Federal directory on hospital quality published

Berlin – The Federal Hospital Atlas is available today online. The transparency directory about hospitals and their services in Germany is maintained by the Federal Ministry of Health (BMG) operated. Federal Health Minister Karl Lauterbach has been promoting the project since last year.

The atlas is intended for all patients to find the best clinic for their specific illnesses, Lauterbach explained today at the federal press conference. The vast majority of patients still do not have a good idea of ​​which clinic is particularly suitable for their treatment. “This is not acceptable,” Lauterbach said. Atlas aims to change that.

The directory is also aimed at doctors who, for example, make hospital admissions and also want to learn about clinics and their services, says Lauterbach. He is confident that the medical team will use the atlas frequently.

The tool is designed as an interactive search engine into which you can enter a disease and a location or zip code. The system also recognizes colloquial words like “Ziegenpeter” for mumps, Lauterbach explained. You don’t need to be an expert to use Atlas. The data is displayed using a tachograph, which aims to assist in better classification. Up to ten clinics can be directly compared with each other.

Firstly, the almost 1,700 somatic hospitals (excluding psychosomatic and psychiatry clinics) are presented with treatment numbers for the respective disease and department, nursing staffing for the entire site and nursing staffing ratios, minimum quantities, emergency levels and selected certificates.

The atlas also provides information on day care treatment locations or the designation of detention centers. Lauterbach announced that complication rates will also increase in a few weeks.

Next year, the atlas will be further expanded to include the number of doctors, the number of midwives and data on all registered certificates. Lauterbach admitted that the number of doctors represented a new documentation task for clinics.

The remaining data is already available and just needs to be processed. The directory will lead to greater specialization, Lauterbach said. He was convinced today that patients would become more selective about their treatments.

Algorithm must be developed using AI

According to Lauterbach, up to a million people could enter their search queries in ten minutes. The atlas is currently based on a fixed algorithm, and further development using artificial intelligence (AI) is planned. This would improve data evaluation. He explained that we are talking to companies that could implement this.

The Institute for Quality Assurance and Transparency in Healthcare (IQTIG) brings together the different data. Data is obtained from billing data and hospital quality reporting data. The atlas currently shows data from 2022, but will soon be updated to data from 2023, said IQTIG head Claus-Dieter Heidecke.

In the fourth quarter, treatment numbers will also be displayed for each care group, Lauterbach announced. These are intended to be introduced as part of planned hospital reform and to improve patient care through national quality criteria.

The federal states had already criticized in advance the fact that the federal government was already assigning service groups to hospitals using the atlas before they themselves changed hospital planning and assigned the groups in accordance with the reform plans in 2025/2026.

Lauterbach explained today that the federal government would not assign performance groups, but would simply reflect the status quo. The grouper will be ready in September, Lauterbach said. This software instrument aims to link diagnosis-related cases (DRG) to the 65 initial care groups.

The grouper contains the definitions of the service groups so that it is possible to check which clinics meet the requirements of the respective service groups, Lauterbach explained. Each service/treatment is assigned to a service group by the grouper. The federal states, on the other hand, should actively decide which hospitals should offer which services in the future. The prerequisite is that the clinics meet the criteria.

Four month delay

The federal and state governments have fought hard for the clinical atlas in recent months. Last November, the federal states blocked the underlying hospital transparency law with a narrow majority and appealed to the mediation committee.

The federal government successfully appeased the states with a corresponding protocol declaration, and the law came into force at the end of March after a four-month delay. The portal was originally scheduled to be published on April 1, 2024. Among other things, the federal states criticized the order: hospital reform should come first and then a corresponding hospital atlas.

They were also concerned about the allocation of action groups by the federal government. Lauterbach pushed for quick publication. There was also criticism that hospital directories already existed in this format. Heidecke highlighted today that the Federal Hospital Atlas is the first conceptually different and newly created “independent and objective portal”.

Lower Saxony’s Health Minister Andreas Philippi (SPD) today criticized the new atlas system based on performance groups that have not yet been introduced and assigned. The Atlas works with indicators that have not yet come into force and that will also undergo significant changes.

“Therefore, with the Federal Hospital Atlas, the second step was taken before the first”, complained Philippi. It remains to be seen whether the Federal Hospital Atlas will create added value. Because there are already significant information offers, for example from the German Hospital Society (DKG) or the German Cancer Societysaid Philippi.

“Whether another product is really necessary can at least be questioned.” This is even more true because the clinics rightly point out additional bureaucratic tasks that go hand in hand with the Federal Hospital Atlas. “First the reform, then the atlas would have been the correct order.”

Offers now available

The German Medical Association (BAK) was critical. It is good and right to provide patients with easily accessible and understandable information about the services offered on site when choosing a hospital, said BÄK President Klaus Reinhardt.

“The new registry initially creates additional bureaucracy and no real added value for patients, because the information provided there was already widely available in established registries, such as the white list or that German Hospital Directory accessible in layman’s terms.”

He also criticized that the time and political energy invested in this project would have been better invested in serious efforts to reach an agreement with states and autonomous government partners on hospital reform. As far as hospital reform is concerned, Reinhardt hopes that parliamentary procedure can begin after the cabinet decision.

“We hope that special attention will be paid to the importance of medical personnel. The personnel evaluation system developed by the German Medical Association must be anchored in law. “Furthermore, continuing medical education must be properly considered in the performance group system and also in funding,” demanded Reinhardt.

Bundestag member and health politician Armin Grau (Greens) welcomed the launch of the clinical atlas. “We are taking a decisive step towards greater quality transparency in the German healthcare system.” He hopes that the atlas will be used by many citizens and that it can be continually improved with the help of improvement suggestions from users.

Today, at the start of the federal project, the German Hospital Association once again referred to its own clinical atlas. This would be used by over half a million people every month. DKG CEO Gerald Gaß thus questioned the meaning of “another directory, this time financed by taxes”.

AOK Plus CEO Rainer Striebel also pointed out another similar existing offering. “With the Federal Hospital Atlas, Federal Minister of Health Karl Lauterbach presents something that the AOK system has been offering its policyholders for more than 15 years.” AOK Health Navigator I already offer more relevant information than what the Federal Hospital Atlas contains. The AOK directory also provides information about the quality of treatment in hospitals. © cmk/aerzteblatt.de