Healthcare Region Berlin-Brandenburg
Masterplan
Berlin 2007
Healthcare Region Berlin-Brandenburg
Masterplan
adopted
Inter-Ministerial Steering Group of
State Secretaries for
Economics, Health and Science
as well as the Heads of the Senate Chancellery and the State Chancellery of the States of Berlin and Brandenburg
26 October 2006
Draft
prepared by
alpheios GmbH
Outline
Healthcare as Challenge and Opportunity 5
Points of Departure for the Region 7
Vision10
Strategic Goals 11
Strategic Action Clusters13
01Health Sciences as Foundation and
Motor of the Development13
02Teaching, Training, Ongoing Education17
03Transparency and Governance21
04Developing the Brand, Exhibitions, Congresses25
05„Bio-Technology und Bio-Medicine“28
06„Medical Technology“ and „Tele-Medicine“32
07Offerings and Services for Senior Citizens
includingNursing Care 35
08Modernizing und Optimizing Healthcare Provision 41
09Prevention, Support of Good Health, Medical
Rehabilitation and Nutrition46
10Lengthening and Strengthening
the Value Added Chains52
11Healthcare Sites and their Development56
12“Export of Health“ and “Medical Tourism”61
Concluding Remarks65
Members HealthCapital Berlin-Brandenburg66
Glossary69
Healthcare as Challenge and Opportunity
Healthcare in nearly all respects is facing profound upheavals. This represents both a challenge and an opportunity, which require innovation in the various areas of healthcare, but which also provide the foundation for such innovation.
-Demographic developments, especially the growing number of elderly persons, will mean that increasing numbers of people with age-related chronic diseases will be placing demands on the healthcare system. After 2010 the declining birth rate will lead to reduced demand for training in healthcare professions and this, in turn, means that manpower shortages can be expected to emerge before long.
-Preventive medicine gains in importance, because there is no scientific doubt that the course of many chronic diseases can be positively influenced through preventative measures. In this regard other means of treatment – such as natural healing methods, healthful nutrition, wellness and fitness – can also be expected to increase in significance. A psychosomatic orientation can be expected to gain ground with respect to the purely somatic view which is prevalent in broad areas of medicine.
Innovation, especially from molecular-biological and medical-technical research, will increasingly bethe motor of development.Thus the mapping of the human genome makes possible quantum leaps in the early diagnosis of potential illnesses and in their preventive andtherapeuticaltreatment – and, quite soon, in regeneration as well.
Demographic developments, new work biographies, changing understandings of the principle of solidarity and medical progress require changes in legacy methods of financing and remuneration within the healthcare system; competition among suppliers of healthcare services will increase in this context and state planning will change its function.
Progress in microsystemstechnology, optoelectronics and information technology enable new forms of treatment and organization within the healthcare system.
-Healthcare tasks which until recently were widely viewed as responsibilities of the public sector are already today increasingly being performed by private organizations. This necessitates changes in state healthcare planning and provision, but also in the ownership and governance structures of suppliers of public services.This results in increasing outsourcing to external suppliers of non-medical, but also of healthcare-related services.
The self-confidence and the desire for information on the part of (potential) patients are growing. Their right to autonomous decision-making as healthcare customers and as healthcare partners is gaining recognition. This results in a new relationship with respect to healthcare service providers with far-reaching consequences for process transparency and quality management, rights to information and questions of liability. Cooperative relationships, which are also sensitive to gender-specific healthcare needs, replace the old culture of „paternalistic“ medicine.
The Healthcare Region Berlin-Brandenburgtakes an active role in managing and shaping these challenges and changes. It finds itself thereby in competition with other regions of Germany and Europe. Success in this competition requires the efforts of all actors and – in addition to appropriate state support – in particular the engagement of private investors and institutions.
The Government (Senate) of Berlin resolved on 7 September 2004 that “the growth potential of the economic and locational factor healthcare in the fields of the health economy, health sciences and healthcare provision is to be realized more strongly and to be developed further”. An Investigative Commission of the Berlin Parliament “A Future for Berlin” (Drucksache 15/4000 vom 9. Mai 2005) identified the health economyin its final report next to communications, media and culture as one of two possible scenarios for the future development of Berlin.
