Kendziorra Jennifer, Seerig Kirsten H, Winkler Till J, Gewald Heiko
Chair of Information Management, University of Hagen, Hagen, Germany.
Institute for Digital Innovation (IDI), Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany.
BMC Health Serv Res. 2025 Apr 18;25(1):568. doi: 10.1186/s12913-025-12656-2.
The integration of digital therapeutics (DTx) into the German statutory healthcare system marks a significant shift in medical practice through the introduction of innovative, reimbursable digital interventions for patient care. While DTx can bridge therapy gaps and enhance patient care, the number of prescriptions is increasing slowly. This study aims to explore the challenges physicians face when integrating DTx into their treatment options and the changes this integration entails for their medical workflows.
A qualitative approach was adopted, gathering data from semi-structured interviews with 46 physicians across Germany. Participants, sampled for diversity in specialty, experience, and region, were interviewed between June 2022 and August 2024. The interviews explored physicians' knowledge, experiences, and perspectives on DTx. Data were analyzed using qualitative content analysis, combining deductive and inductive coding.
The introduction of DTx into physicians' workflows impacts their practice on multiple levels. First, physicians must become aware of the new regulations and therapeutic possibilities, requiring significant information intake and time to feel adequately prepared for prescribing DTx. Second, DTx add complexity to patient assessment, as physicians must evaluate factors such as digital literacy, motivation, and cognitive conditions, necessitating a deeper understanding of their patients. Third, the integration of DTx reshapes the physician‒patient relationship, as it alters interaction dynamics, redistributes responsibilities, and poses new communication challenges. Fourth, DTx expand therapeutic options, particularly by bridging therapy delays and enabling more personalized care. Finally, the integration of DTx has the potential to drive long-term changes in physicians' workflows and mindsets, fostering alignment with multimodal and patient-centered treatment approaches.
DTx offer opportunities for patient care but also pose challenges, such as the development of digital skills or familiarization with new regulations, that necessitate adjustments in physicians' workflows. Physicians are generally confronted with an innovation that demands time, reliable information on effectiveness, practical experience, and openness to adopting digital health tools as complementary treatment options. However, the reception and integration of DTx into treatment vary among physicians, reflecting individual preferences and approaches. Further research should explore these diverse adoption strategies and examine the long-term effects of DTx on care delivery and patient outcomes.
将数字疗法（DTx）纳入德国法定医疗体系，通过引入创新的、可报销的数字干预措施用于患者护理，标志着医疗实践发生了重大转变。虽然数字疗法可以弥合治疗差距并改善患者护理，但处方数量增长缓慢。本研究旨在探讨医生在将数字疗法纳入其治疗选择时所面临的挑战，以及这种整合对其医疗工作流程带来的变化。
采用定性研究方法，通过对德国46名医生进行半结构化访谈收集数据。参与者在专业、经验和地区方面具有多样性，于2022年6月至2024年8月期间接受访谈。访谈探讨了医生对数字疗法的知识、经验和看法。使用定性内容分析法对数据进行分析，结合演绎编码和归纳编码。
将数字疗法引入医生的工作流程在多个层面影响他们的实践。首先，医生必须了解新法规和治疗可能性，这需要大量信息获取并花费时间才能为开具数字疗法处方做好充分准备。其次，数字疗法增加了患者评估的复杂性，因为医生必须评估数字素养、动机和认知状况等因素，这就需要更深入地了解患者。第三，数字疗法的整合重塑了医患关系，因为它改变了互动动态，重新分配了责任，并带来了新的沟通挑战。第四，数字疗法扩展了治疗选择，特别是通过弥合治疗延迟并实现更个性化的护理。最后，数字疗法的整合有可能推动医生工作流程和思维模式的长期变化，促进与多模式和以患者为中心的治疗方法保持一致。
数字疗法为患者护理提供了机会，但也带来了挑战，如数字技能的培养或熟悉新法规，这需要医生调整工作流程。医生普遍面临一项需要时间、关于有效性的可靠信息、实践经验以及愿意将数字健康工具作为补充治疗选择的创新。然而，医生对数字疗法的接受和整合情况各不相同，反映了个人偏好和方法。进一步的研究应探索这些不同的采用策略，并研究数字疗法对护理提供和患者结局的长期影响。
