Shaping the healthcare system of the future

Monika Rimmele, MPP 2011, examines how technology affects provision of care, patients, laws and business.

In the not-too-distant future, people will actively be involved in and manage their healthcare every step of the way. Already in some digitally advanced healthcare systems, patients are notified on their mobile phones whenever a doctor or hospital administrator accesses their healthcare records. In some countries like Estonia, health records are already secured through “blockchain” technology, a kind of digital ledger that keeps a secure and transparent protocol of records managed by the patient. Digitalisation of healthcare not only makes healthcare systems and provision of care more transparent, it also prevents fraud that drives up costs in healthcare systems. But mainly it protects and empowers patients, says Hertie School Master of Public Policy graduate Monika Rimmele, who works in government affairs for Siemens Healthineers.

“If you look at digitalisation in healthcare, we have several governance issues. One that is particularly sensitive in Germany is data protection and privacy,” Monika says. “But there are several technologies  that also make healthcare safer – for example, if you can know who saw your documents, at what time and in which hospital.”

Monika’s job is to look at such state-of-the-art developments and help determine what they will mean for healthcare in general, for patients, for lawmakers and, of course, for the technology company Siemens Healthineers.

“My job in government affairs is to provide advice on current and developing legislation, both for the company and legislators,” says Rimmele. “Politicians want to enact laws they believe are right and that also protect the patient, but these can sometimes have consequences they have not considered.”

Monika knows both sides of the story. Between her first and second years at the Hertie School, she participated in the Professional Year programme, working in the German Ministry of Health. There, she got to observe first-hand how healthcare legislation works and was able to start building a network of contacts in the private and public healthcare sector. “I think my experience at the Hertie School gave me a solid understanding of what matters to states, what governments provide for their citizens and how it influences the policies they make,” she says.

In her current job, she spends a lot of time talking to members of parliament or contacts in ministries about new technologies, what’s being done in other countries and what Germany can learn from their experiences. She is also involved in fostering research and development projects, which Siemens Healthineers conducts either on its own, with hospitals, or together with government ministries, especially for widespread healthcare challenges like diabetes, cardiac diseases or cancer. One major issue for introducing new technology, such as diagnostic imaging machinery or other treatments, is the question of reimbursement – if the treatment isn’t reimbursed, then doctors tend to not use it. “That’s an important part of our work – ensuring that innovative new technologies that have proven their added medical value get reimbursement so that there is actually a market for them.”

Technology itself is fundamentally changing the healthcare system, Monika says. The era of big data means tailor-made solutions for individual care. One day, 3-D printers may print bespoke medication for each patient, or even body parts, like a knee, joint, or skin. At the same time, digital analytical tools can help manage healthcare for entire populations, pinpointing where and when diseases will occur, and subsequently bringing the analysis back to the level of the individual.  As a result, preventative care as well as precision care will take on greater importance in the future, Monika says. “Digitalisation will change healthcare systems profoundly. One shift will be from the current emphasis on treatment to a greater focus on prevention,” she points out. “For that to work, doctors need to earn more for preventative care. We need to talk to politicians about the changes digitalisation of healthcare will require in the current system, make them understand and then come up with ideas for the healthcare system of the future.”