The German healthcare system has a good international reputation and is considered a role model for many countries. Nevertheless, its efficiency, structures, financing and control instruments are called into question again and again. The health care sector is facing increasing challenges in the form of demographic change, the rise in chronic and mental illnesses and the shortage of skilled staff. The diversity of these changes leads to very different perspectives in politics, health care, the economy, science and society concerning the future viability and need for reform of the health care sector. Debates about new practices, regulations, organizational forms or system structures are often guided by vested interests due to “a culture of opposition”, which constitutes an obstacle to innovation.  

Overcoming innovation obstacles

In order to overcome such innovation obstacles, researchers from Fraunhofer ISI have developed the “Zielfokussiertes Evaluationstool für Innovationen im Gesundheitswesen (ZEIG)“ (Objective-focused evaluation tool for innovations in the health care sector). This indicator-based tool is oriented towards twelve fields such as “quality assurance and improvement”, “prevention and health promotion” or “strengthening patients’ rights”. Innovations and activities in the health care sector can be checked for conflicting objectives before or after their introduction using test questions and an evaluation scale. This makes their effects transparent and able to be discussed.

Dr. Nils Heyen, who coordinated the ZEIG project at Fraunhofer ISI, describes the application of the evaluation tool as follows: “With ZEIG, we can review to what extent innovations in the health care system achieve twelve overriding objectives and therefore contribute to its positive overall development. These include good working conditions for medical and nursing staff as well as the economic success of health care facilities, the quality of care, or limiting the financial burdens on those insured. If potentially conflicting objectives are identified and then alleviated, this improves the chances that implementing an innovation will be successful. ZEIG can be used to estimate the future effects of an innovation and to evaluate the already visible effects of innovations and activities”.

Focus on social innovations

The ZEIG project considers innovations that imply an improvement for at least some of the actors in the health care system. The focus is on social innovations rather than technical ones. Examples include setting up new forms of cooperation between different actors, introducing mandatory staffing levels for inpatient care or redistributing tasks among the health care professions. ZEIG could even be used to test the effects and potentially conflicting objectives of a political reform of the health care sector.

Severin Schmidt, head of the social policy discussion group and responsible for the topics of health care policy at the Friedrich-Ebert-Stiftung, emphasizes one main area of application of the evaluation tool: “ZEIG can be used in particular for health care policy discussions and negotiations in which the different actors are already in entrenched positions. The tool makes it harder to reject proposals across the board, makes interests more tangible and makes contentious and uncontroversial points more visible. The entire health care system could benefit from this”. In addition, the tool can be used for individual actors as part of a self-reflection exercise and in a research context.

ZEIG is freely available and can be accessed online at www.zeig-analyse.de.

The Fraunhofer Institute for Systems and Innovation Research ISI analyzes the origins and impacts of innovations. We research the short- and long-term developments of innovation processes and the impacts of new technologies and services on society. On this basis, we are able to provide our clients from industry, politics and science with recommendations for action and perspectives for key decisions. Our expertise is founded on our scientific competence as well as an interdisciplinary and systemic research approach.