ISSN 0041-8811  
E-ISSN 2665-0428  
de la  
del Zulia  
Fundada en 1947  
por el Dr. Jesús Enrique Lossada  
y de la Salud  
Año 14 N° 40  
Mayo - Agosto 2023  
Tercera Época  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
Digital Healthcare in the Context of Challenges and Opportunities of  
Technological Progress in the Countries of the European Union  
Vitalina Nikitenko*  
Valentyna Voronkova**  
Yurii Kozar***  
Roman Oleksenko****  
Oleksandr Yanchevskyi*****  
Igor Korobko******  
The objective of the article is to investigate the theoretical and practical aspects of digital medical  
care in the context of the challenges and opportunities of technological progress, and to outline the  
main guidelines for the development of digital technologies in the field of Medicine. The  
methodology consists in the use of a systematic method, which offers the achievement of sustainable  
development of digital technologies of medical institutions; the proposal is based on the adaptability  
and flexibility of the management structures of medical institutions, capable of using the available  
data and digital technologies to provide assistance to the population; a synergistic method based on  
self-organization and the search for the bases of self-organization, which can help medical  
institutions to overcome the crisis and instability. The study shows that the digital change is  
increasingly visible in Medicine. Thanks to digital technologies and tools in Medicine, particularly  
through eHealth technologies, prevention, diagnosis, treatment, monitoring and administration have  
been improved. The problems of digitization are discussed not for themselves, but for the  
improvement of medical care, digital health in the context of the challenges and opportunities of  
technological progress, the formation of a new concept of digital technologies in the field of health.  
KEY WORDS: Digital technologies, medical field, digital healthcare, artificial intelligence, data  
management, innovations.  
Zaporizhzhia National University, Zaporizhzhia, Ukraine. ORCID iD:  
7836. E-mail:  
*** Lugansk State Medical University, Ukraine. ORCID ID: E-mail:  
*** Dmytro Motornyi Tavria State Agrotechnological University, Zaporizhzhia, Ukraine. ORCID ID:  
***** Lugansk State Medical University, Ukraine. ORCID ID: E-  
Recibido: 08/02/2023  
Aceptado: 11/04/2023  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
La salud digital en el contexto de los retos y oportunidades del progreso  
tecnológico en los países de la Unión Europea  
El objetivo del artículo es investigar los aspectos teóricos y prácticos de la atención médica  
digital en el contexto de los desafíos y oportunidades del progreso tecnológico, y esbozar los  
principales lineamientos de desarrollo de las tecnologías digitales en el campo de la Medicina.  
La metodología consiste en el uso de un método sistemático, que ofrece el logro del desarrollo  
sostenible de las tecnologías digitales de las instituciones médicas; la propuesta se basa en la  
adaptabilidad y flexibilidad de las estructuras de gestión de las instituciones médicas, capaz  
de utilizar los datos disponibles y las tecnologías digitales para brindar asistencia a la  
población; un método sinérgico fundamentado en la autoorganización y la búsqueda de las  
bases de la autoorganización, que puedan ayudar a las instituciones médicas a superar la  
crisis y la inestabilidad. El estudio demuestra que el cambio digital es cada vez más visible en  
la Medicina. Gracias a las tecnologías y herramientas digitales en Medicina, en particular a  
través de las tecnologías eHealth, se ha mejorado la prevención, el diagnóstico, el tratamiento,  
el seguimiento y la administración. Los problemas de la digitalización se analizan no por sí  
mismos, sino por la mejora de la atención médica, la salud digital en el contexto de los desafíos  
y oportunidades del progreso tecnológico, la formación de un nuevo concepto de tecnologías  
digitales en el campo de la salud.  
PALABRAS CLAVE: Tecnologías digitales, campo de la Medicina, sanidad digital,  
inteligencia artificial, gestión de datos, innovaciones.  
