# Insight

Hospital Rises to
the Challenge

Battling the coronavirus is part of everyday operations at Munich’s Rechts der Isar Hospital. Commercial director Dr. Elke Frank sees opportunities now to catch up on digitalization.

Munich’s Klinikum Rechts der Isar is one of Germany’s largest hospitals. Michael Stobrawe/Klinikum rechts der Isar

Elke Frank always starts her day by look­ing at her phone. “The first thing I do when I get up is check my e-mail, says the com­mer­cial direc­toof Munich’s Rechts der Isar Hos­pi­tal. “Some­times I get a call in the mid­dle of the night, she adds. That has been hap­pen­ing more often now since the out­break of the coro­navirus—for exam­ple, if a col­league from China offers to arrange a ship­ment of per­son­al pro­tec­tive equip­ment. When Dr. Frank arrives at her office in a pre-war build­ing of the his­toric hos­pi­tal, she begins by check­ing in with other direc­tors and staffRight now, of course, our pri­or­i­ty is on deal­ing with the pan­dem­ic. But we’re also try­ing to main­tain a cer­tain sense of nor­malityand our every­day work con­tin­ues as well. 

With around forty clin­ics and depart­ments, this hos­pi­tal at the Tech­ni­cal Uni­ver­si­ty of Munich’s School of Med­i­cine is known as supramaximal facil­i­ty—mean­ing it could han­dle a huge influx of patients in a short peri­od of time. Togeth­er with Munich’s other uni­ver­si­ty hos­pi­tal at Lud­wig Max­i­m­il­ian Uni­ver­sity (LMU)it treats around half of the Covid-19 patients in the state cap­i­tal of Bavaria, which has a pop­u­la­tion of near­ly one and a half mil­lionIn addi­tion to our local patients, we take on very severe cases that small­er hos­pi­tals are gen­er­al­ly not equipped to han­dle, says Frank, who has a busi­ness degree in addi­tion to a doc­tor­ate in biol­o­gyThe two uni­ver­si­ty hos­pi­tals also advise state min­istries and author­i­ties on health pol­i­cy mat­tersTheir medi­cal per­son­nel rou­tine­ly exchange infor­ma­tion about Covid-19 with col­leagues around the world. We have close ties with Italy, Spain, and China, for exam­ple. The net­work of research projects that already exist­ed before the out­break has been help­ful in this regard. 

Elke Frank expects the pandemic to yield some positive results for hospitals. Peter Pulkowski

Budgets take a back seat

The coro­n­avirus has led to a tem­po­rary sus­pen­sion of the usual eco­nom­ic mechanisms at hos­pi­tals. In mid-March 2020, the fed­er­al gov­ern­ment ordered hos­pi­tals through­out Ger­many to post­pone elec­tive oper­a­tions and treat­ments. Other coun­tries have taken sim­i­lar actions, includ­ing Aus­tria, Switzer­land, and Spain, as well as parts of the U.S. The aim is to avoid run­ning out of resources to treat seri­ous­ly ill patientsBut this also means that hos­pi­tals are los­ing an impor­tant source of rev­enue. Nev­er­the­less, bud­get issues are superseded by the imper­a­tive to con­trol the pan­dem­ic. The state gov­ern­ment instruct­ed us to ensure suf­fi­cient treat­ment capac­i­ties under all cir­cum­stances, says Frank. The hos­pi­tal had already made plans back in Feb­ru­ary to take steps such as increas­ing the num­ber of ICU beds. If need­ed, we can crank up our capac­i­ties rel­a­tive­ly quick­ly, she adds. 

Digitalization could be a big help to us—if we already had a state-of-the-art system in place.

Dr. Elke Frank
Commercial Director, Rechts der Isar Hospital at the Technical University of Munich

That being said, the hos­pi­tal is not in the most advan­ta­geous posi­tion to han­dle the upcom­ing chal­lenges. Dig­i­tal­iza­tion could be a big help to usif we already had a state-of-the-art sys­tem in place, says Frank. Yet she also notes that efforts to dig­i­tal­ize are gain­ing momen­tum. To a cer­tain extent, Covid-19 is giv­ing us the impe­tus to catch up, she remarksRoman Hippthe Senior Part­ner at Porsche Con­sult­ing in charge of the health sec­tor, views the Munich facil­i­ty as rep­re­sen­ta­tive of many large hos­pi­tals. Trig­gered by the pan­dem­ichos­pi­tals are intro­duc­ing more dig­i­tal tech­nolo­gies at faster rates in order to sup­port their per­son­nel and pro­vide the best pos­si­ble care for their patients. Those that had already insti­tut­ed smart strategies now have a clear head start, he says. Anoth­er impor­tant task at present is to har­ness this momen­tum and build net­works. Hos­pi­tals will not be able to advance dig­i­tal­ization on their own, says HippTo derive the great­est ben­e­fits from dig­i­tal ways of serv­ing patients, com­pa­nies in the med­ical tech­nol­o­gy and phar­ma­ceu­ti­cal sec­tors will need to add their own exper­tise to the mixas will start-ups and investors. Special­ized future-ori­ent­ed con­fer­ences such as the Dig­i­tal Health Sum­mit at the Tech­ni­cal Uni­ver­si­ty of Munich are well suit­ed to forge con­nec­tions among key play­ers in the health­care fieldwith the shared aim of pro­mot­ing dig­i­tal inno­va­tions. 

Weaknesses are becoming evident

At Rechts der Isar Hos­pi­talthe extra­or­di­nary cir­cum­stances are prompt­ing changes not only in tech­nol­o­gy but also with respect to human resourcesOur employ­ees are help­ing out wher­ev­er they’re need­ed, says the com­mer­cial direc­tor. This level of inter­dis­ci­pli­nary col­lab­o­ra­tion was hard­ly imag­in­able in the past. But Frank also notes that the response to the virus has revealed some weak­ness­es. For one thing, indi­vid­ual depart­ments at the hos­pi­tal still have dif­fer­ent process­es. That affects not only patient man­age­ment but also areas like sur­gi­cal process­es and ster­ile goods man­age­ment. We’ll have to work togeth­er to stan­dard­ize our process­es in the future, she says. Ini­tial steps have already been taken. In 2019, the hos­pi­tal worked togeth­er with Porsche Con­sult­ing to define man­age­ment guide­lines and to strate­gi­cal­ly realign com­mer­cial orga­ni­za­tion­al struc­tures. The improved process­es are all the more help­ful to us right now, says Frank. Take the twen­ty-five process and trans­for­ma­tion facil­i­ta­tors who were trained over the course of those projects. Some of them are pro­vid­ing use­ful struc­tur­al rec­om­men­da­tions at our cri­sis man­age­ment ses­sions, which are lay­ing the best pos­si­ble ground­work for the deci­sions we need to make. That is of great help to the board of man­age­ment.  

Dr. Frank is pleased to see the expres­sions of appre­ci­a­tion for hos­pi­tals and their employ­eesI hope it con­tin­ues, and also that every­one from cus­to­di­ans and clean­ing per­son­nel to front-line providers like nurs­ing teams and physi­cians regain a sharp­er aware­ness of their respec­tive roles. That could lead to a new view of health­care in gen­er­al. For that to hap­pen, how­ev­er, all the health­care-relat­ed pro­fes­sions and occu­pa­tions would need to make use of the oppor­tu­ni­ties pro­vid­ed by this new level of appre­ci­a­tion. The com­mer­cial direc­tor has some doubts as to whether that will in fact occur. “How­ev­er, I do believe that this sit­u­a­tion will lead to some pos­i­tive devel­op­ments over­all for hos­pi­tals. 

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