In their 'EbM+Theory Approach' (2021 and 2023), Holger Pfaff and Jochen Schmitt address questions of evidence-based decision-making that evidence-based healthcare research dealt with 30 years ago. Their EBM+Theory Approach is based on at least six assumptions, the practical-empirical tenability of which is examined. A conclusion addresses the risks and side effects of the EBM+Theory approach and predicts that this approach will survive forever because it is based on eminence.

Prof. Dr Oliver Gröne, Chief Scientific Officer and Head of Research at OptiMedis AG and member of the PaRIS-SUR consortium, believes that the OECD Patient-Reported Indicator Survey (PaRIS) initiative will have a similar significance to the OECD Programme for International Student Assessment (PISA). The first flagship report was recently presented to the public. The survey is to be carried out every four years in future and, according to Gröne, will provide a 'truly unique set of indicators' for the further development of the participating (so far) 19 countries. However, Germany and Austria, unlike Switzerland, are not yet represented as German-speaking countries.

Introduction: Demographic change poses major challenges for medical care in Germany. Structurally weak regions in particular are already suffering from gaps in care, which are being exacerbated by the increasing demand for healthcare services and the simultaneous shortage of specialised medical staff. Regional healthcare networks, which follow the integrated care approach, offer a promising solution by improving care and making it more efficient through greater cooperation between healthcare stakeholders. However, networking is often context- and region-specific, meaning that existing approaches often represent isolated solutions. In order to promote the transferability of possible solutions, the question of which factors contribute to the success of healthcare networks and which obstacles stand in the way of their development will be answered. Methodology: A multi-case interview study was conducted to analyse the success factors and obstacles of regional healthcare networks. The data was collected through semi-structured expert interviews with those responsible for seven exemplary healthcare networks in Germany. The structured interview guideline included questions on the motivation for founding, financing, success factors and barriers, operation and successful network elements. In addition, a comprehensive literature review was carried out in order to place the empirical findings in a theoretical context. Results: Healthcare networks have the potential to significantly stabilise medical care in structurally weak regions, especially if coordination is carried out by a management company, there is close cooperation with non-physician healthcare professionals and a well-functioning digital infrastructure is in place. Nevertheless, it is clear that existing legal and financial framework conditions are hampering the further development of the networks. The healthcare networks are often heavily dependent on the personal commitment of the founders, which can lead to instability in the long term if no sustainable refinancing models are established for core and cross-sectional functions. The transition from initial project-related financing to a regularly financed operating structure proves to be particularly challenging. In addition, interpersonal factors, such as reservations about network work and mistrust among stakeholders, can cause resistance and make cooperation within the network more difficult. Conclusions: Regional health networks have the potential to sustainably improve medical care in structurally weak regions. However, to ensure their long-term success, political measures are needed to overcome legal and financial obstacles and to promote preventive measures, the nursing professions and the integration of civil society initiatives.

Following Prof Peter Sawicki (2004 to 2009) and Prof Jürgen Windeler (2010 to March 2023), Dr Thomas Kaiser has been the third Director of the Institute for Quality and Efficiency in Health Care (IQWiG) since April 2023. In the cover interview with 'Monitor Versorgungsforschung' , Kaiser, one of the founding members of the 'special-purpose organisation of the non-profit Foundation for Quality and Efficiency in Healthcare', sets out his goals for the coming years. The convinced EbM expert wants to strengthen international links and participation in EU projects and - as he says - dedicate himself to 'more scientific investment beyond the processing of our commissions'.

In Germany, we used to talk only about overuse and misuse, but today the German healthcare system is threatened by a new phenomenon: underuse. Missing specialist appointments, hospital closures, supply bottlenecks for medicines - and the costs are rising rapidly. The aim of the 'Autorengruppe Gesundheit' statement is therefore to place this new issue at the centre of public debate. It seems all the more important to draw attention to undersupply given the considerable reticence that can be observed in professional and scientific circles when it comes to this topic. Whereas a few years ago the focus was still on patient orientation and patient-reported outcomes, today, in the style of paternalistic concepts, there is talk of patient control and optimisation. The paper is divided into 7 sections: Clarification of terms, concept of underuse based on the Expert Council's concept of need, systematic approach to the forms of underuse with particular emphasis on access, and then specific presentation in five selected subject areas: general practitioner care, specialist care, hospitals, nursing care and pharmaceutical care. The penultimate chapter deals with the systemic causes of underuse. Finally, some possible solutions are discussed, which will be presented in more detail in subsequent papers.