Digital health, including artificial intelligence, health data management, the growing  
use of telemedicine and much more, is an important and relevant topic for Member States of  
the WHO European Region in the field of digital skills of health personnel. Therefore, the  
main task is to develop a health workforce capable of using digital technologies. The COVID-  
9 pandemic has highlighted the importance of developing a health workforce that is able to  
adapt to a rapidly changing environment and use available data and digital technologies to  
provide care to the population. However, while the need for standardised approaches to  
developing the digital skills of health professionals in the European Region has long been  
recognised, best practices in this regard have not yet been established. Assistance to  
countries in using digital technologies to improve health service delivery is needed. The  
WHO/Europe Data and Digital Health Programme coordinates a leading initiative on digital  
health. It provides technical advice, guidance and expertise on the safety and effectiveness of  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
digital health solutions, while upholding equity, gender equality and human rights as  
fundamental human values. The program's activities support countries in using digital  
technologies to improve the interaction between people and health services, which aims to  
improve the performance of health systems, contribute to strengthening the basic functions  
of public health, such as disease monitoring, early warning and risk assessment, develop the  
skills of health workers in the field of digital technologies in terms of policy, research,  
education and clinical practice. The main challenge is to integrate digital skills into current  
health workforce training practices (initial and continuing) to prepare them to use digital  
health technologies today in their roles as well as in the digital future of health and care.  
New technologies are finding their way and starting to change the hospital in the long  
term. Starting with the automation of previously analogue processes to "true digitisation" and  
the use of artificial intelligence, we are now experiencing numerous innovations. The  
hospital is becoming more and more networked, both internally and externally. A good  
example of this is the transfer of ECG data from ambulances to emergency departments,  
digital platforms for discharge management or, for example, networked communication with  
laboratory suppliers. The arrival of robotics will be particularly prominent. Whether it is an  
autonomous medical trolley or a humanoid robot: healthcare professionals are getting new  
tools for everyday life. It is important to take patients and employees with them. For example,  
a well-designed digitalisation strategy can help to identify and act on challenges. We should  
not forget one thing: digitisation is not an end in itself; instead, we want to make our  
processes and structures more efficient with digital technologies, data and solutions and  
create added value for the people we work for".  
Many questions are raised: What technologies are currently being used and how do  
big health data sets help in diagnosis? What brings real help to patients? What are the  
chances to assess the state of human health? How much data is protected? The new digital  
strategy of the United Nations Development Programme (UNDP), a United Nations agency  
established by the General Assembly resolution of 22 November 1965 through the  
consolidation of the United Nations Expanded Programme of Technical Assistance and the  
Special Fund, supports efforts to help countries to build inclusive, ethical and sustainable  
digital societies. UNDP also recognizes that digitalization will continue to change the way  
the organization responds to the monumental challenges our world now faces. This includes  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
harnessing its power to combat climate change and restore the natural world. It will also  
complement the United Nations' many global efforts to increase the digital capacity of  
vulnerable and marginalized groups, including women and people with disabilities. In many  
ways, this strategy will make the organization ready for current and future technological  
change, including finding ways to enhance the digital experience of our staff. This digital  
strategy demonstrates that UNDP is refusing to stand still and, guided by the Sustainable  
Development Goals, continues to provide cutting-edge development assistance at a critical  
time for people and planet.  
According to the study, there are five innovations in particular that will shape the  
future of healthcare: 1) Artificial Intelligence (AI): examines digital health data and can  
recognize patterns with a high level of accuracy. This technology can provide valuable  
services in diagnosis and decision making and we see great potential in applications that  
support doctors in their work rather than replace them. Artificial intelligence can help, for  
example, to adapt treatment pathways to the current state of science and individual patient  
symptoms. In addition, there are areas of indications such as dermatology or ophthalmology  
where AI can support the doctor in making a diagnosis." 2) Big data: provides an opportunity  
to determine the risk of disease earlier and personalize treatment. 3) Telemedicine: allows for  
monitoring, diagnosis and therapy at different geographical distances, facilitating, for  
example, the use of services of well-known specialists and the provision of medical care in  
rural areas. Such digital consultation hours are particularly recommended for introductory  
appointments, check-ups and follow-up examinations. 4) eHealth: This is a collective term  
for all programs that rely on new information and communication technologies to deliver  
health care. 5) Robotics: currently used mainly in the form of assistance systems, but in the  
future it will be increasingly integrated into operating rooms and care. According to Bitkom,  
there is another trend: 6) 3D printing: This is an umbrella term for all manufacturing  
processes in which material is applied layer by layer to create three-dimensional objects. The  
majority of doctors expect that organs such as gastric implants, skin slices or cartilage will  
be created using a 3D printer in the future. More than half also expect that animal  
experiments will be replaced by experiments on 3D printed cell structures. Medicine 4.0 has  
already become a reality in other countries. Many of the developments described here may  
still sound like science fiction, but their breakthrough and widespread use will develop at an  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
astonishing rate in the coming years. After the emergence of modern medicine in the 19th  
century, its mechanization in the early 20th century, the introduction of ITand the increasing  
automation of certain tasks in the 1980s, many countries are now in the fourth stage of the  
development to the so-called medicalization. 4.0 has arrived. They have successfully  
integrated health care with the help of information and communication technologies so that  
important information can be shared between providers. Furthermore, in many places (semi-  
autonomous systems) are taking over more and more tasks in everyday medical life. Of  
course, it would be wrong to categorically reject any progress in the field of digital  
technologies. But it is also wrong to just uncontrollably and uncritically agree to every step  
of modernization. For example, we need medical fields that have been further digitally  
developed, we can support mobility in old age with semi-autonomous driving, but we should  
not give others access to our driving profile. Ultimately, it is about the human image in the  
digital world: about preserving dignity, freedom and self-determination.  
