Please enable JavaScript to view this page correctly WASHINGTON — The Defense POW/MIA Accounting Agency announced Friday that U.S His regiment was engaged in fierce fighting near the town of Biesdorf when he was reported killed in action by small arms fire on Feb His body was unable to be recovered due to intense fighting against heavily reinforced German forces on an elevated position Pittis’s remains were not accounted for during or after the war the American Graves Registration Command was tasked with investigating and recovering missing American personnel in Europe remains were recovered from a wooded area southeast of Biesdorf an American helmet and ammunition were found but no identification tags or personal effects were located The remains were designated X-8517 Neuville and interred at the U.S known today as the North Africa American Cemetery Department of Defense and American Battle Monuments Commission personnel exhumed X-8517 Neuville for forensic analysis and comparison with unresolved soldiers known to have been lost in the Biesdorf area The remains were sent to the DPAA laboratory for identification scientists from DPAA used anthropological and dental analysis scientists from the Armed Forces Medical Examiner System used mitochondrial DNA Pittis’s name is recorded on the Walls of the Missing at Luxembourg American Cemetery along with the others still missing from World War II A rosette will be placed next to his name to indicate he has been accounted for Pittis will be buried in Freeport on a date to be determined Today's breaking news and more in your inbox announced that Zach’s Towing signed on as a U-Haul .. MARTINS FERRY — Martins Ferry police are looking for suspects following reports of shots fired on Broadway Street .. | https://www.timesleaderonline.com | 200 S A public graveside service with full Military Rites will be at 2:00 pm on Tuesday June 4 The Barkley Funeral Chapel in Greenup is assisting the family Harold had four sisters and two brothers: Harley Poulter Lana Lee; nephews Olin Harley “Bub” Cline in the European Theater during the Second World War Historians at the DPAA report that on 8 February 1945 Private POULTER was killed in action near Biesdorf An officer for the regiment submitted a report stating that Private POULTER died by small arms fire after being engaged by enemy forces from an elevated position A solider from his unit also witnessed his death his remains were not accounted for during or after the war Harold was awarded the following medals: Purple Heart European-African-Middle Eastern Campaign with two Bronze Service Stars would like to thank the Barkley Funeral Chapel and Rex Vault in Newton for donating their services and stainless-steel Athenian Burial Vault Online condolences can be expressed at www.barkleyfuneralchapels.com Staatliche Museen zu Berlin A remarkable archaeological find dating back to Berlin’s prehistoric era is now on display as part of the permanent collection at the Museum für Vor- und Frühgeschichte: the roughly 11,000-year-old deer mask from Biesdorf will be housed in its own display case in the Neues Museum’s Stone Age hall The deer mask from Biesdorf is among the oldest human-made artefacts found in the Berlin region It was unearthed in 1953 in the course of construction work conducted along the Wuhle river in Berlin-Biesdorf The mask is approximately 11,000 years old and was preserved in the calciferous silt of what was once a lake depression The back of the deer’s head has been cleanly sliced off and both of its antlers have been bisected lengthwise Objects such as this were most likely worn as ornamental headdresses – a hypothesis that is substantiated by the decision to reduce the weight of the antlers and by the fact that other similar artefacts had holes drilled into them that were presumably used to fasten the masks to a person’s head Similar finds have been made in England and Germany dating back to the early Mesolithic period – around 9000 to 8000 BC Deer antler masks – especially those that have been as pristinely preserved as the mask from Biesdorf – are incredibly rare and provide us with invaluable insight into the ritual practices of Stone Age humans the Biesdorf deer mask was on display at the Stadtmuseum Berlin Ever since it was founded more than 190 years ago the Museum für Vor- und Frühgeschichte had collected archaeological artefacts – first from Prussia When the Märkisches Provinzialmuseum was founded in 1874 a second institution was created that went on to amass a collection of artefacts pertaining to the prehistory and early history of Berlin and Brandenburg the prehistoric collection of the Märkisches Museum was held in trust at the Museum für Vor- und Frühgeschichte negotiations were conducted regarding the question of where the archaeological collections should be held A recent cooperation agreement with the Stiftung Stadtmuseum Berlin (formerly the Märkisches Museum) stipulates that the Museum für Vor- und Frühgeschichte is to preserve Berlin’s archaeological artefacts in trust on a long-term basis This decision sees the deer mask move from Biesdorf to the Neues Museum where it will join other extraordinary finds dating back to the end of the last ice age and the beginning of the current interglacial period including the Hansaplatz Elk and the Combe-Capelle Skull This special piece of Berlin’s prehistory will be displayed in a central position in the museum and will be housed in its very own display case execution becomes easier: integrating data and creating new tools and training efforts occur in the context of a clear vision for driving business value—a vision that’s unlikely to run into funding problems or organizational opposition one key benefit of big data and analytics is that you can learn things about your business that you simply could not see before Stefan Biesdorf is a principal in McKinsey’s Munich office David Court is a director in the Dallas office and Paul Willmott is a director in the London office Mobile health—the practice of healthcare supported by mobile devices—is often hailed as the future of digital services in healthcare our survey shows that demand for mobile healthcare is not universal It is therefore not the single critical factor in the future of healthcare digitization and providers often think they need to be innovative when designing their digital-service offerings But the core features patients expect from their health system are surprisingly mundane: efficiency and the availability of a real person if the digital service doesn’t give them what they need and more social media are far less important to most patients (Exhibit 3) many institutions—not only those in healthcare—think it is necessary to “go big” before they can achieve anything; they believe they must build a comprehensive platform with offerings along the entire spectrum of customer services But our survey finds that it can be smarter to start small and act fast (Exhibit 4) Understanding the myths and realities about what patients want from digital healthcare is vital to capturing its value—but where should healthcare organizations go from there Three steps can help