Digital failure: Health officials are wandering through the pandemic

IIn October 2019, shortly before Covid-19 is believed to be transmitted to a human for the first time, Jens Spahn visits Nigeria. The Minister of Health (CDU) is impressed: The country appears to be fighting the Ebola epidemic, which broke out in 2014 to have won. A central component of disease control: The epidemic management system “Sormas”, which was co-developed in Germany, for tracking contacts in real time.

More than a year later, several 10,000 people in Germany are infected with the corona virus every day at. Bavaria’s Prime Minister Markus Söder (CSU) is upset. In one The resolution of the Council of Ministers from the beginning of December reads: “The health authorities are obliged to immediately use the Sormas program uniformly throughout Bavaria.” The previous encouragement did not help, now comes the compulsion.

The software, which already works in Nigeria but not yet in our country, bundles the data exchange between local authorities, the Robert Koch Institute (RKI) – Germany’s most important authority in the fight against the pandemic – and the state authorities and is also one of the authorities Supplement to the Corona app. If the move into digital works this time, Bavaria would be ahead of the rest of the republic.

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Because the offices are still collapsing with the extremely important contact tracing of infected people under the load of paperwork and fax tables. The country is also in the second lockdown because this “contact tracing” was partially abandoned weeks ago.

There have been dozens of appeals from the digital economy since the beginning of the pandemic and reminders. “Many offices have been at their limit for months,” says Sassan Sangsari, medical director at the start-up Siilo, which wants to promote digital networking in the health system using a messenger app. “Despite overtime and increased staff, it is not possible to adequately follow up contacts and communicate results with the necessary urgency.”

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From his point of view, the strange discrepancy between effort and result is mainly due to the digital backwardness of the authorities. “The problems are hardly surprising, as one of the most important devices for data transmission between offices and laboratories is still the fax,” criticizes the ex-surgeon.

Even the RKI is having a hard time. The institute could have been better equipped for a long time if the politicians had only wanted to: as research by WELT AM SONNTAG has shown, the budget committee approved just four of the 68 requested IT positions.

RKI boss Wieler slows down all expectations

Around 400 health authorities work nationwide for the RKI. They should all work more efficiently by the end of 2020 at the latest using Sormas. So far there are not even 100. So it’s no wonder that it is still not really clear how the virus is spreading. But RKI boss Lothar Wieler is slowing down expectations again: The introduction by the end of the year could not be guaranteed, he said on Tuesday.

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The failures of the authorities affect the entire reporting chain in the tracking of infected people. In particular the laboratories, which have been under full capacity almost everywhere since spring, are affected. “We had to go back to the digital middle ages,” says Andreas Bobrowski, Chairman of the Professional Association of German Laboratory Doctors.

Source: WORLD infographic

“Many laboratories are technically well equipped. But it is of no use if we send numbers to the authorities that do not arrive. ”Communicating again by fax was an involuntary decision, he says. “The process could be much faster if the public health system had not been neglected so financially in the past.”

Programs like Sormas are needed to ensure that the messages run smoothly. “Unfortunately, there is no standardized reporting software, which of course slows down the process,” said Wieler at the beginning of December. “This is less of a failure than the federalism that prevents it.”

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In fact, the Federal Ministry of Health hesitated for a long time with clear announcements. Many offices therefore acted independently and installed programs, some of which only work in their own district. Almost every house now works in its own way, there are no interfaces – a nightmare for IT experts.

An example from Bavaria makes this clear: only one of the 76 offices used Sormas at the end of November, according to a request from the Greens in the state parliament. Another 35 introduced the “BaySIM” software developed in the spring – the name already indicates the local limitation, which has now been confirmed: Bayerischer Rundfunk recently reported a lack of functions and missing interfaces.

Paper mess and help from the Bundeswehr

In April, the state government celebrated itself as a “nationwide pioneer” – after a few months, the Bavarian go-it-alone approach is about to end due to a lack of compatibility with the rest of the republic.

In September the federal government promised four billion euros for personnel and digitization with the “Pact for the Public Health Service” – the first funding will arrive in 2021 at the earliest.

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So far, investments have tended to be in additional staff for contact tracking: semi-skilled temporary workers who have to type in addresses and telephone numbers, scan reports, compare and save data twice. A complex process in which the Bundeswehr still has to help out in many places.

In addition, data protection is slowing down, and employee retraining can sometimes take a long time. “While the authorities have now developed a high level of technical competence in the context of conventional IT, experiences with cloud offerings are often not that widespread,” says Matthias Kuss, CEO of the Tyme Group, a provider of digital video consulting. This complicates the already idle bureaucracy in the selection of the software provider.

“If we had highly efficient technology, we wouldn’t need a lockdown”

The heart of the Tübingen strategy are the free tests. As early as May, Tübingen appealed to the federal and state governments to regularly test the staff in geriatric care. In an interview with WELT, the Tübingen mayor calls for more efficient contact tracking.

Even its own advisors give the federal government a devastating testimony. The digitalization of the administration has been delayed for too long, writes the National Regulatory Control Council (NKR). The 2020 annual report of the independent advisory body reads almost desperately in places. For years, the council has been calling for consistent digitization. Corona reveals the “considerable backlog at all government levels,” it says, for example.

“Many problems could have been avoided,” writes NKR chairman Johannes Ludewig elsewhere. “For example, reporting channels to health authorities that are far too long. Fax machines and paper put the brakes on crisis management. ”The council immediately sent an urgent warning: the slow progress threatened to have negative consequences for Germany as a business location.

Digitization of the offices delayed

In view of this misery, the digital industry now believes itself to be the big winner of the crisis. Across all industries, it seems to have agreed on the fax machine as a symbol of backwardness: “The virus will keep us busy in 2021 as well. It is no longer enough to just communicate with individuals by phone and fax, ”says Sangsari.

The Federal Association of the Digital Economy (BVDW) is also calling for a new start: an overwhelming majority of the population regards digitization as part of the solution to the economic crisis, according to a BVDW survey. “In the fight against the virus, the faster wins,” says managing director Marco Junk. “You have to ask why we are only now talking about a program that should make the offices’ work more efficient. Loss of time due to inefficient data transmission costs human lives. “

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All digital tools are available: programs such as Sormas, the Corona app or the Climedo symptom diary. “Their potential effects are limited, however, since a comprehensive digitization of the offices has been neglected in the past few years,” says Junk.

After all, Corona caused a boost in one of the delayed projects. According to the RKI, 363 health authorities are now connected to the German Electronic Reporting and Information System for Infection Protection (DEMIS) – which does not mean, however, that they also use it. The ministry commissioned a feasibility study as early as 2013, and the project started in January 2016.

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According to the RKI, the implementation should be completed by December 31, 2020 – five years later. On Tuesday, Lothar Wieler also softened this deadline in a joint press conference with Health Minister Jens Spahn: The software should now be “connected in January”. It worked faster in Nigeria.


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