Health requires a good user experience and a high level of security. In eHealth in  
particular, many successful use cases show what is already possible today, from prevention  
and diagnosis to treatment, monitoring and administration. The digitalization of medicine  
makes it easier for patients, saves doctors' time that can be invested in treatment, and  
significantly advances medical research through the analysis of collected data. One of the  
biggest implementation obstacles that the healthcare system in this country has to contend  
with is the numerous siloed solutions that make cross-sectoral networking difficult.  
Digitization also carries risks, as the use of sensitive data makes patients potential victims of  
cybercriminals. There is also concern that the personal connection between doctors and their  
patients may suffer, and as a result older people in particular may become increasingly  
isolated. To address the challenges of secure electronic exchange of patient information, the  
federal government is creating a framework based on the highest security standards: the  
telematics infrastructure. In addition, when choosing an IT service provider, stakeholders in  
the healthcare sector should make sure that they guarantee secure applications and that data  
is stored in certified data centers.  
Regarding the relationship between doctors and patients, it should be emphasized  
that apps and wearable devices should not - or cannot - completely replace visits and  
personal conversations. They serve as supplements that allow for better and more  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
comprehensive treatment. In order to accomplish this task, they must not only simplify and  
speed up processes, but also be easy to use. Ultimately, in healthcare it is no different from  
all other areas of life: to be successful, a digital product must be accepted by users and used  
with pleasure. Numerous studies have shown that an excellent user experience is crucial  
here. Digitalisation offers a wide range of opportunities for social work: digital technologies  
can strengthen the self-determination of those in need of care, facilitate the participation of  
people with disabilities, relieve the workload of care staff and caring relatives and make work  
processes more efficient. Many things are only at the testing stage, and already clear  
simplifications in care can be felt through "mobile data collection" in outpatient services. In  
addition, the Diakonisches Werk Württemberg is working on the social services platform  
live with us", which is an easily accessible offer of advice, mediation and information for the  
elderly and caring relatives. Part of our strategic orientation is to promote the digitization of  
society for the benefit of people. The vulnerable life situation of the people supported by  
Diakonie requires special efforts in the areas of data security, information self-determination  
and training in new technologies. The heart of the Diakonia's social work will continue to be  
the meeting between people. Only specialists can be responsible for the quality of social  
work. Digitalization should create space for human commitment. Aspects of rationalization  
are legal, but decisions on the use of digital technologies should be based on the human need  
of the people in need of support.  
According to the digital association Bitkom, digital technologies such as implantable  
microchips, custom-made medicines and surgical robots will definitively change medicine  
and the healthcare industry over the next ten years. The study surveyed 102 health experts.  
Most respondents believe that digital technologies can bring great benefits to health and  
healthcare. Of those surveyed, 80 percent believe that digital technologies can help defeat  
diseases such as cancer. In addition, almost 70 percent believe that digital technologies  
extend people's life expectancy. Almost as many believe that digital technologies will  
improve medical prevention in case of diseases. The consequence of this will be that we will  
live longer and healthcare costs will decrease. Today, it is already common to measure vital  
signs with a fitness tracker, which motivates people to do sports more and more. In addition,  
many people now check their cardiac output with an app that can even give warnings in case  
of bad values. And there are other possibilities when it comes to digitalization when it comes  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
to healthcare. Thus, one of the main tasks of ethics is to keep in mind the dignity and well-  
being of the human being, as well as the importance of trust, which is fundamental to health,  
i.e. the physical, mental and social well-being of the individual. Formalized data protection,  
for example, is no substitute for trust based on intrinsic values that people's data are handled  
with care and respect. Thus, ethics must also ensure that the "smart" patient is not  
overwhelmed in a jungle of options, decisions and largely anonymous co-determinants. This  
becomes all the more important the more we are talking about sick people whose power is  
limited. The digital revolution also creates values and expectations about the perfection of  
the human body and life. The challenge for ethics is to ensure that the enormous  
opportunities that are opening up do not become a "tower of Babel", but are realized with  
modesty and care. Not everything you can do makes sense from an ethical point of view. Thus,  
ethics helps to prevent the destruction of borders. Therefore, ethics should be increasingly  
introduced in all healthcare training courses. Coaching and other ethical support close to  
people should come to the fore in everyday health care".  