healthcare companies begin their journey toward the third wave of digitization We believe the healthcare industry is on the cusp of a third wave of IT adoption and that now is the time for it to go all in on digital strategies Understanding what patients want—and what is purely myth—can help pave the way The Research Area Biesdorf offers a chance to experience the archaeology of Berlin. In a unique cooperation, the Museum für Vor- und Frühgeschichte (Museum of Prehistory and Early History) the Düppel Historic Village (Museumsdorf Düppel) students of the Free University Berlin and teenagers from Marzahn-Hellersdorf present the work of Berlin’s archaeologists The East-Berlin district of Marzahn-Hellersdorf is known for its “Gardens of the World” (“Gärten der Welt”) and to an extent also for its buildings made of precast concrete slabs the so-called Plattenbauten that were widely erected there during the times of the GDR archaeologists have revealed that the district has much more to offer During preparation works for the construction of new buildings in Biesdorf a total of 22 hectares of land was excavated between 1999 and 2014 This uncovered evidence of 10,000 years of settlement history along the small river Wuhle that runs through Biesdorf These questions are answered in the special exhibition Berlin’s Largest Excavation which reveals how archaeologists work and what conclusions can be drawn from their research One of the key aspects of the exhibition is the reconstruction of archaeological finds and features Part of this is the reconstruction of a well which fabricated by the Düppel Historic village more than 100 wells were excavated in Biesdorf wells are one of the most prominent features from this area The reconstructed well will be completed before a live audience on the “Vivid Archaeology Day” scheduled for 6 October 2019 a replica of a Stone Age deer mask has been specially manufactured for Berlin’s Largest Excavation Interactive stations within the exhibition are designed to encourage participation and allow visitors to gain a better understanding of the work of an archaeologist archaeology students from the Free University Berlin will regularly perform small excavations within the special exhibition and explain their work while doing so every thursday and friday from 2 p.m the students will excavate what are known as “block excavations” These blocks of earth were attained at field digs in order to be able to later excavate them in detail under laboratory conditions Thanks to the support provided by the Berliner Projektfonds Kulturelle Bildung young people from the youth support organisation Manege gGmbH in Marzahn-Hellersdorf are now able to play an active role in the project Exploring Biesdorf contributing to the design of the exhibition under the guidance of the set designer and interactive educator Anita Fuchs They are designing an education station covering various areas of enquiry are building parts of the exhibition architecture the Biesdorf Research Site is the first participatory exhibition at the Berlin Museum für Vor- und Frühgeschichte The Neues Museum, Kupferstichkabinett, Kunstbibliothek, Museum für Fotografie and Museum Europäischer Kulturen Reopen in June U-Bahn: Museumsinsel (U5)S-Bahn: Friedrichstraße Sun 10:00 - 18:00Mon closedTue 10:00 - 18:00Wed 10:00 - 18:00Thu 10:00 - 18:00Fri 10:00 - 18:00Sat 10:00 - 18:00 Annual membership Staatliche Museen zu Berlin from just 25,00 EURAnnual Passes for the Staatliche Museen zu Berlin Tel 030 - 266 42 42 42 (Mon - Fri, 9 am - 4 pm)Questions | Bookings | Feedback Press release Museum and the City: “Die Überheblichkeit des Heute erschüttern” – Archäologe Matthias Wemhoff im Interview on the blog of the Staatliche Museen zu Berlin (German only) The dates displayed for an article provide information on when various publication milestones were reached at the journal that has published the article activities on preceding journals at which the article was previously under consideration are not shown (for instance submission Journal of Environmental ManagementCitation Excerpt :Only scientific articles were selected (excluding reviews) with an impact factor (IF) (JCR) (2019) above 1 The titles and abstracts of all articles were carefully read and the articles outside the topic (which did not deal with OAD-FW experiments) and unavailable were discarded totaling 66 articles selected to make up the bibliographic portfolio (Brown and Li Bibliometric analysis has been used to discover the structure of knowledge and development of a research field (Pritchard Science of the Total EnvironmentCitation Excerpt :In addition high-intensity stirring increases the contact of bubbles with surface-active materials and hydrophobic materials and strengthens their adhesion Previous studies have shown that the appropriate stirring intensity generally ranges from 30–120 rpm (Eshtiaghi et al. and some researchers have pointed out that stirring for 10 min per hour is sufficient to prevent foaming (Moeller et al. 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Amid the disruption of traditional medical care caused by COVID-19 some patients have found assistance via new online services these patients found themselves part of digital health ecosystems which are networks of digital service providers that offer a single solution for users’ healthcare needs (see sidebar “Existing digital health ecosystems”) Two recent McKinsey articles—“The next wave of healthcare innovation: The evolution of ecosystems” and “Digital health ecosystems: A payer perspective”—highlight the importance and potential of evolving digital health ecosystems about the roles of different healthcare players because they can differ significantly depending on each player’s market Several digital health ecosystems already exist Widely known examples are Apollo Hospitals in India; Pulse by Prudential in Asia; Ping An in China; and the global Vitality program by Discovery in South Africa WELL was recently launched in Switzerland as a joint venture of Zur Rose Group These ecosystems differ from single solutions by offering user-facing apps via a shared platform that integrates multiple applications into seamless patient journeys Such journeys include solutions for symptom checking This article analyzes data from an interview series with 22 key international industry experts as well as with 81 participants of our ninth Digital Healthcare Roundtable to explore the following three themes: why and when healthcare players seek to provide digital healthcare solutions what kind of digital health ecosystem healthcare players should provide and how the implementation of a digital health ecosystem should be approached 61 percent of respondents consider the main purpose of digital health services to be improving well-being They wish to “achieve clear and visible outcomes which are currently still indirect.” In addition 39 percent wish to keep up with the competition and “fear being disrupted as big-tech players and digital start-ups can leverage their technological capabilities and their [customer-generated] data as a core advantage.” This response was prominent among four of the