Karl Lauterbach views health data as central to AI innovations and is attracting interest from tech giants such as Google, Meta, and OpenAI. He described the electronic health record as a source with significant challenges at the beginning, but its late adoption is opening up new technological opportunities. He expressed these views during his keynote speech at Bitkom's Digital Health Conference.
"The digitalization of the German healthcare system has been slow over the past 20 years. With the introduction of the electronic patient record on January 15 for 70 million insured persons, significant progress is now being made. It forms the heart of digitalization in the healthcare system and will dramatically improve patient care," promised the Federal Minister of Health.
Currently, X-rays and doctor's letters are often still transported physically, which can lead to incomplete information and impair the efficiency of doctor-patient consultations, which typically last only four to six minutes. According to Lauterbach, patients often have difficulty understanding and summarizing medical findings, which can lead to misdiagnoses.
Germany has the most expensive healthcare system in Europe, but according to Lauterbach, there are significant quality deficits. "For the first time, we have a life expectancy that is below the EU average," he noted critically.
Karl Lauterbach aims to address these deficits through comprehensive reforms in digitalization, hospital care, and medical research. He emphasized the importance of the electronic patient record and the Research Data Center for Health (FDZ Gesundheit) at the Federal Institute for Drugs and Therapy Safety as key elements for future developments in the healthcare system.
Lauterbach on the valuable data treasure of the electronic patient record
Karl Lauterbach emphasized the enormous importance of the electronic patient record (ePA), which will serve as the central repository of health data in the future. This record will routinely integrate laboratory findings, imaging data, hospital data, medication data, nursing information, and digital health applications. Lauterbach emphasized: "If you just consider the sheer size of this treasure trove of data – we have a billion doctor-patient contacts in our practices every year."
Thanks to the ePA and the option to opt out of data collection, this treasure trove of data is continuously growing. It is particularly important that the data treasure of the Research Data Center for Health (FDZ Gesundheit) is increasingly being expanded to include additional data from more than 400 medical registries as well as genomic data.
The health insurance billing data is already stored in the FDZ Gesundheit (Health Data Center), and in the future, all data will be linked via a pseudonymized health insurance number. This comprehensive database is intended not only to facilitate individual treatment decisions but also to support clinical studies, epidemiological evaluations, and improved health policy. According to Lauterbach, artificial intelligence (AI) will be used to efficiently utilize this dataset. The dataset was structured from the outset to be "AI-ready." Lauterbach sought advice from Israel to ensure optimal compatibility between data protection and data usage.
The research data center enables secure access to data through "confidential computing" without the data leaving the protected space. Researchers can evaluate the data using AI methods, with access granted only for the specific research purpose. According to Lauterbach, it is crucial that the dataset never escapes this secure environment.
With the introduction of the ePA and the FDZ Health starting in 2025, health data from birth to old age will be collected – representative of the entire population. Lauterbach described the ePA as the largest digital project in German history and a groundbreaking innovation. The goal is to create the "largest," "most representative," and "most interesting" health data set worldwide.
Lauterbach on the global interest in health data and the role of artificial intelligence
Karl Lauterbach reported on the growing interest of leading tech companies in the health data collected by the electronic patient record (ePA) and the Research Data Center for Health (FDZ Gesundheit). According to Lauterbach, Meta, OpenAI, and Google are already in discussions to train and develop their AI models with this data. He assured that German solutions are also being supported, but international interest in this data is enormous.
Another topic Lauterbach emphasized is the use of AI for early disease diagnosis. In the future, very early stages of cancer could be detected through fingerprints reflected in the protein structure of blood. Lauterbach sees great potential for AI to ease the burden on the healthcare system, particularly in the area of second opinions. This could also lead to less invasive treatments such as full-blown chemotherapy being necessary, and more targeted therapies being used.
Lauterbach also has high hopes for innovative treatments such as gene therapy and CAR T-cell therapy. He cited AlphaFold and EvolutionaryScales ESM3 as further positive examples. Lauterbach predicts that 15 million baby boomers will retire from the workforce in the coming years and increasingly become patients. This presents a challenge, but also offers an opportunity to develop improved and more efficient medicine.
In conclusion, Lauterbach emphasized that medicine as an economic sector continues to offer growth opportunities despite economic stagnation in other areas. Sectors such as medicine, digitalization, medical technology, and pharmaceuticals continue to experience positive growth.
TK boss praises Lauterbach's reforms, but also criticizes digitalization
Jens Baas, head of Techniker Krankenkasse, praised Karl Lauterbach for the progress he made with his reforms, particularly the introduction of e-prescriptions, which Baas said was largely successful – apart from a few "minor hiccups." Despite this positive assessment, Baas emphasized that Lauterbach had made many important advances, but that it was crucial to continue to keep an eye on costs.
However, Baas expressed criticism regarding digitalization. He argued that a "fundamentally different approach or mindset" is needed to effectively address the challenges in this area.
Discussion about the visibility of billing data and criticism of the pace of digitalization
Jens Baas, head of the Techniker Krankenkasse (health insurance company), expressed criticism during a discussion with the government regarding the planned automatic filling of the electronic patient record (ePA) with billing data. This data is to be visible to every treating physician in the future. Baas pointed out that there were concerns that sensitive information such as an HIV diagnosis could be displayed in the record, which sparked discussions. He criticized the fact that such considerations could suddenly lead to doctors no longer being able to access all necessary data. Baas called this a "stupid idea" and warned that such discussions would not advance digitalization. He argued that Germany lacks a clear mindset that would involve everyone, including skeptics.
In a recent Bitkom survey, 7 out of 10 respondents stated that digitalization in the healthcare sector is progressing too slowly. However, 83 percent of respondents feel that doctors are generally open to digitalization. Furthermore, 77 percent see Germany lagging behind internationally.
Despite this criticism, Dr. Bernhard Rohleder, CEO of Bitkom, praised the progress made under Lauterbach's leadership. He emphasized that, with the Digital Act and the Health Data Use Act, two important projects were implemented during the shortened legislative period, overcoming years of stagnation in the healthcare system. Rohleder sees digitalization as the key to keeping the healthcare system efficient and affordable in the future.
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