. Objectives  
The object of research is digital health care as a complex social phenomenon and a  
dynamically changing development process.  
. Materials and Methods  
The methodology consists of using: 1) systematic method that offers the achievement  
of sustainable development of medical institutions' digital technologies; 2) Agile  
methodology, based on the adaptability and flexibility of the medical institutions'  
management structures, which are able to use available data and digital technologies to  
provide assistance to the population; 3) synergetic method, based on self-organization and  
the search for self-organizing principles, which can help medical institutions to overcome  
the crisis and instability.  
The study proves that digital changes are becoming more and more noticeable in  
medicine. Thanks to digital technologies and tools in medicine, in particular eHealth  
technologies, prevention, diagnosis, treatment, monitoring and administration have been  
improved. To make sure that the benefits of digital technologies for people are as great as  
possible and the risks are low, it is important to use the digitalization of medicine to better  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
care for patients and gain significant competitive advantages for healthcare institutions and  
organizations. The methodology of the study helps to understand the future medical trends  
such as personalized medicine, telemedicine and diagnostic procedures with the help of IT,  
shows that there are many other medical procedures that can be developed or optimized. The  
study used a statistical method to show 40 percent believe that robotic surgeons could be  
used in everyday life in the future. Digital surgeons are already being used for urological  
interventions to reduce incisions and thus improve wound healing. Almost 50 percent of  
respondents suggest that therapeutic systems consisting of medicines and digital products  
such as apps will help patients take them in the future. And the same number expect that the  
production of prostheses and implants on a 3D printer will become commonplace. Also in  
ten years, implanted microchips for taking medications will become part of doctors' daily  
lives. But doctors will remain important in the future when it comes to uninterrupted  
treatment. Digital technologies will not be able to replace doctors anytime soon. Almost 30  
percent of respondents believe that digital technologies will be able to replace doctors. The  
experience and intuition of many doctors cannot be replaced by microchips, algorithms or  
robots, according to 93 percent of respondents. Nevertheless, they can be a useful support in  
the future. Another consequence of digitalization will be a change in business models in the  
healthcare industry. In the future, pharmaceutical companies will no longer act exclusively  
as drug manufacturers, but will offer other products and services. Almost 98 percent of  
respondents now believe that so-called lifestyle products, such as dietary supplements, will  
account for a significant share of pharmaceutical companies' sales in the future. Even digital  
products, such as apps that support medication intake, will not soon be unusual for  
pharmaceutical companies (93 percent). In addition, 82 percent said they anticipate that  
services such as the evaluation of health data to develop medical dosage forms or to monitor  
therapy will be offered more frequently. Over 50 percent of respondents believe that  
evaluating data from social media or apps about the impact and side effects of medications  
will become a common model in the near future. The study used general philosophical  
methods - analysis and synthesis, abstraction, generalization, historical and logical analysis,  
cross-cultural method, in the context of which the comparison was made.  
3. Literature Analysis and Problem Statement  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
In the study we focus on the works of such authors as Voronkova Valentyna;  
Andriukaitiene Regina "Trends in the development of the philosophy of medicine of the XXI  
century in the context of foreign experience"(2022); Buhaychuk, Oksana; Nikitenko Vitalina;  
VoronkovA Valentyna; Andriukaitiene Regina; Malysh Myroslava. "Iteraction of the digital  
person and society in the context of the philosophy of politics" (2022); Nikitenko Vìtalina;  
Voronkova Valentyna; Oleksenko, Roman "Medicine of the future in the context of  
philosophical reflection" (2022); Nikitenko, Vitalina; Voronkova, Valentyna; Andriukaitiene,  
Regina; Oleksenko, Roman "The crisis of the metaphysical foundations of human existence  
as a global problem of post-modernity and the ways of managerial solutions" (2021).  