eight interviewed groups: big-tech companies Other primary purposes mentioned include a wish to increase customer retention (38 percent) and marketing or branding (35 percent); digital health is seen as “a good area for marketing.” The latter topic was especially chosen by respondents from start-ups and payers and insurers Integrating core products into digital health ecosystems and offering patient journeys are seen as criticalWhen prompted by several statements about digital health ecosystems a vast majority of survey respondents generally agreed that ecosystems will generate great economic impact (86 percent) are critical to offer to existing customers (82 percent) and need to be integrated with existing products (77 percent) The most common core belief about digital health ecosystems is that patients are looking for integrated journeys rather than single solutions (90 percent) 63 percent of respondents believe they are best positioned to orchestrate a health ecosystem Of the groups that generally agreed they could orchestrate a digital ecosystem payers and healthcare providers expressed the most confidence while pharma respondents were the least confident This suggests there can be different natural owners depending on medical conditions or journey steps such as when moving from awareness to diagnosis or from treatment to adherence management The implementation of digital healthcare solutions is often considered time critical but requires careful planningA majority of survey respondents anticipate implementing digital healthcare solutions within the next three years players believe that “a well-functioning ecosystem will still take some time,” with 41 percent expecting to move on this topic within one to three years respondents do not believe that a time span of more than three years is needed because many already include ecosystems in their strategic plans This underlines the point that if healthcare players want to be part of the creation of digital health ecosystems they should start conversations as soon as possible Seventy-seven percent of survey respondents expected high demand for convenient digital health ecosystems among customers While one of the core beliefs is that patients want integrated journeys (as noted in the previous section there are three success factors that are considered even more important than end-to-end journeys Respondents “consider convenience as success factor number one to reach and retain customers with [their] digital health solutions.” Following this trust (60 percent) and impact on health outcomes (53 percent) are seen as important requirements to satisfy the needs of the customer which is predominant across sectors in Europe is preferredRespondents largely prefer the string-of-pearls approach in which individual applications reference one another with the customer needing only a single sign-on account This is especially true for players in the pharmaceuticals sector and payers and insurers prefer the so-called superapp approach in which an app integrates several functionalities from multiple providers in one place While players assume customers will demand integrated patient journeys 64 percent deem the string-of-pearls approach to be “more realistic” because integrating various solutions into a single app is highly complex and requires significant effort per solution as well as concerns over privacy and data security China and other Asian countries have predominantly used superapps which include a range of services from food delivery to telemedicine “health-management solutions to telemedicine” is not seen as a viable starting position by respondents A clear strategic direction (74 percent) and cultural transformation (62 percent) are considered the most important success factors for the implementation of a digital health ecosystem This shows that many players would like to build up ecosystems but are not sure how to proceed strategically or how to shift cultural mindsets 54 percent of respondents identify collaboration with the right set of partners and 38 percent identify technological capabilities or know-how as being important to achieving “a wide customer reach even if you have a small market share yourself.” Ecosystem participants do not see short-term returns as a requirement because they believe in a long-term effort when building a digital health ecosystem Respondents also repeatedly pointed to interoperability as a success factor beyond the suggested survey answers “Providing interoperability just in data management is not sufficient for a successful ecosystem and workflow management” to create a consistent customer experience “We need a broad and integrated data pool that can easily exchange data from one point of the patient journey to another.” and digital health start-ups are seen as the driving forces in the digital health ecosystemA majority of survey respondents see big-tech players (62 percent) and digital health start-ups (47 percent) as driving forces for digital health solutions One respondent summarizes the role of the different stakeholders in this way: “Big-tech companies are building the highway while start-ups are building the cars and governments are removing the roadblocks.” Hence while governments are expected by respondents to be among the least important players when implementing digital health ecosystems they may also play an important role in enabling others While all players assume that big-tech companies will be the driving force in developing digital health ecosystems big-tech players do not rank themselves in the top category this view is reflected by the fact that payers and healthcare providers are the only players that rank themselves in the top category Participants prefer ‘making’ the front end while ‘collaborating on or buying’ the back end with capabilities and speed being key decision factorsSixty-three percent of respondents prefer to build the front end They want to “control customer touchpoints to access and guide patients” and believe they “have the in-depth understanding of the patient’s needs.” 71 percent are willing to collaborate with partners or buy back-end technology Potential advantages named by respondents include compensating for missing capabilities and increasing speed some players realized that “maintaining and operating the system by themselves is too cost intensive.” About the survey methodologyOur findings are based on the opinions of 103 key healthcare experts collected through structured interviews with business and digital-transformation managers from 22 businesses The structured interviews were conducted from November 2020 to June 2021 and questions were answered and discussed in one-on-one video calls Five of the interview questions were also asked of participants at our ninth Digital Healthcare Roundtable on May 7 Interviewed groups included healthcare providers Of the 79 participants who disclosed their location 5 percent in North America or South America Digital health ecosystems are more likely to succeed if players can identify their individual contributions and create their own road maps and regulations specific to certain countries Considering that all