Observing the Long Struggle for Digital Transformation in German Hospitals: Results from a Panel Study 2017 to 2025.

INTRODUCTION

Despite major policy initiative, Germany's hospital digital transformation remains slow.

METHODS

This study analysed data from the IT-Report Healthcare (2017, 2023 and 2025) to evaluate changes in five domains related to the Hospital Future Act (KHZG): clinical documentation, order entry, clinical decision support (CDSS), medication management and discharge management. A panel of 49 hospitals was examined using linear mixed models (LMM).

RESULTS

While most hospitals applied for funding in documentation and discharge management, by 2025, most projects also in these areas were still in progress. Significant improvements to 2017 were observed in medication management (p = 0.009 in 2023; p = 0.044 in 2025) and discharge management (p < 0.001 in 2025), while progress in other areas was limited.

DISCUSSION: The findings indicate that digital maturity increased only partially due to administrative delays and implementation bottlenecks and that a sustained evaluation beyond the KHZG period, including consideration of the implementation context, is needed to capture the long-term effects on clinical digitalisation.