The articles note that the philosophy of medicine of the XXI century is based on the  
exponential growth and convergence of technologies, based on genomes, stem cells, 3D  
printers, electric transport, etc. When it comes to medicine, it turns out that the system is  
more unhealthy than the patients, even the terminology is confusing. At the same time, as a  
result of this technological convergence, two paradigms are changing. The first is the  
strengthening of the emphasis from disease to health, the transition from a system that reacts  
to the consequences to a system that acts proactively and seeks a personal approach to each  
patient. The next one is to change the management system, use the potential of augmented  
reality, namely artificial intelligence and exponential growth of information (use of BIG  
DATA: 10-11). In 2018, the National Institutes of Health at Harvard and similar organizations  
launched the All of Us project, giving out $27 million in grants to decode millions of genomes.  
If they succeed in this, they will be able to grow organs for transplantation, obtain weapons  
to fight viruses and cancer, cheap medicines and vaccines (pp.10-11). A great importance for  
our work was provided by Diamandis Peter, Cotler Stevens "The future is closer than it  
seems. How technology is changing business, industry and our lives" (2021: 320). In the  
article by Nikitenko, Vìtalina; Voronkova, Valentyna; Oleksenko, Roman "Medicine of the  
future in the context of philosophical reflection". The collection of materials of the III All-  
Ukrainian Scientific and Practical Conference with international participation " Socioethical  
and deontological problems of modern medicine (non-medical problems in medicine)"  
February 24-25, 2022) is noted that the development of medicine of the future in the context  
of philosophical understanding is based on cellular medicine, the concept of it appeared in  
the 1990s after the discovery of stem cells, which were planned to be used in the fight against  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
Vitalina Nikitenko et al/// Digital Healthcare in the Context of Challenges … 315-333  
diseases. Now this plan provides for the use of other types of cells, not only stem cells, but  
their essence remains unchanged (pp. 231-234). To determine the competitiveness and  
strengthening of competition as a result of digitalization of medical organizations and  
institutions, the works of Afanasyeva, L.; Muzya, E.; Koleva, K.; Oleksenko, R. 2017.  
Intercultural dialogue in the context of Ukraine's unification". Ukrainian Studies Almanac,  
Vol. 21, pp. 15-20; Oleksenko, Roman "Policy of ensuring Ukraine's competitiveness in the  
world food market in the context of globalization: trends and prospects". Melitopol: Kolor  
Print (2011); Oleksenko, Roman "Philosophy of market relations. Formation and  
development in Ukraine in the period of globalization and information revolution: social and  
philosophical analysis. Kyiv: Knowledge of Ukraine (2013, 367 p.). To determine the  
directions of digitalization development in healthcare, we used our own research Nikitenko,  
Vìtalina; Voronkova Valentyna; Shapurov Oleksandr; Ryzhova Iryna; Oleksenko Roman "The  
Influence of Digital Creative Technologies on the Development of Education and Medicine".  
International Journal of Health Science (2022: 699-708); Kyrychenko,Mykola; Nikitenko,  
Vìtalina; Voronkova, Valentyna; Harbar, Halina; Fursin, Alexandr. 2021. "The search for new  
forms of personal expression in the era of postmodernism (2021: 248-254); Punchenko Oleg;  
Voronkova Valentyna; Andriukaitiene Regina. 2018. "Sociodynamics of the globalizing world  
in its civilization dimension" (2018: 48-60). All these developments allowed to form the  
concept of digital healthcare in the context of challenges and opportunities of technological  
progress and to outline the main directions of digital technologies development in the field  
of medicine.  
. Research result  
.1. Increasing competition as a result of digitalization of healthcare  
organizations and institutions  
But the competitive situation will also change as a result of digitalization. 70 percent  
of startups assume that their biggest competition will be companies from the biotechnology  
sector. Only one percent of respondents consider international competitors from the  
pharmaceutical sector even more important. National competitors rank third with 58  
percent, followed by online retailers (39 percent). Online pharmacies are also considered  
strong competitors (28 percent). In addition, 25 percent consider large companies in the  
digital industry to be competitors. The respondents stated that strict regulation is an  
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additional obstacle to innovation (61 percent). Many patients are not yet ready for this step.  
Many patients are also not ready to spend money on health (56 percent). In addition, many  
patients indicated that the lack of IT specialists in this area is another obstacle (38 percent).  
