Governance of Large Innovation Projects: The Implementation of the Electronic Health Card in Germany

Lang, Achim; Mertes, Alexander

doi:10.1007/978-3-642-12563-8_11

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…However, since they are neither powerful nor numerous enough and, most importantly, have no particular goals regarding health care governance, they cannot serve as a bridge between the two competing sub‐coalitions. This is in line with Lang and Mertes's (2012) findings of a marginalization of IT actors in the German implementation network.…”

Section: Discussionsupporting

confidence: 91%

“…Consequently, Mertes argues that negatively affected interest groups, notably health care providers, can act as barriers to successful implementation. Moreover, an analysis of the policy implementation network shows how the traditional health policy actors (health care providers and health insurance funds) dominate influence channels and information flows while IT associations and research institutes are located at the periphery of the network (Lang & Mertes, 2012). Finally, a recent comparative study on the e‐health policy process from the viewpoint of stakeholders in Germany, Austria, and Switzerland points to implementation difficulties (e.g., applications unfit for practice), varying efforts for consensus‐building and missing strategies on the side of politicians.…”

Section: The Digitalization Of Health Care Systems From a Comparative Perspectivementioning

confidence: 99%

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Varieties of health care digitalization: Comparing advocacy coalitions in Austria and Germany

Bogumil-Uçan

Klenk

2021

Review of Policy Research

119

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The paper compares the politics of e‐health policy with a particular focus on the implementation of e‐health records (e‐HRs) in two SHI countries: Austria and Germany. Although these countries share many similarities in terms of political and health care regime, they differ widely with respect to health care digitalization. Thus, the question arises which configuration of factors has facilitated health system digitalization in Austria while being potentially absent in Germany. As a research strategy, we use the Advocacy Coalition Framework to identify the respective actor coalitions for and against the advancement of e‐HRs and analyze how their formation, their resources, and strategies are related to country‐specific governance structures. We find that differences in the beliefs of patient representatives; variations in the institutional access for physician associations; and, finally, differing internal dynamics within the pro e‐HRs main coalition do account for differences in health care digitalization.

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Section: Discussionsupporting

confidence: 91%

Section: The Digitalization Of Health Care Systems From a Comparative Perspectivementioning

confidence: 99%

Varieties of health care digitalization: Comparing advocacy coalitions in Austria and Germany

Bogumil-Uçan

Klenk

2021

Review of Policy Research

119

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“…The legal guidelines regarding eHealth are modeled after previous large-scale innovation policy projects in which the federal government was the driving force behind technology innovation. The new legislation lists the entire structure and members of the implementation organization as well as the funding scheme and privacy requirements [ 54 ]. Additionally, the organization’s structure allowed for the participation of a large number of NGOs such as health insurance associations, chambers of the medical profession or ICT business associations.…”

Section: Resultsmentioning

confidence: 99%

Government capacities and stakeholders: what facilitates ehealth legislation?

Lang

2014

Globalization and Health

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BackgroundNewly established high-technology areas such as eHealth require regulations regarding the interoperability of health information infrastructures and data protection. It is argued that government capacities as well as the extent to which public and private organizations participate in policy-making determine the level of eHealth legislation. Both explanatory factors are influenced by international organizations that provide knowledge transfer and encourage private actor participation.MethodsData analysis is based on the Global Observatory for eHealth - ATLAS eHealth country profiles which summarizes eHealth policies in 114 countries. Data analysis was carried out using two-component hurdle models with a truncated Poisson model for positive counts and a hurdle component model with a binomial distribution for zero or greater counts.ResultsThe analysis reveals that the participation of private organizations such as donors has negative effects on the level of eHealth legislation. The impact of public-private partnerships (PPPs) depends on the degree of government capacities already available and on democratic regimes. Democracies are more responsive to these new regulatory demands than autocracies. Democracies find it easier to transfer knowledge out of PPPs than autocracies. Government capacities increase the knowledge transfer effect of PPPs, thus leading to more eHealth legislation.ConclusionsAll international regimes – the WHO, the EU, and the OECD – promote PPPs in order to ensure the construction of a national eHealth infrastructure. This paper shows that the development of government capacities in the eHealth domain has to be given a higher priority than the establishment of PPPs, since the existence of some (initial) capacities is the sine qua non of further capacity building.

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Governance of Large Innovation Projects: The Implementation of the Electronic Health Card in Germany

Cited by 2 publications

References 7 publications

Varieties of health care digitalization: Comparing advocacy coalitions in Austria and Germany

Varieties of health care digitalization: Comparing advocacy coalitions in Austria and Germany

Government capacities and stakeholders: what facilitates ehealth legislation?

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