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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******

ABSTRACT

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: https://orcid.org/0000-0001-9588-

7836 . E-mail: vitalina2006@ukr.net

*

* Zaporizhzhia National University, Zaporizhzhia, Ukraine. ORCID iD: https://orcid.org/0000-0002-0719-

1

546 . E-mail: valentinavoronkova236@gmail.com

*** Lugansk State Medical University, Ukraine. ORCID ID: https://orcid.org/0000-0002-6424-6419 . E-mail:

yurij.kozar@ukr.net

*

*** Dmytro Motornyi Tavria State Agrotechnological University, Zaporizhzhia, Ukraine. ORCID ID:

https://orcid.org/0000-0002-2171-514X . E-mail: roman.xdsl@ukr.net

*

**** Lugansk State Medical University, Ukraine. ORCID ID: https://orcid.org/0000-0002-1243-598X . E-

mail: yanchevskiyalex1985@gmail.com

*

***** Lugansk State Medical University, Ukraine. ORCID ID: https://orcid.org/0000-0002-1292-9971 . E-

mail: marjinsky@gmail.com

Recibido: 08/02/2023

Aceptado: 11/04/2023

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La salud digital en el contexto de los retos y oportunidades del progreso

tecnológico en los países de la Unión Europea

RESUMEN

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.

Introduction

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-

1

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

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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

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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

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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

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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

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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".

1

. Objectives

The object of research is digital health care as a complex social phenomenon and a

dynamically changing development process.

2

. 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

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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

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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

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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.

4

. 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

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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.

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The digital revolution poses serious ethical challenges, especially for the healthcare

system and all stakeholders, and contributes to the competitiveness of healthcare

institutions. As global markets with giant players, tech and other non-medical players have

long defined how we deal with what ultimately matters to the patient. Whether artificial

intelligence becomes a curse or a blessing depends on what we do with this technology, how

we design and shape it. The social responsibility in working with this technology, as well as

individual responsibility, remains with us. What is artificial intelligence allowed to do and

where should it be ethically limited? How should we develop principles of artificial

intelligence with which we can solve medical problems between benefit and harm? Equity

(

access for all) and respect for individual choice can be part of this set of principles. As well

as the realization that there is an unbridgeable gap between data and reality. When it comes

to artificial intelligence, the biggest concern is the data power of leading corporations. In the

next ten years, telemedicine procedures will take up more and more space. The exchange of

a doctor with other specialists will increase in the future. X-ray images can, for example, be

evaluated via video together with fellow specialists. 98 percent believe that operations

supported by telemedicine will play an important role. Then, when there are problematic

cases, a leading specialist can be called from abroad. According to all experts, routine

telemedicine monitoring of human health will be of great importance. In the future, patients

with heart disease or diabetes will be able to transmit electronically to the doctor from home

such indicators as blood pressure, ECG, weight or blood sugar level. Values can thus be

checked independently by the doctor without constant visits to the practice or patients

staying in the hospital. 70 percent of experts believe that online consultations between

doctors and patients are becoming increasingly important. It should not eliminate the need

to visit a doctor, but only to replace it. Telemedicine offers far-reaching benefits, especially

for the chronically patients, the elderly and people and patients in sparsely populated

regions, as patients receive quality care without having to travel long distances. Of course, in

the next ten years, telemedicine procedures will occupy more and more space. The exchange

of a doctor with other specialists will increase in the future. X-ray images can, for example,

be evaluated via video recording together with specialist colleagues. 98 percent believe that

operations supported by telemedicine will play an important role. Then, when there are

problematic cases, a leading specialist can be called from abroad. According to all experts,

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routine telemedicine monitoring of human health will be of great importance. In the future,

patients with heart disease or diabetes will be able to electronically transmit to the doctor

from home such indicators as blood pressure, ECG, weight or blood sugar level. Values can

thus be checked independently by the doctor without constant visits to the practice or

patients staying in the hospital. 70 percent of experts believe that online consultations

between doctors and patients are becoming increasingly important. This should not

eliminate the need to visit a doctor, but only replace it. Telemedicine offers ambitious

benefits, especially for the chronically patients, the elderly and people and patients in

sparsely populated regions, as patients receive quality care without having to travel long

distances. Of course, this factor also improves the patient's quality of life. Individual

medicines are no longer something special.There are other options in personalized medicine.