Initiated by the Ministry of Employment, Social Affairs, Health and Family Affairs, on 8 November 2005the Government of the State of Brandenburg discussed developing healthcare economy in Brandenburg. The Ministry of Employment, Social Affairs, Health and Family Affairs had presented a study of the structure and the economic potential of healthcare economy in 2006 (IGES Institut für Gesundheits- und Sozialplanung GmbH, Gesundheitswirtschaft Brandenburg. Stand und Entwicklung. Expertise commissioned by the Ministry of Employment, Social Affairs, Health and Family Affairs of the State of Brandenburg. Berlin July 2006).
The Inter-Ministerial Steering Group of the States of Brandenburg and Berlin, in presenting the revised Masterplan with its Strategic Goals and Strategic Action Clusters, seeks to involve the various actors and solicits their suggestions and inputs. Concrete measures must now be developed and be implemented. This is not something for the Senate of Berlin or the Government of the State of Brandenburgto accomplish alone, nor should they even seek to play the leading role. The lead should rather be taken by all those who are active in the area of healthcare in Berlin and Brandenburg. Therefore the Masterplan names as coordinators and participants persons and institutions already active in the areas of the health economy, health sciences and healthcare delivery. The intention is to activate the potential of the Healthcare Region for the achievement of the ambitious goals of the Masterplan. The Senate of Berlin and the Government of the State of Brandenburg call upon all actors play their part in the interest of all.
Points of Departure for the Region
Berlin and Brandenburg already fulfil the requirements for a Center of Competence in Healthcare: the number of actors and projects in various areas of health, such as, for example, bio-technology, medical technology, tele-medicine and laser medicine already transcends the “critical mass”. Berlinand Brandenburg already achieve top performance in international comparisons in various areas of healthcare; they havesufficient capacity to encompass the entire value added chain from research, education and training to production, service provision and marketing.
Berlin and Brandenburg together dispose over important potential resources, which complement each othernicely with differing points of emphasis, along the entire length of the value added chain.Among these resources is a highly regarded structure of healthcare provision for the population of the region. Networks already exist which transcend the border between the jurisdictions, such as TSBmedici or BioTOP Berlin-Brandenburg, in addition to innovative infrastructures which combine research, business and partially also healthcare provision (Buch, Adlershof, Charlottenburg, Golm, Hennigsdorf, Luckenwalde). Organizations from Brandenburg participate actively in Berlin networks (e. g. TSBmedici) as well as the other way around.
Berlin and Brandenburg host an unusual concentration of healthcare-related university, extra-university and entrepreneurial research platforms. For many years Berlinand Brandenburg have had a concentration of research potential in specific areas, to which, in particular molecular medicine and bio-technology belong. Support for interdisciplinary research clusters has contributed to networking scientists with each other and with business. Examples are to be found in the areas of structural biology, RNA-technology, clinical pharmacology, glycobiotechnology, auto-immune diseases, human genome research. On the basis of scientific excellence – evidenced by the universities, the Max-Planck-Institute for Molecular Genetics in Dahlem, the Max-Delbrück-Centrum for Molecular Medicine, the biotechnology sites at Teltow-Seehof and Potsdam-Hermannswerderetc. – Berlinand Brandenburg have developed themselves to one of the leading locations for human genome research in Germany. Brandenburg has set its own specific accents in nutritional sciences (at the University of Potsdam and through the German Institute for Nutritional Research Potsdam-Rehbrücke) in addition to specializations in bio-technology and medical technology.