Other obstacles include lack of capital for research and development (27 percent) and overly  
strict data protection regulations (20 percent). 43 percent of the companies surveyed are  
positive about the future of German pharmaceutical companies. Almost 10 percent even  
believe that German companies will become world leaders in this field. When it comes to  
digital innovation, the pharmaceutical industry will be in the middle (39 percent) in the next  
few years. Only ten percent believe that they play only a subordinate role. Most companies  
see great opportunities in digitization. Only three percent consider it a risk. Pharmaceutical  
companies have recognized the opportunities of digital technology, only the prerequisites  
must be implemented by all if you want to take advantage of these opportunities. But the  
legal requirements should also be more rigidly enshrined, for example, in the eHealth Law.  
In particular, it is planned to introduce telemedicine with a doctor's prescription for  
teleconsultation diagnostics using X-rays. But that is not all, other areas of application such  
as stroke, heart failure or diabetes must be approved by the legislative bodies. Digitalization  
of medicine is an important component of the healthcare system. But digital transformation  
is comprehensive and is also changing the industry in many other areas. Electronic medical  
records, prescription health apps or hours of video consultations between doctors and  
patients: the digitisation of medicine has made progress in Germany in recent months. This  
was driven on the one hand by political decisions, but above all by the corona pandemic as a  
catalyst. Out of necessity, new concepts that had previously been discussed for years in  
theory but rarely, too slowly, implemented in practice were introduced almost instantly.  
The benefits of digitisation are obvious: improved communication that is independent  
of location, patient self-monitoring through wearable devices and apps designed for this  
purpose, or even personalised medicine through new diagnostic and treatment options are  
just a few examples. "Digital technologies can help us better address the challenges faced by  
almost all healthcare systems in the Western world - more and more elderly and chronically  
ill people need to be treated, expensive medical innovations need to be paid for, and  
structurally weak rural areas need to be provided with healthcare. However, there is still a  
long way to go to digitize medicine, despite the progress made in this country recently. Only  
REVISTA DE LA UNIVERSIDAD DEL ZULIA. 3ª época. Año 14, N° 40, 2023  
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last year, according to the digital health index, Estonia, Canada and Denmark topped the list.  
Germany took the penultimate place in the international comparison with 16 other countries.  
Thirty-four indicators were assessed on strategy, technical readiness or digital readiness, and  
actual networked health data exchange. Only Poland was worse. Only 15 percent of German  
citizens said they could also make an appointment with their family doctor online. For  
comparison: in the US and Spain - 55 percent each. The impression that Germany still has  
some catching up to do in terms of digitalization in the field of medicine is confirmed by a  
joint survey by the digital association Bitkom and the doctors' association Hartmannbund,  
which examines, among other things, the offer of video consultations of the hour. Although  
it increased during the corona pandemic, today communication between doctors remains  
predominantly traditional. Accordingly, the telephone is still the most important  
communication channel in the exchange with patients (77 percent), pharmacies (61 percent)  
and practices (53 percent). In addition, every fifth doctor (19 percent) communicates with  
medical practices mainly by mail, and 22 percent rely mainly on fax. Only one out of 20  
doctors communicates mainly by email with other practices (5 percent), pharmacies (6  
percent) or patients (5 percent).  
Digital gap between clinics and practices. If files and reports are submitted in paper  
form, double checks, security flaws and loss of information are inevitable. It is more  
important that digital processes are implemented throughout the entire healthcare system.  
Accordingly, 86 percent of clinic doctors see digitalization primarily as an opportunity  
for the healthcare system - 10 percent see digitalization as a risk. Among GPs, only 53 percent  
emphasize the opportunities - and 39 percent the risk perspective. At the same time, three  
quarters said comparable crises could be better managed with digital technology. 71 percent  
called for accelerating the expansion of digital offerings in healthcare, and 70 percent  
expressed the view that Germany is lagging behind when it comes to digitizing the  
healthcare system. In accordance with the report, 71 percent of Germans want prescriptions  
that are transmitted to pharmacies in real time, as well as electronic documents such as  
vaccination records, pregnancy and maternity records or organ donor cards. In addition, a  
digital patient dossier is high on the agenda (70 percent). While 73 percent of respondents  
rated the degree of digitalization in German hospitals as "average", 60 percent were also  
convinced that it should be "high" for optimal quality of care.