Lauterbach hopes for German leadership in medical...

Lauterbach hopes for German leadership in medical…

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Karl Lauterbach (SPD), Federal Minister of Health /picture alliance, Michael Kappeler

Berlin – Federal Health Minister Karl Lauterbach (SPD) expects that Germany will become a leader in the development of artificial intelligence (AI) in medicine thanks to its currently emerging data infrastructure in the healthcare sector. He explained this today in Berlin.

The Digital Act (DigiG) and the Health Data Use Act (GDNG) would create enormous opportunities, especially for the development and further development of AI. “With what we are doing here, we probably have the world’s largest data space in which this data is also interlinked,” said Lauterbach. “So I believe that this will take us a long way forward.”

In future, health data from the electronic patient file (ePA) will be transferred in pseudonymized form to the Research Data Center (FDZ) currently being set up at the Federal Institute for Drugs and Medical Devices (BfArM), from where any natural person in the EU can request access for research purposes.

This will open up huge opportunities for training AI algorithms that rely on the largest possible quantities of high-quality data sets. “We want to establish Germany as a global research leader here,” Lauterbach explained.

As examples, he cited prediction models for certain diseases that are similar to weather forecasting: Based on large numbers of parameters, AI algorithms could calculate probabilities of whether and when a disease would break out in a patient, without understanding the scientific context in detail.

It is known that atrial fibrillation increases the risk of stroke, especially in a certain constellation of frequency and amplitude of the fibrillation, because this promotes the formation of clots in the blood.

In the case of Alzheimer’s disease, on the other hand, it is known that the interaction of a whole series of factors – including certain gene alleles, but also fat and insulin metabolism – could be indicators of a patient’s likelihood of developing the disease.

Just as in meteorology, predictions for the weather at a certain time and place can be made from a large number of factors, from air pressure to wind speed to humidity, the same will be done with diseases in the future. “All of this will be possible if we homogenize and combine the data.”

In addition, the new data volumes will open up entirely new opportunities for research. For example, there is still insufficient knowledge about the effect of long-term use of HIV medication on the development of neurodegenerative diseases. This will be of considerable benefit to research.

AI will also bring about major changes in healthcare itself, he stressed again. “This new medicine will not be ignored by any general practitioner, that’s clear,” he said. In the future, there will be “digital companion doctors” who can give patients assessments and explanations of their diagnoses, which in turn will relieve the burden on human doctors.

The current version of ChatGPT can already explain medical connections today. In the near future, AI could reach the level of specialists. “This will lead to a completely new understanding of patients’ illnesses,” he emphasized.

In addition, the emergence of AI in understanding complex relationships is already evident. Language models will soon be able to summarize content not on the basis of probabilities, but instead develop a deeper understanding of a patient’s health status based on the data from an ePA, for example.

All of this will lead to greater transparency in healthcare. The human factor must be retained if, for example, patients value advice from a human doctor in the case of serious diagnoses.

When it comes to the further development of AI in outpatient care, he expects good cooperation with the National Association of Statutory Health Insurance Physicians (KBV), especially with the responsible board member Sibylle Steiner.

The “ePA for everyone”, as the BMG calls the ePA with opt-out solution, is to be introduced from January 15, 2025. The ministry expects that almost all those with statutory insurance will receive their files within the first four weeks, explained Sebastian Zilch, head of the “Gematik, Telematics Infrastructure, E-Health” sub-department at the BMG.

Doctors will then be required to upload documents and other data to the ePA, but this should happen automatically in most cases. There will be no standardized check to see whether they comply. “The requirement to comply with the law also applies to doctors, of course,” said Zilch.

However, there may be cases of sanctions if, for example, a doctor explicitly refuses to put content into the ePA. The patient can then submit a complaint to the responsible Association of Statutory Health Insurance Physicians (KV).

After the launch of the ePA with an objection solution in January, the first expansion is expected to be the digital medication process around the middle of the year. The BMG can determine further structured use cases itself; Zilch named laboratory findings and an electronic patient summary file as possible next steps. © lau/aerzteblatt.de

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