Berlinand Brandenburg dispose over a highly respected network of curative acute healthcare institutions. The Charité is among the leading university hospitals in Germany. Vivantes isthe largest public hospital company in Germany. In terms of quality, Berlin´s hospitals achieve results which compare favourably to the best in Germany, Europe and – in some areas – even the world (examples: heart transplants at the German Heart Center Berlin, organtransplants at the Charité, various areas of oncology, minimally invasive surgery). In contrast to Berlin, the strengths of Brandenburg lie above all in rehabilitative medicine, in the area of wellness and health tourism as well as in nutritional sciences and economy.Both complement each other meaningfully. Berlin as a whole, as well as the twelve Berlin districts and Potsdam are members of the WHO-“Healthy Cities Network” of the Federal Republic of Germany, which strives to coordinate health-supporting structures and services in the area of prevention.
Especially since the fall of the Berlin Wall (1989), several innovative and high-performance hospital, medical rehabilitation clinic and nursing care companies have emerged in Berlin and Brandenburg, which advance the development of qualitative standards, make service offerings more transparent and engage in expansion beyond Berlin and Brandenburg (German Heart Center Berlin, Clinics of the German Red Cross Berlin, Society for Building Protestant Hospitals, Societies of the Alexianer, Johanniter Corporation, Diaconical Group, Public Interest Parity Association for Health and Social Services Inc., Schlosspark-/Park-Clinics Weissensee, Trauma Center Berlin, Clinic for Minimally Invasive Surgery. Of the estimated turnover of ca. 7 billion €uros per year for all 40 hospital companies headquartered in Berlin, the above named together with Charité, the Vivantes Network for Health Inc. and HELIOS Hospital Inc. have a yearly turnover of 5-6 billion €uros).
Private investors are prepared to invest inthe “Healthcare Region Berlin-Brandenburg”. The attractiveness of Berlin for the health economy is documented in the fact,among many others, that HELIOS Hospital Inc. has invested more than 200 million €urosinthe new Buch Hospital and beside this has relocated its headquarters to Berlin. In Brandenburg major private medical rehabilitation clinic companies are engaged. The region of Berlin-Brandenburg has invested heavily into medical rehabilitation as well as into the wellness and cure sector.
Already today there are approximately 344.500 peopleemployed in the field of health with its related areas in Berlin and Brandenburg.This meansthat 13.5% of the workforce is working in the field of health (for this and the following data see D. A. Ostwald/A. Ranscht, Wachstums- und Beschäftigungspotenziale der Gesundheitswirtschaft in Berlin und Brandenburg.A study commissioned by HealthCapital Berlin-Brandenburg. Berlin April 2006). According to this study the gross added value of the region resulted into 12.24 billions €uros in the year 2004 – representing 10.2% of the total gross added value of the region. 80% of the workforce is employed in Berlin, in the neighbouring counties and in the cities of Brandenburg/Havel, Potsdam and Frankfurt/Oder; 85% of the gross added value is produced here. Compared to the national average the percentage of healthcare with a focus on healthcare provision is higher, while the percentage of health production and trade is lower. The authors of the study consider the perspectives for long-term growth of health economy to be good. The number of employees in this sector is considered to increase to 374.100 and the gross added value is to grow to 15.08 billion €uros in 2020.Further networking between health sciences, health economy and healthcare provision provides additional potential for development and growth. It presupposes an interdisciplinary and holistic approach to healthcare. Internationalperspectives have to be developed. Promotional programmes have to be utilized even more effectively for supporting the main focus, which is healthcare.
The Federal Government of Germany – by means of different programmes of the Federal Ministry of Health, the Federal Ministry of Sciences and the Federal Ministry of Economy – as well as the EU support of projectsin the health economy, health sciences and healthcare provisionprovides considerable financial resources.In addition to this, subsidies of the EU, the World Bank, the UN and other international organizations are available for the modernization and reconstruction of the healthcare provision in Central and Eastern Europe or in Iraq. Frequently interested institutions or enterprises hear too late about invitations of tenders, sometimes they are over-challenged by the complicated application forms.
