Susanne Ozegowski – There is untapped potential in the use of smart data

Head of integrated care health insurance contracts unit at TK discusses efforts to implement electronic health records in Germany

Since 2004, many have endeavoured to establish accessible and secure electronic health records in Germany. None have succeeded... so far. This is where Susanne Ozegowski, head of a unit managing integrated care contracts at Techniker Krankenkasse (TK), the largest health insurance fund in Germany, comes into the picture.

For a year and a half, Ozegowski and the insurance fund she works for have taken it upon themselves to bring an electronic health record into the market. They have worked with IBM and have recently revealed a preliminary version. They have since been trying to connect both hospitals and ambulatory care with the system.

Ozegowski is a member of the inaugural cohort of Sciana – The Health Leaders Network, which convened for their third meeting last week. This Network brings together experts in the health and health care profession to discuss outstanding issues in health care policy and innovation.

Back in November, 2017, a key theme of their meeting centred around the future of artificial intelligence and robotics, as well as concerns surrounding this use of technology. While this topic is quite relevant to the electronic health record Ozegowski is working on, she said they’re “future topics for us, at the moment; we are building the basis, i.e., we are working on giving every patient access to their health data.”

The former managing director of the German Managed Care Association (BMC) added, “Once we have established that transparency, of course using artificial intelligence can be very interesting when it comes to identifying health risks or providing care management. We have a huge amount of data on health in Germany, but it’s so decentralised… there are many diseases which we would be able to detect a lot earlier and therefore treat better… There’s a lot of potential in the smart use of data that we have not tapped on at all so far.”

Integrating care contracts is another challenge Ozegowski underpinned. Given the significant gaps that she believes exist in the German health care system, integrated care contracts are an important instrument offering the potential for better care pathways for patients.

“We have lots of different health care providers,” she noted, “but there’s not really a systematic way of how they’re working together, so it’s usually the patient who himself has to kind of figure out ‘where do I have to go next, how do I get information from physician A to physician B?’ And that’s a big problem. So the idea of integrated care is how can we standardise patient care pathways through the system so that it helps the patient manage his health better than it is today.”

As an insurer, one of her key responsibilities is evaluating the cost-effectiveness of certain programmes and exploring how those programs will look going forward. As an example, Ozegowski described an integrated program which she said could be very useful for patients “with psychological or mental health problems… [it] tries to keep patients out of the hospital and tries to treat them in their… home.”

Communication is also a substantial aspect of the finance side of things, particularly when it comes to informing insurance patients about specific programs.

“In Germany, as a public health insurer, we are not allowed to analyse and then inform patients based on their specific situation,” Ozegowski said. “Therefore, it’s quite difficult actually to provide real care management.”

Reflecting on the impact of the Sciana Network, Ozegowski stressed that we should be looking at health care and what makes people healthy from a much broader perspective, rather than in a narrow sense.

Citing what the Sciana crew came to call “Harry's stuff,” referring to Sir Harry Burns, a senior ambassador of the Sciana Network and a Strathclyde professor of global health, Ozegowski said, “It’s very helpful and very important to consider the broader perspective on health. What Harry is advocating is that…  you can offer the greatest hospital care, and you can have the best physicians and so on, but health also requires social cohesion and healthy communities where people can interact with each other.”

For this reason, Ozegowski believes “we are often too narrow in our approach to health care here, and it’s something I took from [Sciana]. I still have the feeling that I’m not at the point where we’re actually putting that thinking into practice, but I would like to work further on that.”