the respondents to our survey predict that digital health ecosystems will evolve in the next three years—or even within this year—it’s clear that players should move quickly to reflect on their position in the status quo and to determine the strengths of their roles in the digital healthcare landscape Do you want your voice to be heard? Share your views on digital health ecosystems by answering our digital health ecosystem survey on McKinsey.com and receive an analysis of how your views compare with those of your peers The authors wish to thank all participants of the structured interviews and the ninth Digital Healthcare Roundtable and Viktoria Medvedenko for their contributions to this article but our neighbors are already one step ahead Austria has ELGA—an electronic health record system—that can easily be accessed by any medical practitioner or hospital as necessary and Estonia send prescriptions electronically to the patient or straight to the pharmacy that delivers the medication And Britain’s state-run NHS has partnered with Google to deploy artificial intelligence (AI) as a way to utilize the inordinately vast pool of data about successful treatments and disease progressions that the NHS has compiled over the years and providers are hoping that digitization will enable faster access to data digitization holds the potential for massive bottom-line value A McKinsey study prepared in partnership with the German Managed Care Association (BMC) suggests that up to EUR 34.0 billion in potential value could have been realized in 2018 if the German healthcare system had been fully digitized This is equivalent to around 12 percent of its actual total projected costs of around EUR 290 billion this year Trends continue unabated: on top of a nominal annual increase of 4.5 percent Germany’s aging population and expensive treatment methods are driving the rise in health spending For this study the authors analyzed the potential value—primarily the potential savings—that might be captured through 26 digital solutions and then quantified these for healthcare in Germany observations and learning from previous projects and interviews with leaders in healthcare were used to assess the impact of each digital solution (see Appendix: “Study methodology and approach”) This study explores the most effective digital solutions that simultaneously benefit patients and reduce costs The methodology is based on a robust approach that has already been validated in Great Britain Any duplication of effects—triggered by the impact of multiple technologies on a single use case—were resolved by conducting a comparative analysis and defining two assumptions for 2018: Beyond determining the value of each digital solution the analysis also revealed how the value would accrue to the sector’s various stakeholders the study discovered that 70 percent of the value could be captured by healthcare providers with the remaining 30 percent captured largely by health insurers This finding clearly dispels the old argument proffered by many providers that digital technologies would only create additional work without delivering a benefit The study also addresses another healthcare myth: that digitally supported patient self-management would lead to the largest savings The reality is that digitization in this particular area is expected to release a mere EUR 4.3 billion for Germany the study shows that electronic health records and electronic prescriptions will have a vital role to play Their introduction will not only massively and directly increase efficiency but will also prompt improvements in care equivalent to more than double the value of the direct gains in efficiency The 26 digital solutions were divided into six solution categories: 1) paperless data Analysis showed that the potential value of digitizing healthcare in Germany approaches EUR 34.0 billion This sum comprises both efficiency gains and reductions in demand for services Demand will drop when duplicate examinations are avoided and subsequent treatments are minimized by improving treatment quality Most of the value will appear in inpatient hospital care (EUR 16.1 billion) and outpatient GP and specialist care (EUR 6.5 billion and EUR 8.6 billion the switch to paperless data is likely to have the greatest impact (EUR 9.0 billion) closely followed by online interaction (EUR 8.9 billion) and work flow/automation and outcome transparency (around EUR 6 billion each) patient self-treatment and patient self-care account only for around EUR 4.3 billion patients might see significant value in these solution types because they enable patients to have a greater role in managing their health issues and determining their own journey through the healthcare system which means there are fewer reference points to help gauge their value the study’s authors adopted a conservative analysis approach Deploying just the seven most promising solutions could help the German healthcare system capture more than 50 percent of the total value available through digitization The largest savings can be expected from the transition to unified electronic health records which represents potential savings of EUR 6.4 billion (19 percent) The value lies in the subsequent productivity and efficiency gains Unified electronic health records allow for faster by reducing the time needed for administration and cutting the number of unnecessary duplicate tests for patients to fully accept electronic health records they must maintain control over their data they decide which doctors and hospitals are given access E-prescriptions (EUR 0.9 billion) also facilitate paperless processes and increase quality since they allow for automatic checks of possible adverse reactions between the drugs that have been prescribed to a patient This solution also offers up to EUR 4.4 billion in potential value The option for patients and doctors to request advice from specialists can significantly reduce the amount of time spent on GP and consultant visits The virtual nature of the platform is particularly useful in rural areas where the number of on-site registered specialists is limited mobile networks for nursing staff can further improve quality of care A digital solution would give nurses and caregivers full access to patient information wherever they are working and allow them to record their findings on a tablet continuous care and monitoring of patients receiving outpatient care Digitization is not just transforming the work of doctors and nursing staff; it is also giving patients options for managing their own care and sharing relevant data with their doctors Digital tools already exist in the German market for managing mental health as well as cardiovascular Online portals are also available for booking appointments with GPs and specialist consultants which benefits both sides: patients do not have to spend time on hold on the phone and practice staff are freed up to deal with other tasks There are countless digital “health assistants” around today they deliver a mere fraction of the available potential Exhibit 2 illustrates how linking a drug management app with an online diagnostic service