In particular, this means therapy adapted to the patient using big data technologies. This

allows factors such as lifestyle, gender, age and genetic makeup to be taken into account

when treating cancer. In addition, it reduces negative side effects and also increases the

chances of recovery. 60% of the surveyed experts said that in a few years the production of

individual medicines will cease to be something special. In particular, diagnostic procedures

with IT (decision support systems) will become more important. This refers to computers

connected to medical databases. In addition, these databases can be read very quickly. Thus,

doctors can identify diseases faster and more accurately. Almost 80 percent believe that in

ten years this process will become standard. Now medical research is developing at a rapid

pace, so it is not always easy for doctors to keep up with the rapid development. High-

performance computers and big data technology can be useful for doctors.

4

.2. Directions of digitalization development in healthcare

The electronic health record, the measurement of health data via an app, the

communication between doctors and the hospital via a platform, video consultation hours

are just a few examples of the digital technologies that are currently transforming the

German healthcare industry. The basis of digitization is the medical data of the insured

person, which is exchanged between doctors and patients, as well as between individual

service providers using modern information and communication technologies. Digitalisation

creates new diagnostic and treatment possibilities, such as personalised medicine, which

facilitates communication between individual players in the healthcare system and allows

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individual patients to monitor their health more effectively, for example through apps and

information on the Internet. Digitalisation of healthcare enables faster detection of diseases

and better control of them. Digitalization opens up great opportunities: better and at the

same time more accessible care. It also offers an opportunity to address the lack of

digitalisation skills. Germany is lagging far behind: in other European countries, digital

technologies are already part of everyday medical life, while in Germany there are still

implementation barriers, such as numerous isolated solutions that make cross-sectoral

networking difficult.Digitization also contains risks: citizens fear losing the sovereignty of

their data. Therefore, the topic of data protection is particularly important, so it is necessary

to create uniform and secure rules. Opportunities for digitization. The main challenges facing

the German healthcare system include demographic changes and sharply rising costs.

Digitalization can help address these challenges. Whereas previously it was only possible to

improve the quality of care for the individual or to reduce costs for the general public, this

conflict of goals can be resolved through digital innovation: digitalization ensures high-

quality and accessible care for everyone. It also provides people in structurally weak rural

regions with access to medical expertise through telemedicine solutions.

When it comes to digitalization, the German healthcare system lags far behind in

international comparison. Many of the opportunities offered by digital technology are not

yet used in Germany, while telemonitoring, video consultations and electronic patient files

have long been standard in other European countries. Although there are innovative ideas

from companies, they have not yet entered the standard health insurance (SHI) system. In

order to push the development forward in Germany as well, the Federal Ministry of Health

has taken various legislative measures, among other things, health insurance companies are

obliged under the Recording and Supply Services Act to store electronic patient files for their

insured persons from January 2021. Telematics infrastructure is to be expanded through the

eHealth initiative. Citizens are less critical of the digitalisation state: according to a PwC

study, 61 percent believe that Germany is already well positioned when it comes to digital

technology. Technology and its capabilities are making a variety of innovations by digital

companies in the healthcare sector in detail. Artificial intelligence examines digital health

data and can thus recognize patterns. This can help doctors in diagnosis and decision-

making. The shortage of skilled workers in the healthcare sector is getting worse: a PwC

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study shows that by 2030, Germany will be short of at least 400,000 full-time employees. The

insured patients are already experiencing a shortage of qualified employees - they criticize

that resident doctors take too little time and patients wait too long to see a specialist. In the

hospital, the insured patients are already noticing a shortage of staff. Digitalization can help

to counteract the shortage of skilled workers: digital technologies such as artificial

intelligence or robot-assisted care systems help doctors and nurses to make their work much

easier, for example in administrative and documentation activities, as well as in diagnostics

and daily activities.

