Presentation of digital solutions at HSK conference in Germany’s capital

Berlin, 17/06/2021. "Through the pandemic, the Medical Informatics Initiative and its protagonists were suddenly pushed into the limelight and put to the test while under huge time pressure – a test they passed with flying colours. This was particularly evident in the close cooperation and support experienced when establishing the German Network of University Medicine for COVID-19 research,” stated Thomas Rachel, Parliamentary State Secretary to the German Federal Ministry of Education and Research (BMBF), at the HSK conference (Hauptstadtkongress) in Berlin.

The German Network of University Medicine (Netzwerk Universitätsmedizin, NUM), which has received funding from the BMBF since March 2020, systematically collects medical data on Covid-19 patients and consolidates them in the CODEX database.

Thomas Rachel, Parlamentarischer Staatssekretär bei der Bundesministerin für Bildung und Forschung © Presse- und Informationsamt der Bundesregierung
Thomas Rachel, Parlamentarischer Staatssekretär bei der Bundesministerin für Bildung und Forschung © Presse- und Informationsamt der Bundesregierung

“We would not have succeeded in implementing the CODEX database so quickly without the infrastructure and expertise of the Medical Informatics Initiative. Analysis performed on CODEX data led to new insights that were used, for example, to develop new treatments,” emphasised Rachel. 

In his welcoming address at the digital session of the Medical Informatics Initiative (MII), entitled “Digital Transformation: Milestones in Medical Research – The BMBF Medical Informatics Initiative”, he underlined the importance of the data integration centres (DICs) at the university hospitals and their role as the MII’s ‘backbone’. The MII forms the basis for enhanced quality within shared data usage:

“It provides a nationwide infrastructure that enables the cross-site use of routine health data. It forms the foundations for medical research using data from clinical healthcare,” Rachel continued.

Within the scope of the MII, all of Germany’s university hospitals cooperate with other research facilities, companies, health insurers and associations representing patients, at over 30 sites – with the overarching aim of strengthening data-driven health research and improving medical care. The university hospital sites are organised within four consortia, and have established data integration centres and developed IT solutions for more than a dozen concrete use cases. The MII has been allocated around 180 million euros in funding from the BMBF until 2022. The MII coordination office is led by TMF (Technology, Methods and Infrastructure for Networked Medical Research).

In his talk, Chairman of TMF’s Board of Directors Professor Michael Krawczak, University Medical Center Schleswig-Holstein, described the coronavirus crisis as a ‘missing data’ crisis. The pandemic cast a harsh light on the frequent lack of reliable data. He emphasised the need for a more rapid digital transformation of medicine. A comprehensive collection of data is essential for medical research and for political decision-making, in order to be better prepared for future crises. He highlighted the key role that the MII plays in this endeavour.

MII infrastructure adds value for research and healthcare

Hauptstadtkongress Referent:innen
All speakers of the session of the Medical Informatics Initiative at the HSK conference (Hauptstadtkongress) in Berlin (from top left to bottom right): Professor Michael Krawczak, Professor Melanie Börries, Professor Karl-Walter Jauch, Professor Gernot Marx, Professor Simone Scheithauer, Professor Dagmar Krefting, Professor Hans-Ulrich Prokosch and Sebastian C. Semler

Professor Karl-Walter Jauch, formerly Medical Director of the Hospital of Ludwig-Maximilians-University (LMU) Munich, regards the MII as a lighthouse project for the digital transformation of medical research and the integration of university hospitals in Germany. This nationwide initiative has, he underscored, achieved structural and functional advances: It enabled agreement on a standardised template for patient consent for the use of data and biosamples for a variety of research purposes (broad consent), approved by data protection authorities. IT and medical data standards, such as LOINC and SNOMED CT, have been introduced. And the data integration centres established by the MII at 29 sites form a Germany-wide infrastructure for data-driven medical research, and are an important precondition for the cross-site, interoperable use of data.

Professor Melanie Börries, Medical Center – University of Freiburg, referenced the example of the molecular tumour board to illustrate how IT solutions can help doctors recommend appropriate treatments. Within a molecular tumour board, an interdisciplinary team discusses what treatment options offer the best chances for fighting a tumour. Under the aegis of the MII, the Medical Center – University of Freiburg has developed a method of processing and visualising genetic sequencing data that is being rolled out to other university hospitals. The goal is to identify patients with rare tumour types and offer them targeted treatments.

Professor Gernot Marx, RWTH Aachen University, presented the Algorithmic Surveillance in Intensive Care (ASIC) app, also developed within the MII. This smartphone app for the intelligent use of routine healthcare data is the first certified MII medical product, and is already in use in intensive care units at several university hospitals. If vital sign readings for a patient in intensive care indicate impending respiratory failure, the attending physicians immediately receive an alert via the app with advice on corresponding treatment. As a result, they are able to reach a diagnosis and take countermeasures far earlier. This early warning system therefore also improves care for Covid-19 patients.

Next steps within the MII: from university hospitals to general practitioners

During the second part of the session, the focus was on the proposed future extension of MII infrastructure to general practitioners, illustrated by the Digital Hubs: Advances in Research and Health Care (Digitale FortschrittsHubs Gesundheit). The hubs were initiated by the BMBF this year, with the central goal of improving data availability and cooperation between various healthcare sectors – including in-patient and out-patient treatment, rehabilitation and follow-up care by general practitioners/primary care physicians. The aim is to harness regional healthcare data for research, while complying with data protection requirements, in order to effectively improve care and treatments. The MII is therefore taking a significant step forward with the rollout of digital solutions from university hospitals to local general practitioners. For instance, one of the six BMBF-funded projects will establish a patient and doctor portal. This will improve data exchange between university hospitals and the local physicians responsible for aftercare, and will enable patients to participate in research.

Looking to the future, Sebastian C. Semler, TMF/MII coordination office, addressed the interoperability of the MII infrastructure with the research-compatible electronic patient record (EPR, known by its German acronym ePA). From 2023, patients will be able to voluntarily make data in their ePA available for medical research, in pseudonymised form. It is now important to effectively and securely leverage the possibilities created by corresponding legislation for the use of healthcare data in research. This will require coordination and consolidation on the part of research institutions. “The MII is the ideal platform for a corresponding dialogue with gematik [a company specialising in telematics for healthcare], and for advancing the use of ePA data for research,” stated Semler with regard to the next MII funding phase from 2023.

The MII experts discussed the next steps for the initiative on the day before the HSK conference at the 4th annual meeting of the MII and at a subsequent stakeholder meeting. Input was provided by representatives of patient associations, politics and government agencies, research institutions and scientific organisations, professional associations and the healthcare industry.

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