and online pharmacies could make patients’ everyday lives easier and healthcare cheaper To ensure patients can transition smoothly across the various links in the digital chain It would require data from the existing healthcare system to be integrated into the chain so that a patient’s previous diagnoses and related data are available to an online doctor Having an open electronic health record that allows patients to choose who is permitted to view their data is therefore the most important prerequisite to setting up these chains be ignored—particularly as the majority of digital solutions currently available lack a viable scalable business model: remuneration from health insurers is not an option at present an interface between online and traditional healthcare service providers must be established to allow patients to switch to a real-life doctor or hospital at any time Given the myriad of software solutions in use this will require considerable effort and expenditure It is unlikely that a single international provider will be able to establish a complete chain from start to finish some of the links in the chain are distinctly national in character and any provider of online medical services needs local providers who are registered with local health insurers and understand the local language International offerings will be available for other links in the chain—an AI-driven app for checking symptoms does not have to be redeveloped from scratch for each country Providers of these apps can do business with many users in a large number of countries Thus it makes very little sense for German health insurers to spend massively on developing similar apps for their own use Developing these apps is a job for organizations that have an international base and will find it easier to achieve the necessary scale to make the effort worthwhile Their payoff is that any cost increase will be minimized if they can attract 10,000 or 100,000 active users rather than 1,000 fully functional digital chains of pearls need an orchestrator to tie together the regional and international links in a chain Also necessary is an infrastructure made up of electronic health records and e-prescriptions to ensure that data can be shared between online providers and to establish links with the world of traditional healthcare providers Linking together several of these hybrid chains gives rise to an ecosystem that could offer new The implementation of digital solutions will trigger a value shift between the various stakeholders in the healthcare system If all the solutions are fully implemented we can expect the majority of the value (70 percent) to reach providers whereas payors and the healthcare system itself will capture only an average of 30 percent of the benefits The introduction of electronic health records would massively benefit providers which should be a good enough reason for them to support this development Other digital solutions tend to favor health insurers remote monitoring of patients with chronic diseases can be expected to deliver a total added value of EUR 3.3 billion which includes a reduction in hospital stays a subsequent drop in rehabilitation activities and a decrease in costs for emergency transport We can assume that payors could save up to EUR 2.3 billion by reducing case-group-specific remuneration for hospitals and eliminating redundant activities which means they would benefit from almost 70 percent of the potential value while the other 30 percent would be captured by providers these solutions will only be successful if providers actually prescribe them to patients healthcare providers would suffer financially were that to happen It might be useful at this point to consider balancing the various interests through financial incentives This example shows that the value pool and benefits for the various stakeholders are going to shift meaning those stakeholders need to discuss how that additional value should be distributed This study is intended to serve as a basis for this discussion providing initial insights and facts about expected value distribution The German healthcare market is at a crossroads Digitization is paving the way for new approaches to medicine and creating opportunities to address several of the country’s most pressing healthcare issues Although there are still some concerns about privacy patients are already taking advantage of digital healthcare solutions such as online services and interactive tools The use of digital solutions can also help make the system more efficient and establish a more heavily integrated approach Significant challenges await the healthcare market’s professional stakeholders politicians and regulatory authorities need to facilitate the rapid implementation of electronic health records and e-prescriptions It is important to ensure that health records allow for open interfaces between online and offline care and that patients retain absolute control over the personal data that is created and shared Business models based solely on accessing healthcare data should be avoided at all costs regulators should rethink the current structural options for digital care They need to offer opportunities for health insurers to build ecosystems of online and offline providers that create real value Health insurers need to commit to their role as orchestrators of hybrid care models And since electronic health records and e-prescriptions are essential components of these ecosystems health insurers also need to actively support their development stakeholders in the healthcare market also need to carefully monitor activities by companies outside the sector: several global digital champions are already dipping a toe into the waters of healthcare Experience has shown that the tech giants’ appetite for larger shares of a given market grows quickly and they strive for dominant market positions Digitizing the healthcare system will affect every step of the value chain including pharmaceutical and medical technology firms These firms are already building new digital care models (“beyond the pill”) and discussing possible business models Even if there is no clarity yet about the role they might play pharmaceutical firms can become partners to emerging digital care chains or can even establish themselves as orchestrators within these chains The trend toward digital care models will continue and the value pool will shift from traditional care to a new The future hinges on the extent to which traditional players accept and help fuel this revolution and whether new competitors will claim all the potential for themselves This study demonstrates the scope of the potential economic benefits to the German healthcare system through digitization all of its stakeholders should learn from other industries’ experiences with digitization which has delivered significant improvements each time its efforts were focused on the customer and progress in the sector is characterized by faster and more affordable treatment and improvements in health outcomes A more efficient and more effective digital healthcare system requires stakeholders to start making progress now The value