Giebel G D, Abels C, Börchers K, Kampka B, Neusser S, Cissarek H R, Plescher F, Wasem J, Blase N
Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany.
QM BÖRCHERS CONSULTING+, Herne, Germany.
Front Health Serv. 2024 Mar 13;4:1372522. doi: 10.3389/frhs.2024.1372522. eCollection 2024.
Since 2019 people who have insured in the German statutory health insurance are entitled to use certified apps called the Digitale Gesundheitsanwendungen [Digital Health Applications (DiGAs)]. The prerequisite for this is that an app certified as DiGA and suitable for their diagnosis exists. The DiGA can then either be prescribed by a physician or psychotherapist or requested by the patient from the statutory health insurance fund. Given the novelty of this type of healthcare, the implementation of a DiGA should be closely monitored to identify potential weaknesses and achieve quality improvements. To enable an analysis of the supply of DiGAs step-by-step, we aimed to create the DiGA-Care Path.
We conducted three steps to create the DiGA-Care Path. First, a knowledge base was created based on a structured literature research matched with knowledge gathered from the superordinate research project "QuaSiApps" funded by the German Federal Joint Committee. Second, we aimed to create an "ideal-typical" DiGA-Care Path using a flowchart. Third, based on the first path, a final path was developed using the graphical modeling language "Event-Driven Process Chain."
The DiGA-Care Path was developed to depict the supply of DiGAs in Germany. The final path is constituted by a "main path" as well as a corresponding "sub-path". While the "main path" focuses more on the supply environment in which a DiGA is used, the "sub-path" depicts the supply delivered by the DiGA itself. Besides the process itself, the paths include relevant actors to indicate responsibilities for individual process steps.
The DiGA-Care Path helps to analyze the current supply of DiGAs step-by-step. Thereby, each step can be investigated in detail to identify problems and to detect further steps where quality improvements can be enabled. Depending on the perspective, focused either on the supply environment, or the supply delivered by the DiGA itself, the "main path" or the "sub-path" can be used, respectively. Besides the potential of the DiGA-Care Path to improve the current supply of DiGAs, it can help as an orientation for international policymakers or further stakeholders either to develop their own integration of apps into healthcare systems or for international manufacturers to consider entering the German market.
自2019年起，在德国法定医疗保险机构参保的人员有权使用名为“Digitale Gesundheitsanwendungen”（数字健康应用程序，简称DiGAs）的认证应用程序。前提是存在一款被认证为DiGA且适用于其诊断的应用程序。然后，DiGA既可以由医生或心理治疗师开具处方，也可以由患者向法定医疗保险基金申请。鉴于这类医疗保健方式的新颖性，应密切监测DiGA的实施情况，以识别潜在弱点并实现质量改进。为了能够逐步分析DiGA的供应情况，我们旨在创建DiGA护理路径。
我们分三步创建DiGA护理路径。首先，基于结构化文献研究并结合从德国联邦联合委员会资助的上级研究项目“QuaSiApps”收集的知识创建了一个知识库。其次，我们旨在使用流程图创建一条“理想典型”的DiGA护理路径。第三，基于第一条路径，使用图形建模语言“事件驱动过程链”开发了最终路径。
开发DiGA护理路径是为了描述德国DiGA的供应情况。最终路径由一条“主路径”以及相应的“子路径”组成。“主路径”更多地关注使用DiGA的供应环境，而“子路径”则描述DiGA本身提供的供应。除了流程本身，路径还包括相关行为主体，以表明各个流程步骤的责任。
DiGA护理路径有助于逐步分析DiGA的当前供应情况。由此，可以详细调查每个步骤，以识别问题并发现可以实现质量改进的进一步步骤。根据关注的视角，即要么关注供应环境，要么关注DiGA本身提供的供应，可以分别使用“主路径”或“子路径”。除了DiGA护理路径改善DiGA当前供应情况的潜力外，它还可以作为国际政策制定者或其他利益相关者的指导，要么帮助他们将应用程序融入自己的医疗保健系统，要么帮助国际制造商考虑进入德国市场。
