Prescription apps are being prescribed more frequently – but digitalization in healthcare is progressing only slowly
30.06.2025 15:47
Electronic patient records, e-prescriptions, and apps based on doctor's prescriptions: Germany is driving forward the digitalization of its healthcare system. Digital health applications (DiGAs), in particular, designed to support patients in their treatment, have been increasingly prescribed by doctors since their introduction in September 2020.
In 2023, the number of DiGA prescriptions is expected to reach around 235,000—more than double the number in 2022. With an average manufacturer price of €529 per app, the DiGA market volume was around €125 million. In 2022, it was approximately €60 million.
At the same time, the number of applications covering a broad spectrum of illnesses – from spinal and metabolic disorders to cancer and burnout – is also increasing. By mid-January 2024, 53 applications for 12 therapeutic areas had been added to the DiGA directory – 20 more than in the previous year. This is the result of analyses by the management consultancy McKinsey & Company on the occasion of the new "E-Health Monitor." For the publication, McKinsey measured the digital progress of the German healthcare system using around 30 indicators – from the degree of digitization of hospitals and doctor's offices in Germany to the acceptance of e-health solutions and their benefits for patients.
"The growing importance of digital health applications in the healthcare landscape is an example of the progress made in digitalization in the German healthcare system," says Laura Richter, partner at McKinsey and editor of the study. "Physicians' interest in DiGAs is increasing. Around a third of physicians have now already prescribed a DiGA—more than double the number from the previous year. Another 14 percent plan to try the apps on prescription in the near future."
Demand for digital health services is also increasing on the patient side. In addition to DiGAs, over 14 million downloads of the 40 most popular health apps were recorded in 2023 – a further increase compared to around 12 million downloads in 2022. Furthermore, the proportion of patients requesting online appointment scheduling and digital prescription ordering rose last year to 78% and 69% respectively – each up 11 percentage points compared to the previous year. At the same time, the proportion of outpatient medical practices offering digital services also increased by 5 percentage points to 66%. Research is also increasingly focusing on e-health. 112 studies quantified the benefits of e-health solutions in 2022. 79% of the studies, a total of 88, demonstrated a positive benefit of e-health applications.
ePA activation is increasing slowly, e-prescription usage is picking up speed
Overall, however, digitalization in healthcare is still often bumpy. While almost all pharmacies (99% of all pharmacies) and doctor's offices (98% of all physicians' offices) are now connected to the telematics infrastructure (TI), the technological foundation of digital healthcare in Germany, at the same time, more than two-thirds (69% of all physicians' offices) reported weekly or even daily problems with the technology. Last year, this figure was 50%.
The electronic patient record (ePA) has also been spreading only slowly so far. However, it plays a key role in the digitalization of the healthcare system: Often referred to as the "heart" of digital care, it bundles doctor's letters, findings, and other medical documents in a central location and links important e-health applications such as e-prescriptions and DiGAs. In 2023, around 350,000 ePAs were activated. This was approximately 41% more than in 2022. Nevertheless, only around 11% of those with statutory health insurance in Germany have activated an ePA. However, the introduction of the opt-out procedure, under which insured persons automatically receive an ePA unless they actively object, is expected to boost the spread and use of ePAs. As part of its digital strategy, the Federal Ministry of Health (BMG) is now aiming for ePA coverage of 80% among those with statutory health insurance by 2025.
The e-prescription model clearly demonstrates how mandatory requirements can boost usage. While a significant increase in usage was already evident in the second half of 2023: While the number of e-prescriptions redeemed was still below 900,000 in 2022, it had already risen to around 18 million in 2023. However, this only corresponded to around 21% of the annual statutory health insurance prescriptions. It was only with the mandatory introduction on January 1, 2024, that the momentum for e-prescriptions gained momentum. By mid-January, around 22 million more e-prescriptions were redeemed than in the entire year of 2023 (as of January 22, 2024). This means that around every second prescription redeemed is now an e-prescription.
"The ePA and e-prescriptions are intended to become the cornerstones of digital healthcare in Germany. International experience shows that the introduction of the opt-out procedure could help the ePA achieve a breakthrough," says Matthias Redlich, partner at McKinsey and editor of the study. "Furthermore, it will be essential to continuously improve the user-friendliness of digital services so that they create real added value in practice and achieve long-term success."
Potential of telemonitoring hardly exploited so far
According to the study, telemonitoring could also benefit from regulatory stimulus. This involves monitoring and evaluating health parameters such as blood pressure, heart rate, or blood sugar levels remotely. Telemonitoring is currently only marginally widespread in Germany. This is demonstrated by a comparison with the US, where around 12% of the population now receives care via telemonitoring applications. In Germany, however, the number of telemonitoring patients – for example, for heart failure – is estimated at around 200,000.
Telemonitoring applications can have significant therapeutic benefits for patients and play an important role in the care of chronic diseases. On the one hand, they allow the continuous monitoring of vital parameters, giving doctors a broader database and faster diagnoses and treatment decisions. On the other hand, patients no longer have to come to the doctor's office in person for testing. In addition to contributing to improved patient care, telemonitoring can also generate significant economic benefits for the healthcare system. According to calculations by McKinsey, the potential benefit of telemonitoring technologies amounts to around €4.3 billion annually. 67% of this potential is attributable to the avoidance of hospital stays, 26% to shorter stays, and the postponement of treatment to outpatient care. Further potential arises from the avoidance of follow-up treatments and emergency transport of chronically ill patients.
"Telemonitoring applications can form the basis for vital medical decisions and also enable a structured evaluation of health data, which can also benefit therapy and healthcare research. Of course, it is essential that these technologies are secure and reliable," says Tobias Silberzahn, partner at McKinsey and editor of the study. "Germany hasn't yet reached its goal, but in the long term, digitalization in healthcare will contribute to improving both cutting-edge medicine and routine care, as well as making them more efficient and safer."
About the E-Health Monitor
Complementing the McKinsey analyses, numerous guest contributions provide a multidimensional perspective on e-health in Germany in general and telemonitoring in the German healthcare system in particular. Institutions such as the Federal Association of Self-Help (BAG Selbsthilfe) and the Federal Association of Managed Care (Bundesverband Managed Care eV) have their say. Current insights and perspectives from e-health providers and users, researchers, and physicians round out the E-Health Monitor 2023/24.
This edition of the “E-Health Monitor 2023/24” is once again published in book format by the Medical Scientific Publishing Company: ISBN: 978-3-95466-860-1
About McKinsey
McKinsey is a global management consulting firm that helps organizations achieve sustainable, inclusive growth. We partner with clients across the private, public, and social sectors to solve complex problems and create positive change for all stakeholders. We combine bold strategies and transformative technologies to help companies innovate more sustainably, achieve lasting performance improvements, and build workforces that will thrive for this and the next generation. In Germany and Austria, McKinsey has offices in Berlin, Düsseldorf, Frankfurt am Main, Hamburg, Cologne, Munich, Stuttgart, and Vienna.
McKinsey teams work in more than 130 cities and over 65 countries worldwide. McKinsey was founded in 1926, and the German office in 1964. Bob Sternfels has been Global Managing Partner since 2021. Fabian Billing has been Managing Partner for Germany and Austria since 2021.
Learn more at: https://www.mckinsey.de/uber-uns