that could be realized is so immense that there will always be someone else waiting to capture it Dr. Steffen Hehner is a senior partner in McKinsey’s Dusseldorf office; Dr. Stefan Biesdorf is a partner in the Munich office; and Dr Manuel Möller is an associate partner in the Frankfurt office there is a tendency to believe that technological capabilities are key enablers In discussions with a group of leaders from the European pharma and medtech industry most participants said that technology is not the main issue Scaling up their success from individual pilots to a level of implementation that would lead to substantial impact on their overall business models requires an investment in people and culture—namely moving from a few dozen talents in a digital center of excellence to building digital talent at scale and transforming the mindset and culture of their overall organizations For our biannual European Roundtable on Digital in Pharma and Medtech we invited 25 digital leaders from throughout the European pharma and medtech industry to take stock of digitization in pharma and identify the main barriers these leaders are facing in implementing digital strategy at full scale within their organizations This whitepaper summarizes these discussions and findings When asked for the main success factors and key barriers to success in digital one topic clearly stood out: culture and mindset Digital disruption has been a buzzword for a while and has already affected many industries The pharma and medtech industries operate within a complex environment with a multitude of stakeholders and interfaces from patients The combination of large data sets and the need for seamless interaction across multiple interfaces makes them an obvious choice for digital strategies for obvious reasons related to public health and regulation has slowed down the digital disruption here compared to other industries (e.g. I’m afraid of three guys in Kazakhstan coming up with the next big thing in healthcare that will fundamentally undermine the system we know With some of the large tech players entering this high-margin field with their own products and offerings (e.g. or with analytics-powered decision support systems) and digital healthcare start-ups building compelling offerings disruption has now firmly arrived in the pharma arena the vast majority of our regular roundtable participants have invested in the digitization of healthcare Most of them have set up digital centers of excellence and hired digital talents to start building their own digital healthcare solutions nobody really doubts that digitization has already reached the healthcare sector Having collected the first experiences in this area themselves we asked the digital leaders the question “what comes next?” We wanted to understand what the current status is and what the barriers to Digital@Scale were In a survey on the status of digital strategy it became clear that all pharma and medtech companies in our sample have worked on their digital strategy; many have kicked off pilots or prototype development projects The assessment of the maturity of their digital strategies revealed stagnation: goals and objectives of the digital strategy (the “what”) seem to be in place but there are challenges in defining a clear path toward the operational implementation (the “how”) (see Exhibit 1) we discovered that there is an increasing sense of urgency at most companies and a strong feeling that digital is important and that digitization needs to be incorporated into the overall business strategy there is currently very little evidence of Digital@Scale in the companies we talked to The likely root cause is that pharma and medtech companies still have to put the basic building blocks in place to drive Digital@Scale While we saw favorable responses to questions in the areas of “capabilities of experimentation” and “roles and responsibilities in digital,” the answers to the “company culture” and “technology foundation” questions were rather sobering Protoypes at speed are worthless if culture and willingness to scale are lacking Our survey asked participants for the five building blocks of a digital business model While the majority of the respondents (65 percent) had a strategy in place the “softer” components needed for higher “digital maturity” were present only in a minority of the surveyed companies Only 10 percent said that digital culture is not an issue for them our experts felt that the uptake of digitization was too slow and that leadership in their respective companies was rather conservative when it came to embracing new technologies the three areas that were most frequently mentioned were culture and mindset The challenge of digitization is no longer one of technological capability This is a clear indication that companies need to shift their focus from incubators and initiatives and start thinking about using a change management approach to scale their digital strategies we find that all pharma and medtech companies have started to work on their digital strategy and many have developed prototypes or run pilot projects Scaling up those small efforts requires an effort to change in culture and mindset because Digital@Scale requires buy-in not only from the senior leadership but from the middle management as well This need for strong leadership makes Digital@Scale a CEO and leadership team topic CEOs will have to team up with an operational digital leader with a robust vision that allows them to “upset the status quo” that hinders change and then begin to facilitate the large-scale sustainable implementation of digital models The national programme for IT in the NHS: A case history That’s because such ambitious information-technology initiatives—with a clear focus on IT support for clinical professionals—are typically beyond the core mission of healthcare systems which also often struggle with legacy systems that impede data integration and global connectivity has created a universe of consumers accustomed to everything from checking bank balances those consumers wonder why health systems cannot provide similar service innovations digital-health companies would appear to be best positioned: innovation is in their DNA they have attracted billions of dollars in venture capital and they have the flexibility to design applications that cater directly to patient groups Yet digital-health companies have been impeded by a lack of access to health data along with uncertainty about how to distribute the economic benefits generated by smartphone apps As system leaders struggle to unlock the full potential of technology in healthcare they must answer the following three fundamental questions: We believe the solution is to promote collaboration among providers and digital-health companies by enabling the exchange of health data—a vital enabler of more efficient care delivery To drive technology advancement and adoption each national or federal health system should consider an open innovation platform that holds healthcare data (beginning with highly standardized claims records) and provides data access that is enabled for application programming