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Gesundheitswesen. 2017 Dec;79(12):1080-1092. doi: 10.1055/s-0043-122233. Epub 2017 Dec 29.

[Position Paper of The AG Digital Health DNVF on Digital Health Applications: Framework Conditions For Use in Health Care, Structural Development and Science].

[Article in German; Abstract available in German from the publisher]

Author information

Institut für Allgemeinmedizin, Universitatsklinikum Jena, Jena.
Abteilung für Allgemeinmedizin, Ruhr-Universität Bochum.
Healthon e. V., Initiative Präventionspartner c/o sanawork Gesundheitskommunikation, Freiburg.
WINEG | Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen, Aktionsbündnis Patientensicherheit e.V., Hamburg.
Institut für Geschichte, Theorie und Ethik der Medizin, Heinrich-Heine-Universität Düsseldorf.
Gevko GmbH, Geschäftsführung, Bonn.
Innere Medizin, Universität Köln, Köln.
Contributed equally


in English, German

The term "digital health" is currently the most comprehensive term that includes all information and communication technologies in healthcare, including e-health, mobile health, telemedicine, big data, health apps and others. Digital health can be seen as a good example of the use of the concept and methodology of health services research in the interaction between complex interventions and complex contexts. The position paper deals with 1) digital health as the subject of health services research; 2) digital health as a methodological and ethical challenge for health services research. The often-postulated benefits of digital health interventions should be demonstrated with good studies. First systematic evaluations of apps for "treatment support" show that risks are higher than benefits. The need for a rigorous proof applies even more to big data-assisted interventions that support decision-making in the treatment process with the support of artificial intelligence. Of course, from the point of view of health services research, it is worth participating as much as possible in data access available through digital health and "big data". However, there is the risk that a noncritical application of digital health and big data will lead to a return to a linear understanding of biomedical research, which, at best, accepts complex conditions assuming multivariate models but does not take complex facts into account. It is not just a matter of scientific ethical requirements in health services care research, for instance, better research instead of unnecessary research ("reducing waste"), but it is primarily a matter of anticipating the social consequences (system level) of scientific analysis and evaluation. This is both a challenge and an attractive option for health services research to present itself as a mature and responsible scientific discipline.


Conflict of interest statement

Interessenkonflikt: Ursula Kramer und Horst Christian Vollmar sind Sprecher der AG Digital Health des DNVF e. V.; Ursula Kramer ist Inhaberin einer Agentur für Gesundheitskommunikation, zudem ist Sie Gründerin der Plattform HealthOn, die Gesundheits-Apps analysiert und bewertet. Alle anderen Autoren sind Mitglied der AG Digital Health und geben an, keine Interessenskonflikte zu haben.

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