In einem in englischer Sprache auf der Preprint-Plattform Research Square veröffentlichten Artikel mit dem Titel „Welfarebased healthcare planning: methodology and application to thoracic surgical treatment of lung cancer in Germany“ (1) hat eine Autorengruppe ein Modell zur Ermittlung der optimalen Anzahl und Lokation von Behandlungsorten entwickelt. Das vorliegende Paper entwirft ein „wohlfahrtsbasiertes Versorgungsplanungsmodell” (WHPM) und zeigt am Beispiel der thoraxchirurgischen Behandlung von Lungenkrebs einen Weg auf, die bestmögliche Allokation von Behandlungsorten unter Berücksichtigung aller dieser Aspekte zu ermitteln. Dabei hatte das beste Szenario mit dem höchsten Wohlfahrtswert nur 19 Standorte!

Die Techniker Krankenkasse (TK) hat sich in den vergangenen Monaten umfassend mit dem Thema der digital gestützten Ersteinschätzung und Terminvermittlung auseinandergesetzt und schlägt nun hierfür die Einführung eines strukturierten Modells vor. Das kürzlich vorgelegte TK-Konzept „Digital vor ambulant vor stationär”(1) soll Patient:innen mithilfe digitaler Unterstützung verlässlich und am medizinischen Bedarf orientiert in die richtige Versorgungsstufe lenken.

Background: With the use of artificial intelligence (AI), there is growing interest in AI systems such as ChatGPT for communicating health information. AI has the potential to improve public health literacy by serving as a source of information. At the same time, the question arises as to the possibilities and limitations of the use of AI, especially with regard to the quality and reliability of the information provided. Methodology: The study is based on a literature analysis on the topic of health literacy and AI. PubMed and AI-based literature analysis programmes were used for the search (as of September 2024). A total of 136 hits were identified for 2022-2024, of which 25 articles were included in the analysis after reviewing abstracts and full texts and evaluated with regard to acceptance, information quality and barriers. Results: The analysis showed that AI systems are generally able to convey health knowledge by providing easy-to-understand answers to health questions. However, there are also concerns about accuracy and the amplification of misinformation. It was emphasised that the public should be made more aware of the limitations of AI and the importance of professional advice. Conclusion: ChatGPT and similar AI systems offer opportunities to improve health literacy, but require more critical media skills. Future research should increasingly focus on target group-specific and ethical aspects.

Background: Healthcare is confronted with various challenges. The digital transformation represents both a challenge and an opportunity. Different expectations are associated with the digital transformation, which can only be achieved through high financial and personnel expenditure. Existing staff must be qualified in order to utilise the potential of digital transformation and fulfil expectations. However, it is unclear what qualifications staff need. The aim of this article is to analyse the skills profile from the perspective of quality and risk management and to identify further skills to promote digital transformation. Method: A semi-structured literature search was carried out in scientific and user-related databases and specialist journals. In addition, books and websites were included in the analysis in order to provide a broad publication base for the research. The competences were selected by one person and the identified competence and its assignment to the generic competence cluster was agreed with the participation of all authors. Results: A total of 89 competences for quality and risk management were identified and assigned to the three generic competence clusters of personal competences, technical and methodological competences and competences for promoting digital transformation. For the digital transformation competence cluster, 20 competences were identified, which cover topics such as digital literacy, possible uses of data analytics and artificial intelligence, the ability to make judgements about digital innovations, and will develop further facets with increased use in healthcare. Discussion: The competences identified expand the competence profile of quality and risk management officers and reflect their central role in the management and support of healthcare facilities. The scope and level of detail of all competencies listed may vary by organisation, most commonly associated with their size and culture. In order to achieve the goals of digital transformation, personnel must be sufficiently qualified. Building on this, this skills profile offers the opportunity to address employees in a needs-based and targeted manner with training and further education programmes. The extent to which quality and risk management officers qualify themselves with regard to the competences identified should be coordinated depending on existing professional groups with detailed specialist knowledge and a culture of exchange between all professional groups should be promoted

'You don't need to be in the consulting business these days if you can't do Europe.' This is the motto according to which the owner of the IGES Group, Prof. Dr Bertram Häussler, has been building up the company with eight European country organisations - from Italy to the UK and Norway - under his own steam for around a decade. Häussler, owner of the group, is now igniting the next stage of expansion by transferring a large proportion of his shares to the athagoras Group, another international consulting company in the health science sector. This will provide IGES with capital for further expansion, but above all with expertise in the areas of marketing authorisation, market access and pharmacovigilance as well as artificial intelligence (AI).