 6 p.m.| venue: _Hub 4, Hall 4.2)

•  Guided tour of the fair: Tour 22: IT in In-patient Care (5 – 6 p.m. Central foyer, Hall 3.2 | 4.2)

Third DMEA Day (11 April 2019):

• Seminar: IT in Intensive Medicine and Anaesthetics (time: 9.30 a.m. – 1.15 p.m, | venue: _Lovelace Room, Hall 1.2)

• Guided tour of the fair: Digital Patient Empowerment (time: 2.30 - 3.30 p.m.| venue: Centre Foyer, Hall 3.2 | 4.2)

About DMEA

DMEA represents a strategic evolution of that concept. It aims to mirror the entire digital supply chain including every process along the way. Step by step DMEA will expand into a platform representing every digital field of interest to all players in the healthcare system, both now and in the future. DMEA targets decision-makers in every healthcare sector – hospital managers, IT heads, doctors, nurses, healthcare policymakers and experts in science and research. As an integrated event combining a trade fair, congress, academy and a wide range of interactive formats, it gives participants the opportunity to find out about the latest digital healthcare developments and products, establish industry contacts and acquire high-level qualifications.

DMEA is held by the German Association of Healthcare IT Vendors (bvitg) and organised by Messe Berlin. DMEA is organised in cooperation with the following industry associations: the German Association of Healthcare IT Vendors (bvitg), the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), the German Medical Informatics Professional Association (BVMI). The National Association of Hospital IT Managers (KH-IT) and the Chief Information Officers of University Hospitals (CIO-UK) provide contributions on the subject matter. The three-day event takes place annually on the Berlin Exhibition Grounds.

More information on products, topics, events and industry trends can be found by visiting the health IT homepage of bvitg Service GmbH, a subsidiary of the German Association of Healthcare IT Vendors (bvitg).