>> Mr. Bernhard, GE Healthcare's website states that your company is a leading innovator, enabling precision medicine by integrating clinical care and data across the entire patient journey, simplifying decision-making and delivering care and improve results. That sounds too good to be true; or: How is this supposed to work?
This is not a thing of the future; it is already happening to some extent today, for example when the results of a CT scan taken in the emergency room of a hospital are forwarded directly to the operating room in order to prepare the surgical team. This is the beginning of what we mean by digitalization, but it is still a long way from what would already be possible today.

Where do you locate the obstacles?
The big challenge is the often still missing interoperability, which is of course related to the - let's say: expandable - status of digitalization in a country like Germany. The challenge that hospitals, general practitioners, and diagnostics and radiology centers in particular face is to consolidate the amount of different systems and extremely fragmented data information on a common platform into consistent patient information in the sense of a patient journey then make it available to the respective practitioners at the right time - and in the highest degree in compliance with data protection regulations.

Does that work?
Secure. But only if you want it. GE Healthcare has developed an IT solution called “Edison Orchestrator” and tested it with international hospitals, which has been in widespread use since March of this year. The Edison platform consists of tools and services to develop AI and also integrate AI applications.

How can one imagine this orchestration?
Like many other large and small companies, GE uses many different subsystems in hospitals, private practices and diagnostics and radiology centers. These generate data, but usually do not exchange it, let alone bring it to a common level where, in the best case scenario, it is brought together in a structured manner, stored and, if necessary, issued - in an orchestrated manner - for the timely information of the treating person and for their benefit of the patient.

May GE become “master of the game”.
Our Edison Orchestrator is initially manufacturer-independent. It can store data from the Picture Archiving and Communication System (PACS) or image storage and communication system and from the Radiology Information System (RIS) and in the future also from other archiving areas
enable an analysis of tissue changes in the lungs and large intestine. But also from devices from any other provider that offers open interfaces. This is the core idea of the Edison Orchestrator, which was already presented to some German customers at the 2021 Annual Congress of the Radiological Society of North America (RSNA) in Chicago, but only officially in March at the HIMSS in Orlando and in Germany at the DMEA in Berlin was presented.

Who owns the data?
To the one who feeds them. It is important that our solution works manufacturer-neutrally. This means that neither a hospital nor any other data feeder is forced to become dependent on anything. And yet our digital platform can map the entire patient path from diagnosis through treatment to follow-up care at home.

This is a new approach for a company like ours that has been building data-generating hardware solutions for healthcare for many, many years - with around 70 more innovations coming this year alone. However, the AI approach that the Edison ecosystem embodies is no longer limited to the machine, to the hardware, but creates something completely new that can revolutionize workflow and knowledge management if done correctly - and of course always in compliance with data protection regulations – sets in.

It can be assumed that there are already international benchmarks that can show that this approach works?
Secure. The first prototype IT solutions have been in use by major international customers for some time, which allows us to underpin a secure, widely tested system with corresponding empirical data and findings from these pilot tests.

In the cover interview of the first issue of “Monitor Healthcare Research” this year, Prof. Dr. Wolfgang Holzgreve, the CEO of the University Hospital of Bonn, said on record that he was proud that his large hospital was fully digitalized by the end of the year. But he also says that many other German clinics are still far from being ready. This means: There is still a lot of catching up to do, and of course there is also market potential for you, but there is certainly also a lot of educational work.
Many clinics receive billions of euros from the Hospital Future Fund to advance digitalization. This is a laudable approach, but it also means: You cannot order digitalization, you have to want it, implement it and, above all, anchor it in people's minds as a useful and meaningful instrument. Digitalization only survives if people want to take part because they realize that what they do can be done easier and better with data support than with pens, notebooks and Excel tables filled out by hand. However, there is another difference that many people are not aware of when they think they have been “digitalized”.

Which?
The challenge is to move from the state of “through electrification” to that of “digitalization”. We are still in a kind of intermediate process that is electrifying processes, but not yet completely digitalizing them. For the latter, you need what is often still lacking: interoperability. This is the only way to ensure that the systems really talk to each other and, above all, understand each other, which will streamline and speed up processes, but at the same time make decision-making processes faster and safer. That's a big difference, and often a question of understanding.