Vision
Berlinand Brandenburgdevelopthe region into a knowledge-based reference area for transparent, high-quality healthcare provision dedicated and focussed to the well-being of the patients and oriented towards the fulfilment of their needs. Making use of innovative scientific discoveries, Berlin and Brandenburgoffer patients the most gentle and affordable structures of healthcare available. Scientifically and economically the potentials of health in research and higher education, in professional education and training as well as in the development and the production of products and services represent a unique profile. Berlin and Brandenburg will use it more efficiently and will network it more intensively in the future.They view the unique density of offerings along the entire length of the value added chain in healthcare as an opportunity which allows this region to stand out in comparison to other ones.
Strategic Goals
-The healthcare region Berlin-Brandenburg becomes the most innovative and effective magnet forthe health economy in Germany.
-Berlin and Brandenburgcreate a positive climate for investment in „healthcare“. Instruments for regional economic development are reoriented in a targeted way to support investments in the health economy.
-Berlin and Brandenburgstrengthen and expand regional networks such as TSBmedici or BioTOP and encourage further cooperation at the local level between the economy, science and healthcare delivery, following the positive example of Buch or Adlershof in Berlin and of Golm or Luckenwalde in Brandenburg.
-Berlinand Brandenburgsupport innovative approaches to research (e.g., translational research) and develop an integrative profile for the health sciences: in addition to medicine and nursing sciences, this will explicitly integrate health-oriented parts of the engineering sciences, the natural sciences, computer science, public health and business studies into its expanded purview of health sciences. A welcome side-effect is the strengthening of further and advanced education and training in the health field.
-Berlin and Brandenburguse fully and strengthen the cooperation among the highly specialized hospitals and other partners in the region. Within this context the Charité – University Medicine Berlin and its potentials are of specific importance for the development of the region.They develop this resource to one of the leading university hospitals in all of Europe, with specializations in genome research and regenerative medicine, as well as clinical and therapy research. The Charité combines research and teaching in medicine with bio-technology, medical technology and tele-medicine.
-Berlin and Brandenburgsensitize their citizens with respect to questions of health consciousness. They offer the highest level preventive, curative and rehabilitative medicine in the region and they open the door to treatment of patients from other parts of Germany and – especially within the framework of city partnerships – to treatment of patients from abroad. Preventative medicine becomes a hallmark of the region.
-Berlin and Brandenburgcreate (health)-“Lighthouses” (e.g., particle therapy, the fully digital hospital, molecular imaging).
-Berlin and Brandenburgmeasure the success of their political processes and decisions according to whether these adequately reflect the strategic goals of this Masterplan.
-Berlin and Brandenburg measure the transparency and quality of healthcare provision, the excellence of health sciences and the market significance of the health economy as well as the respect of gender issues - based on continuous gender analysis and on a gender conscious data collection and data processing - according to generally recognized criteria.
-Berlin and Brandenburg create trust among the important actors in health economy by assisting them within the frame of their possibilities to identify synergies, to secure the necessary demand and to avoid superfluous capacities.
On the following pages these strategic goals are collated and analyzed with respect to Strategic Action Clusters and Discrete Measures. Persons responsible to develop further the Strategic Action Clusters and to implement the Discrete Measures are appointed and listed in the annexe (Note of the translator: The annexe is not attached in the English translation). The order of the Strategic Action Clusters is not an expression of priorities. The setting of priorities will be a task of HealthCapital Berlin-Brandenburg, the project cluster management, in cooperation with the various actors. Discrete Measures, on the other hand, are ordered according to priority to the extent possible.For the realization of the Discrete Measures, a structure of leadership responsibility and a sliding time-frame − until 2008 (short-term), until 2010 (mid-term) and until 2015 (long-term) − are proposed.
Strategic Action Clusters
Strategic Action Cluster 01: Health Sciences as Foundation and Motor of the Development
Present Situation
Berlin and Brandenburg are investing an important part of their science and research budget into health-related teaching and research: In addition to medicine and nursing sciences this includes engineering sciences with a focus on medical technology or microsystems technology, natural sciences with a focus on biotechnology or bioinformatics, nutritional sciences, business studies with a focus on healthcare economics or healthcare management and computer sciences with a focus on telemedicine, health information systems, or e-health. Genome research and research in nutrigenomics is one of the strengths of the region.