4

.3. How artificial intelligence is revolutionizing medicine

Artificial intelligence (AI) is a key technology of the future. It helps to overcome the

current challenges of the healthcare system: improving the quality of medical care while

maintaining the accessibility of the healthcare system. Artificial intelligence promises great

success, especially in diagnostics - it ensures that diseases can be detected more accurately

and earlier. A potential that is also seen by the leaders of the German healthcare system, as a

PwC study shows: 64 percent are convinced that AI will revolutionize medicine in the next

ten years. Preventive measures alone could save 90 billion euros over the next ten years in the

case of childhood obesity alone, which is a serious problem for health systems around the

world. 54% of people around the world are ready to use artificial intelligence (AI) in

medicine. 64% of German executives are convinced that artificial intelligence will radically

change the healthcare system.

90 billion US dollars can be saved worldwide in the next ten years only thanks to AI

on the clinical picture of obesity in children. 61% of insured people believe that Germany is

well positioned when it comes to digital technologies. Public view. Insured persons in

Germany are open to the digitalization of the healthcare system: they can well imagine using

telemedicine solutions, such as consultations via video or online chat, as the PwC study

shows. However, they see digital technologies only as a complement to healthcare - face-to-

face exchanges with doctors remain important, especially in the case of serious illnesses, as

7

2 percent of respondents confirm. Most are also positive about new technologies such as

artificial intelligence and robotics. However, as the data security study shows, greater

digitalization of the healthcare system is also accompanied by concerns: insured persons fear

that their hospital may be subject to a cyberattack or that the personal data of resident

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doctors is not adequately protected. Nevertheless, 52 percent of Germans are willing to share

personal information with doctors and their health insurance company through an electronic

health record. Admittedly, hardly anyone likes going to the dentist - especially when there is

a risk of long-term treatment.

Modern technologies speed up dental treatment. CAD/CAM dental technology makes

it possible. The practice has a computer system consisting of a tooth scanner and a dental

milling machine, as well as two ovens. It allows to make dental bridges and crowns

independently. And it works like this: after scanning the teeth on a computer, a model of

dentures is created, which are then made on a dental milling machine. Depending on the

material used, it is glazed or sintered in an oven, i.e. hardened. The electronic customer card,

for example, helps its employees to advise customers individually and according to their

needs, taking into account their purchase history. A picking machine ensures that the

requested products are in stock, if possible. KfW research shows that 87 percent of medium-

sized companies finance digitization projects with internal funds; only seven percent use

bank loans. The picture is quite different with classic investments: 43 percent of them are

financed with internal funds and 34 percent with bank loans. Digital storage allows to

expand the range of goods. Investments and working capital for digitalization and innovation

projects as well as full financing of the needs of innovative companies are eligible for funding.

Conclusions

The COVID-19 pandemic has highlighted the importance of building a health

workforce that is able to adapt to a rapidly changing environment and use available data and

digital technologies to deliver 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 are still unclear.

Helping countries to use digital technologies to improve health service delivery. The

WHO/Europe Data and Digital Health Programme coordinates a leading initiative on digital

health. It provides technical advice, policy guidance and expertise on the safety and

effectiveness of digital health solutions, keeping equity, gender equality and human rights as

core values in their deployment. The programme's activities support countries in using

digital technologies to improve the interaction between people and health services; improve

the performance of health systems; and strengthen core public health functions such as

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disease surveillance, early warning and risk assessment. Digital literacy now means knowing

the techniques needed to succeed in a society where communication and access to

information are increasingly dependent on digital technologies such as online platforms and

mobile phones. The concept covers a broad understanding of a series of digital tools that

enable professionals to perform their duties in the office, hybridly or remotely in any

environment. These tools include real-time collaboration software, such as business chat

applications, and sophisticated asynchronous work tools. Today, digital competence is no

longer a functional proposition, but a state of mind. In the modern workplace, employees are

increasingly expected to quickly master the technologies that accompany their work, as well

as adapt to constantly changing tools and approaches. Professionals must also use technology

strategically, from handling personal mobile phones to managing collaborative workflow

applications. Digital knowledge has become essential for almost every job as technology has

revolutionized processes and industries. Technology is no longer specific to a few sectors.

Digital knowledge and employers' demand for digital skills have evolved along with the

digitization of the economy and the labor market. What was once a bonus is now a core part

of almost every job. And this demand for digital savvy has peaked as employers have adopted

hybrid or remote working standards. Employers are nowmuch better able to identify specific

digital skills and name the software they use. Greater ability to use specific project and office

management software and tools is required so that employees can work more efficiently.

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