Midwives Seek Inclusion in Germany's Health IT Reforms
Larissa.Health advocates for midwives' active role in digital healthcare advancements.
The German Federal Ministry of Health has proposed the "First Ordinance to Amend the Health IT Interoperability Governance Ordinance" (GIGV) to enhance interoperability within the nation's healthcare system. While this initiative is commendable, Larissa.Health, being involved as emerging digital midwifery service, has raised concerns about the insufficient inclusion of midwives and maternity-specific standards in the current draft.
Image by Shubham Dhage
Historically, midwives have been underrepresented in the development of digital health infrastructures. The draft designates the National Association of Statutory Health Insurance Physicians (KBV) as the authority for specifying various Medical Information Objects (MIOs), such as the electronic patient record (ePA). However, it omits the involvement of midwives and their professional associations. Larissa.Health advocates for the active participation of midwives in creating and updating ePA specifications and MIOs. Including midwives in the list of entities in Annex 2 of the GIGV would ensure that their specialized knowledge and requirements are adequately addressed.
The electronic maternity record is vital for monitoring the health of expectant mothers and their babies. Although the KBV has developed a MIO for the maternity record, it does not fully reflect the unique aspects of midwifery practice. Feedback from midwives and their associations has been substantial, yet their specific comments have not been sufficiently integrated. Issues include the lack of flexibility in documentation fields, particularly in areas like bacteriological examinations and urine cultures. Introducing free-text fields would allow for more detailed documentation, aligning with the practical needs of midwives.
Existing identification systems do not adequately recognize the midwifery profession. Modifying these systems to ensure the clear identification of midwives is essential for acknowledging their critical role in maternal care. The current adaptation processes hinder necessary adjustments to meet practical demands. A more adaptable process would enable timely implementation of relevant changes without prolonged formal approvals. Additionally, the use of technical jargon hampers understanding among practitioners. Clear and accessible communication is crucial to promote acceptance and effective use of the MIO maternity record in midwifery practice.
By addressing these concerns, the GIGV can more effectively promote interoperability in healthcare while recognizing and integrating the essential contributions of midwives. Larissa.Health recommends the active involvement of midwives and their associations in the development and revision of ePA specifications and MIOs. Enhancing the electronic maternity record to incorporate the specific needs of midwifery practice, including flexible documentation fields and appropriate identification systems, is crucial. Establishing procedures that allow for swift and relevant updates to standards will facilitate practical application. Using straightforward language in documentation and guidelines will ensure comprehensibility for all healthcare providers.
By implementing these measures, the healthcare system can ensure that midwives are fully integrated into the digital health landscape, ultimately improving care for expectant mothers and their babies.
