How can digital health solutions in Germany truly transform care amid regulatory requirements, practical barriers, and the need to demonstrate real benefits for patients? This was the question at the heart of the scientific think tank “Between Innovation Pressure and System Inertia – DiGAs in Practice: Access, Reimbursement, and Political Reality”, organised by the Health Region South Lower Saxony and HAWK University of Applied Sciences and Arts under the DigiH4A project. In Göttingen, Germany, regional stakeholders from health insurance funds, providers, academia and industry came together to explore how digital health applications (DiGAs) can move from concept to real-world impact.
Between promise and inertia
The discussions quickly underlined a central tension. On the one hand, DiGAs hold clear potential to support prevention, mental health and chronic care. On the other, regulatory caution, fragmented responsibilities and limited resources slow down their path into routine care.
Participants stressed that innovation does not fail because of a lack of tools, but because the system changes around them too slowly. Without clear rules, predictable pathways and shared responsibility, even strong solutions risk getting stuck between pilot and everyday use.
Barriers, enablers – and the role of trust
Across groups, several barriers emerged: unclear reimbursement rules, complex application procedures, and limited time for healthcare professionals to explore and test new tools. Many doctors and therapists still see DiGAs as extra effort with uncertain benefit.
At the same time, the think tank highlighted concrete levers for change. Key messages include:
- Transparent, predictable processes between manufacturers, health insurers and regulators such as BfArM
- Patient-friendly access routes and mandatory education on digital tools to build confidence
- Clear training structures and billing codes so DiGA prescription becomes part of normal workflows
- Above all, trust: DiGAs must be perceived as complementary to professional expertise, not as competitors
Participants agreed that clinical guidelines are the real gateway. Only when DiGAs are embedded in evidence-based recommendations do financing, prescribing and implementation start to align. International examples from Norway and France show how clear, low-threshold pathways can speed up adoption significantly.
Collaboration beyond system boundaries
The think tank also showed that digital healthcare thrives where actors collaborate across institutional borders. Informal networks, regional partnerships and shared goals prove more decisive than any single regulation.
Initiatives such as the “DigiLotse” in Göttingen County and regional networking events demonstrate how local anchors can help patients, professionals and innovators navigate the digital landscape. Long-term collaboration models between start-ups, health insurers and public partners are seen as essential to maintain trust and keep promising solutions in the system.
From pilots to blended care
In everyday practice, DiGAs meet established routines – and the friction is instructive. Many professionals still experience digital tools as an add-on rather than an integrated part of care. This underlines the need for blended care models, where digital support strengthens rather than replaces human relationships.
Examples such as HelloBetter (pictured right) show that rigorous scientific evidence and real-world usability can go hand in hand. When digital interventions are woven into existing pathways, supported by training and reimbursement, they can reduce the burden on staff and offer patients more flexible access to support.
What needs to happen next
The conclusion from the think tank is clear: digital health transformation is not primarily a technical project – it is a societal one. To move from innovation pressure to everyday practice, participants highlight four priorities:
- Inclusion of DiGAs in clinical guidelines, linking evidence, financing and implementation
- Stronger networks between developers, providers, researchers and regional health actors
- Education and empowerment initiatives to build digital competence among professionals and patients
- Structured dialogue platforms between BfArM, health insurers, manufacturers and academia to foster transparency and accelerate innovation into care
Join the conversation
For DigiH4A and its regional partners, the think tank confirms both the complexity and the urgency of the task. The ambition is shared: digital health applications should not remain niche tools but become a natural part of care where they add value.
How do you experience DiGAs in practice – as a patient, professional or innovator? And what still needs to change so that digital innovation reliably reaches those who need it most?
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