And you name your new “Artificial Intelligence Orchestrator” Edison, of all people, whose invention of alternating current triggered the beginning of the comprehensive electrification of the industrialized world.
After all, he is the founding father of our company, which goes back to the Edison General Electric Co. Edison stands for innovation. We are aware that we are only at the beginning of a long journey. We at GE are probably a little further ahead than others in general, but AI is a broad field on the one hand and a high standard on the other. We are still at the stage of machine learning and the use of more or less sophisticated algorithms, which are still a long way from real artificial intelligence and a truly thinking system. Nevertheless, the algorithm-based approach that is possible today helps us to both improve the workflow and support decision-making processes, with the combination of the two being the solution in our view. This makes clinical diagnosis and treatment faster and safer.

According to information from the Federal Office for Social Security (BSS), the number of applications submitted for the Hospital Future Act is now around 6,300, with almost all of the funding items covered having digital components. How many of these funding issues can you offer solutions for?
Most applications came from funding item 2 “Patient portals” and funding item 3 “Digital documentation”. These two areas alone account for around 2,600 of the 6,300 applications. This is followed by the areas of “emergency room” and “IT security” and a number of other smaller areas with very few applications. We offer solutions for 10 of 11 eligible sub-areas, particularly for interoperability and documentation.

Patient portals and apps are certainly nice and useful, but they have very little to do with workflow. Why are complete systems such as your knowledge management system not (yet) in demand?
This is because digitalization, as we understand it, is still far in the future. The hospitals are already challenged by the complexity that the Hospital Future Act brings to them. You also have to know where the very specific interest in very few digitization approaches comes from.

Because politics has built in a kind of sword of Damocles.
Exactly. In two of the six funding areas - “patient portals” and “digital service requirements” - there is a risk of deductions from 2025 if insufficient digitalization is determined.

The surveys conducted by the “DigitalRadar Hospital”, in which hospitals that want to receive funding must take part in accordance with Section 108 SGB V, showed that when asked about their own digital maturity, 1,200 of the 1,600 respondents were at level 3 or 4 Classify 10. Is this self-reported maturity level high or low?
I think the answers are within their own
Assessments on the subject of digitalization reflect a very realistic picture. You can see this if you analyze the survey more closely and realize that the companies generally rate themselves better because they see the technical systems used for administration and billing - the classic KIS - as the measure of things and possibilities. In areas such as workflow or patient safety, the self-rating is even far below 3. But this is exactly where the big challenge begins: Having a truly digitalized hospital is not a question of using a hospital information system, which is now state of the art, but rather precisely that of successful interoperability.

Maybe there is a lack of imagination?
Most of them too. But above all, there is a lack of resources. With the manpower often available in IT, you can set up smaller projects, but if a hospital wants to set up a workflow project, it not only needs a good provider, but also human resources, a lot of know-how and specialist knowledge that is neither generally available , still everyone can afford. All of this then subconsciously leads to a lack of imagination. Many companies then prefer to take the path of least resistance, where they can safely achieve the digitization rate required from 2025, whether this makes sense or not. The “best of breed” approach is usually used to update what you already have or to add additional modules that the existing IT service provider – usually a HIS provider – happens to have in its portfolio.

This seems to have very little to do with a digital strategy.
I think such an approach is a shame because it gives little chance to the possibilities that already exist today. On the other hand, it is certainly understandable because it is intended to avoid many of the apparent uncertainties that can accompany any change of provider. Unfortunately, the “best of breed” approach can lead to monopoly situations and, as mentioned, stand in the way of an innovative and holistic digitalization strategy. That's why we deliberately chose a manufacturer-independent approach for our IT solutions, with which a hospital, even if it wants to keep its current HIS, still has the opportunity to tackle digitalization in the sense of a real workflow improvement.

The Hospital Future Act does see this
Discounts, but no bonuses, for those who, instead of many small, insufficient solutions, tackle a large solution such as a workflow-optimized and supply system-optimized house. In this way, you make manageable projects that are very nice and that you can look forward to can write digitally, but are actually just a fig leaf because you can't really improve care with it.
That's how it will be. But we also have many customers with whom we work on larger issues. Funding criteria 2 and 3, for example, also include workflow solutions in the area of cardiology and radiology, but also solutions for patient data management and exchange, which can certainly be seen as the beginning of a more far-reaching workflow improvement. Not only is it “electrified”, but it is also precisely analyzed which process can be digitized in such a way that it also creates benefits.