interfaces as well as common technical IT services such as identity This platform would serve as the basis for an ecosystem of digital-health-services innovation by certified third parties and could be steered by the respective health system Such a data platform could revolutionize health-service use and delivery and also help health systems bend the cost curve.2 2.Thomas Meek “IT could save NHS £13.7bn a year: Kelsey,” Digital Health stakeholders must address how benefits are distributed and keep four foundational principles in mind sustainable healthcare depends on IT-enabled services and a digital platform but healthcare systems are still unclear on where to focus investment what technologies provide the greatest benefits for patients and healthcare providers we did considerable research into the economic value of digital technologies in healthcare and found that implementing technologies such as patient self-services using digital channels rather than direct physician interaction or patient self-management solutions can produce net economic benefits of 7 to 11 percent of total healthcare spending our work on the ground has confirmed this original analysis including successful cases of IT implementation in the most advanced healthcare systems we believe an even greater impact can be achieved through coordinated joint effort This would involve the interconnection of all digital-health stakeholders through an open innovation platform “NHS IT needs £8 billion - McKinsey,” Digital Health most companies developing today’s digital-health applications lack proof that their apps produce a long-term improvement in user health that leads to economic benefits to health systems The absence of such evidence complicates a fundamental question: who should pay for the applications This option may seem unreasonable in a world where many mobile apps are free or extremely inexpensive But most inexpensive apps have “premium” versions that require users to pay considerably more to access the most desirable features and asking users to pay more for applications could restrict the market to those willing and able to do so—a segment that may not include those users who would benefit most Another option would be to provide the applications for free if users share data with the developer raises privacy concerns and other data-sharing issues Some successful examples include patients who share data with companies making a conscious contribution to research and discovery of new life-saving treatments and drugs Companies must collaborate with health systems to conduct the clinical trials needed for approval of their products One solution could be to introduce a “value-based digital health” reimbursement model: since health systems hold the data needed to measure outcomes why not use this information to measure the outcomes of digital-health services If cost reductions or quality improvements can be found in the data the benefits can be shared with the digital-health solution providers This approach would resolve issues for both sides: digital-health service developers can create sustainable business models while payors avoid the risk of investing in innovations that don’t deliver tangible value Given the poor results of most electronic-patient-records (EPR) projects it’s unlikely that developers will be able to link their data directly to patient records any time soon There is a viable alternative: claims data kept by payors this data is less detailed than patient records but they contain sufficient information to allow health systems to measure a digital application’s effectiveness—and the appropriate reimbursement claims records are standardized enough that adapting them to a common form is far less complex than merging records from thousands of providers into a single EPR Linking application developers’ data with claims records would require an open but highly secure IT platform that both sides could use The platform would have to restrict access to claims records to accredited digital-application developers—and limit that access to only the records developers really need Payors would have access to the developers’ data about the frequency and duration of application use patients would have to give consent regarding who could see and use their data Creating an open innovation IT platform will require close cooperation from multiple stakeholders in each country We believe that the likelihood of success will rise dramatically if each player focuses on what it does best As health systems consider the best approach to building an open innovation platform leaders must focus on the following four essential principles: The security of patient records must be a top priority The IT platform must have strong data-protection measures in place to minimize the risk of a data breach and allow individuals to determine who can see their records Many patients are concerned about the confidentiality of their medical records and some may not want application developers to have access to those records the popularity of online communities suggests that some patients are willing to share data if they believe it provides a near-term benefit In general, regulations have not caught up with today’s digital world, and this is particularly true in healthcare. Few countries other than the United States8 8.The United States passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996 and updated it in 2013 HIPAA contains clauses governing the privacy of individually identifiable health information and the security of electronic health information have passed laws governing the use and privacy of patient-identifiable data Countries differ significantly in how they view such issues as online consultations with doctors and whether patients can voluntarily share data with their doctors through channels less secure than traditional EPR systems National governments have yet to address such questions as whether the developers of a mobile app designed to increase medication adherence should be required to report side effects most European countries would agree on a similar set of rules If health systems are to pay for successful digital applications they should adopt innovative payment models based on the value delivered and not the activity provided a mobile app is shown to improve a patient’s ability to manage diabetes with less medication the developers should be paid based on the system’s savings changing the method of reimbursement may require regulatory changes it will be easier to prove the value of applications that produce immediate savings compared with ones that provide only long-term benefits The appropriate reimbursement for this latter type of application may have to be approximated as more data is contributed by payors and application developers and aggregated in the open IT platform it will be easier for countries to perform scientifically robust risk-adjusted measurements of outcomes achieved providers may come to believe that they should not be left out of the effort The owner of an open innovation platform such as the one we have described must be an organization that understands healthcare delivery and the