Business models for electronic healthcare services in Germany: Telemonitoring of chronic heart failure: A case study

Health information systems have the potential to improve healthcare quality. Accordingly, German health authorities are currently building a nationwide telematics infrastructure (TI) to connect care providers' information systems via a common network. Telemedicine services based on this TI will offer communication cooperation documentation and analysis features such as web services to ensure pervasive availability and integrity of medical data in the German public health system. Fields of applications involve pharmaceutical drug safety, insurance data maintenance, electronic healthcare records (EHR) and emergency records. These services are specified by the German public health authorities for all caregivers. Value added applications that use the infrastructure and its services to support treatment and administration, can be deployed by software vendors thus supplying innovative services in the field of e-health. In order to enable a vital competition for value adding services, it is essential to provide sustainable business models for medical service providers to foster development and adoption of innovations deployed via the TI. This chapter uses a case study to illustrate the situation of a services provider that wants to offer a solution for telemonitoring via the TI. The analysis of the current state of the German public health system and the TI reveals several barriers hindering the progress of the proposed system. Pointing out critical issues for the development of sustainable e-health solutions, the work elaborates key success factors of past e-health projects. The most significant findings, such as privacy, controlling structures and incentive mechanisms, are addressed and analyzed in depth. A corresponding business model for the service provider is developed, using an integrative business model approach to address external factors, such as legal conditions, competitors and strategy development. The result is an actor, revenue and services model for the provider of the telemonitoring solutions. For verifi cation of the revenue model, the article uses the e3 value methodology to assess the fi nancial profi tability of the approach. The discussion includes the adjustment of fi nancial incentives for the developers of sustainable e-health innovations that boost the improvement of information technology utilization in healthcare.