A nationwide digital maturity assessment of hospitals – Results from the German DigitalRadar

Objectives

In 2019, the German government established the Hospital Future Fund, allocating 4.3 billion Euros, to support investments in the digital infrastructure of hospitals. The DigitalRadar consortium was commissioned by the German Ministry of Health in 2020 to develop a holistic digital maturity model and evaluate the current state of digitalization and the impact of the funding program. To date, the nationwide digitalization of German hospitals has remained a relatively understudied phenomenon. This study aims to address this gap in knowledge by examining the influence of various factors identified by the DigitalRadar maturity model on the digital maturity of hospitals in Germany. In doing so, it seeks to elucidate the implications these findings have for the development of a digital, patient-centred, safe, and high-quality hospital landscape in the country.

Methods

The model was developed through a scoping review of digital maturity models, requirements set forth in the Hospital Future Act, analysis of components from existing models and feedback from a sounding board. Ultimately, the model includes 234 questions (items) categorized into 7 dimensions of digitalization. It was piloted in 12 hospitals and revised accordingly. 1,624 hospitals (91% of all German hospitals) participated in this self-assessment, as participation was mandatory to receive funding.

Results

The average DigitalRadar score on a 100-point scale is 33. Maturity is comparatively high in the structures and systems dimension, but low in the clinical processes, exchange of information, telemedicine and patient participation dimensions, suggesting that data exchange is hampered by a lack of interoperability. Drivers of digital maturity are teaching status, size, connectivity, and level of emergency services.

Conclusions

The transparency gained allows hospitals and regulators to identify areas for improvement and develop digital strategies. Additionally, it enables researchers to analyse, for example, the correlation between digitalization and the quality of care, as well as the mechanisms of action of large-scale funding programs for hospital digitization.