need to protect sensitive patient data we believe that the owner should be the national health system or a national payor in each country Our research shows that patients trust public institutions with their personal health data: our research shows that in the United Kingdom 71 percent of people are more comfortable sharing personal health information with the National Health Service For the open innovation platform to succeed the owner must fulfill the role of an ecosystem manager that is able to attract and manage a community of innovators and operate a technical platform loaded with sensitive data This role would require a dramatic step up for most health systems examples exist of public institutions that have been able to take on this role successfully: the UK government has established a cloud-based marketplace between vendors and public-service buyers Health systems must begin developing open innovation platforms to enable payors and digital-health application developers to share data With appropriate patient privacy safeguards and regulatory changes these platforms will enable health systems to offer patients innovative ways to improve their health while avoiding wasting money on ineffective applications Many digital-health applications will no doubt fail but time to market will be accelerated for applications that succeed and their developers will enjoy a more sustainable business model The ideal result would be a digital-health partnership in which the end result is better than anything the stakeholders could have developed separately This approach would make digital-health innovation the first innovation in healthcare that is not leading to higher cost but to a more efficient and effective health system Gerardo Aue is an associate principal in McKinsey’s London office Stefan Biesdorf is a principal in the Munich office and Nicolaus Henke a director in the London office October 28, 2021By Uta Allenstein, Stefan Biesdorf, Ulrike Deetjen The COVID-19 pandemic dramatically cut in-person visits to healthcare providers. To help fill the care void, many providers across the world turned to digital alternatives, especially teleconsultations and therapeutics apps Providers are now better positioned than ever to integrate digital care with traditional care to improve access and patient engagement as the pandemic recedes Incorporating digital care gives providers a more holistic view of patient health which they can use to prevent or more effectively manage chronic conditions Growth in digital healthcare will accelerate the need for patient-centered data ecosystems The healthcare sector still relies on extremely decoupled decentralized data repositories due to the high bar of healthcare regulations such as HIPAA and business concerns about data ownership and sharing Any company that orchestrates an ecosystem will need to address not only technical considerations but also business issues including agreements to share intellectual property Here we provide five actions to lay a solid foundation Step one in setting up a data ecosystem is to receive patient consent with a process that encourages participation The process must be convenient and transparent for the user and backed by policies and mechanisms to prohibit the transmission or use of data in ways that violate patient consent These protections must be safeguarded across the entire data ecosystem the rapid pace of medical advances makes some patients reluctant to give consent because they are suspicious of how their blood or other medical information will be used—now or 20 years from now Ecosystem participants can encourage consent with messages that appeal to users’ altruism (for example life-saving treatments that new research might yield) they can partner with well-established and trusted patient-advocate organizations Anonymization is an important instrument to gain insights without risking exposure of highly personal data but true anonymity is difficult to achieve.1 To strike the right balance between the data that need to be collected and shared and the risks of personal-data exposure participants should focus on the specific business case and collect only essential data elements Security breaches can occur anywhere in the ecosystem they can erode trust and even imperil lives unidentified bad actors breached the Singapore national health database and stole personal data belonging to 1.5 million people.2 In the United Kingdom the WannaCry ransomware attack locked 34 hospitals out of their digital systems destabilizing medical devices and reducing admissions during the lockout by 6 percent Security is not simply a check-the-box exercise for the IT department or a concern only for the orchestrater It is a mandate for all ecosystem participants and requires a shared commitment from the outset to embed security into culture The ecosystem is only as strong as the weakest link so every participant must stress-test and adhere to compatible IT security standards Of all the activities associated with building a data ecosystem IT integration poses the highest risk of failure The US healthcare sector has more than 40 standards-development organizations.4 There are multiple US standards for data transport and exchange—for example Fast Healthcare Interoperability Resources (FHIR) and DirectTrust—and even for terminology The integration effort requires two building blocks: (1) a next-generation data layer that provides APIs to accommodate the wide range of interfaces and enables ecosystem partners to integrate their data repositories and (2) distributed data management with the ability to ensure data integrity and privacy Organizations increasingly view data as a valuable asset Some are amassing vast data stores and are reluctant to share them patients must retrieve and provide data while navigating through the ecosystem which leads to disconnects and limits visibility into health status and outcomes Although retaining ownership of the patient relationship is an important objective for ecosystem involvement, data sharing doesn’t undermine that goal. An ecosystem works only when everyone collaborates to achieve network effects, meaning the ecosystem’s value increases with more participants ecosystem participants can multiply the insights they derive from it—for their own benefit and that of patients participants can establish guidelines that will serve as a North Star emphasizing collaboration over competition and helping to resolve any ownership battles that arise the healthcare data ecosystem can begin to deliver on its promise Uta Allenstein and Jessica Mayer are consultants in McKinsey’s Munich office, where Stefan Biesdorf is a partner; Ulrike Deetjen is a partner in the Stuttgart office; and Jannik Podlesny is an alumnus of the Berlin office McKinsey: What about your long-term vision Are you considering expanding into other therapeutic areas For more interviews on how the pharmaceutical industry is evolving and how leaders can adapt, see Biopharma Frontiers Anton Kittelberger is the chief operating officer of mySugr and Frank Westermann is its CEO and cofounder Stefan Biesdorf is a partner in McKinsey’s Munich office.