The difficulty is certainly that a hospital consists of a wide variety of areas.
And every area - from emergency medicine to nursing - has its type of - as we say - horizontal digitalization, which will also help to advance the level of digitalization of the German hospital system. But what will happen when we reach the stage of vertical digitalization?

Are we then at real digital hospitals like Johns Hopkins?
We also have them here, they are called Charité, UK Essen and Vivantes and maybe also UKB. But unfortunately, both nationally and internationally, people forget the number of houses that are still very far away from this. However and whatever you do: the KHZG will help ensure that the degree, but above all the acceptance, of digitalization will increase.

You certainly have an insight into many houses. Where are we in this country on the path from “electrification” to “digitalization”?
Given the resources available to it, a small, regional house faces a really big challenge in even coming close to implementing the solutions it demands. There will be no room for big throws. The situation is different for larger municipal institutions, larger corporations and of course university hospitals, which will separate themselves from the rest.

In Great Britain, for example, the clinics operating in a large region are networked via a common IT platform, i.e. a kind of data pool.
This is a viable approach. The fact that there are so few pool solutions in the IT sector is because the topic of data is closely linked to data protection and data sensitivity, which rightly have to be high. Looking back, if Covid-19 has brought something good with it, is that nowadays you can look at the topic of digitalization, AI and simplification of processes not only through the eyes of data protection, but also of health protection, without being immediately pilloried. But not only the pandemic, but also the shortage of skilled workers that is becoming visible everywhere will mean that the entire health system will have to raise all its resources in order to continue to function well - one of which is digitalization.

Describe a best practice example that can be labeled digitalization rather than electrification.
The Albis and Sana clinics should be mentioned here.

These are both privately financed hospital groups. Are there other examples, for example in the municipal sector?
The Nuremberg Clinic comes to mind, where we have linked our cardiology information system with various other digital solutions. By introducing our central IT solution for cardiology, the Nuremberg Clinic has now achieved a time saving of 60 percent in digital cardiological reporting, with the creation of a structured report taking between 5 and 10 minutes.

GE Healthcare is now set to become independent from 2023 and will then focus exclusively on precision medicine. What do you mean by that?
We are already looking forward to the spin-off in the first quarter of next year. From then on we will be a truly large company that can reinvest the money we generate into our own development. We look forward to this independence, for our customers, for our employees and for what we do.

What do you mean by “precision medicine”?
We actually use the English term: “Precision Health”. The English term is much broader than the German translation, which is usually only used in a medical context. “Precision Health”, on the other hand, means a meaning and value chain across the entire patient path, but also extends into areas such as patient safety and theragnostics – i.e. diagnostics and therapy. We will gradually expand the focus field of Theragnostics. For example, last year there was an acquisition of an invasive medical company called BK Medical. If you imagine a patient's journey - from initial diagnostics, to theragnostics, monitoring and knowledge management, you have what GE Healthcare means by “Precision Health”. This means that our scope will expand rather than narrow.

What do you expect from 2023?
GE Healthcare is the vision of a company with around 45,000 employees and global sales of $20 billion. This is going to be a pretty big spin-off, perhaps the biggest ever in the medical field. We will then focus entirely on what we want to do, true to our mission statement “Improving lives in moments that matter”.

There are only a few months left until 2023. What are the next big steps for you?
There will be a variety of medium-sized steps. Despite the certainly demanding spin-off, one rule applies to us: We want to continue to concentrate 95 percent of our time on day-to-day business and not worry about the spin-off. That may not be entirely true for me this year, but it will be for my employees. The big strategic goals for the DACH region for the next few months is certainly the launch of the “Edison Orchestrator”. We are also strengthening our organization in the area of executive account management so that we can strengthen our presence with major customers across all of our products, including digital components or even AI solution approaches.

Mr. Bernhard, thank you for the interview. <<

The interview was conducted by MVF editor-in-chief Peter Stegmaier.

Christian Bernhard
has been responsible for the entire GE Healthcare portfolio as General Manager DACH (Germany, Austria, Switzerland) since January 1, 2021. Prior to this position, he built and led GE Healthcare Financial Services in Europe since 2016. Before joining GE Healthcare, Bernhard spent ten years at GE Capital in various commercial, Six Sigma, M&A and operational leadership roles in Switzerland, the UK, France and Germany. He is a Six Sigma certified Master Black Belt. He also holds a Master of Philosophy/Pedagogy and an Executive MBA from the Universities of Mannheim and Essec/Paris.