DiPAs - Digital care applications

Falls are a major nursing risk. How can a DiPA help here? There are several technologies that, for example, app-supported, characterize a movement pattern and give a self-assessment of what a fall grade is. Now you might ask, "How does this information help me?" And it's at this point that the topic of "DiPA" starts to get exciting. Dive deeper into the topic in the interview with Prof. Dr. Jürgen Zerth - Vice President for Research and Institute Director of the IDC Research Institute at SRH Wilhelm-Löhe University.

Prof. Dr. Zerth, what can you imagine by digital care applications (DiPAs) ?

Prof. Dr. Zerth: Digital care applications address people in need of care - not only within their own four walls. DiPAs are therefore intended to support those in need of care and their relatives, as well as the (outpatient) care service to maintain a certain degree of self-determined life. They are not prescribed by a doctor, but are part of long-term care insurance. That is, you need a care degree and can apply for a DiPA through the long-term care insurance.

What examples of DiPAs are there?

Prof. Dr. Zerth: On this I must mention in advance that DiPAs are not yet applied, because an application regulation, which must be issued by the Federal Ministry of Health, is missing so far. Originally, it was said that it would be issued in the second quarter of 2022. However, it may well be that it will drag on for a bit longer. In a nutshell, DiPAs can be thought of this way: Falls, for example, are a major nursing risk. Here, app-supported technologies can characterize movement patterns and provide a self-assessment of how pronounced the personal fall risk is. The idea is to use this information to generate a kind of self-management, so that the person in need of care classifies himself or herself in a kind of longitudinal follow-up and also discusses the information with his or her family caregivers, nursing service or family doctor.

The "Expert Group on Care Innovations," a format of the Forum MedTech Pharma, has formed a working group and published a thesis paper on the nursing benefits of DiPAs. What lessons can be learned ?

Prof. Dr. Zerth: The working group has formulated seven theses that say "Yes, DiPAs are an opportunity, but they fall a bit short." There are three reasons for this: First, DiPAs focus very much only on the outpatient setting and do not sufficiently ask technical or organizational questions such as "What happens to the DiPA if the person in need of care with a higher level of care needs to move to the inpatient context after all? Can he then simply take the DiPA with him?". Furthermore, secondly, methodological or social questions arise, such as "What is the caregiving benefit of living at home in a caregiving relationship with relatives? What would be a "shared care benefit" from the perspective of the person in need of care but also from the perspective of the caregiver?". Third, the compensation aspect needs to be discussed. Perhaps we can discuss this in more depth later.

Which further demands are formulated in the thesis paper ?

Prof. Dr. Zerth: Well, a quite substantial demand is to be thought apart from an extension of the perspective of the ambulatory range also on other ranges. For example, the issue of empowerment to deal with apps. There are various studies on so-called health literacy or digital literacy. And I don't think we need to be surprised that health literacy in general, but also digital literacy in particular, is dependent on a few parameters - on the one hand, the level of education, and on the other, age. Now, in the nursing field, by the very nature of things, we have a target group that is aimed somewhat in the direction of the older population. But it's not just about those who are currently being cared for; it's also a perspective for the future. It is also formulated in the draft bill of the German government, for example, that in four years, around 10 percent of those in need of care would be using DiPAs. But these DiPAs will not simply work. On the one hand, you need the technical competence to operate the device. And on the other hand, you need the competence to be able to deal with the health information provided. So in the future we need more guidance in the form of training, etc.

How are DiPAs applied for or financed?

Prof. Dr. Zerth: It must be established that I am in need of care and then I can apply for the DiPA as a person in need of care, similar to an aid. Depending on the care level, a capped amount is paid by the care insurance. At the moment, the law stipulates that 50 euros are paid per month, which must then be concentrated and divided between the DiPA and accompanying support services. There seem to be unanswered questions about how to divide this up. That may also still be a reason that, in my estimation, may delay the introduction of DiPAs.

The interview was conducted by Dr. Petra Blumenroth, Project Manager Technology I Frugal Innovation at Bayern Innovativ GmbH.

Listen to the full interview as a podcast: