Healthcare: The hospital atlas (Klinik-Atlas) encounters legal hurdles

Frankfurter Allgemeine Zeitung

12.06.2024

The hospital atlas (Klinik Atlas) encounters legal hurdles

Patients can find out about hospitals via a new website. But there are pitfalls.

The "Hospital Atlas", which was recently introduced by law, is intended to bring more transparency to hospital care. Patients can find out about the services and quality of a hospital before undergoing treatment.Data on availability, experience with certain procedures or the quality of services can be viewed online. 
Hospitals must therefore send the data required for inspection to the Institute for the Hospital Remuneration System (InEK) on a quarterly and annual basis. This data is then analysed by the Institute for Quality Assurance and Transparency in Healthcare (IQTIG) using existing data and finally published by the Federal Ministry of Health in the Hospital Atlas. In addition, the Hospital Transparency Act provides for hospitals to be categorised into different levels, with the categorisation ranging - in simplified terms - from Level 1 (basic care provider) to Level 3 (complex care provider). A hospital achieves a high level by being assigned many service groups.

This is legally controversial. On the one hand, the clinic atlas is seen as superfluous in view of existing information portals. This is not only a question of work organisation, but also has a legal component:The new obligation for hospitals to provide extensive data sets could violate the constitutional principle of proportionality and the data protection principle of data minimisation if this obligation is not necessary, in view of the effort involved and the resulting gain in knowledge.

On the other hand, critics argue that the mere number of service groups makes no statement about the quality provided: smaller, but highly specialised hospitals could suffer from this, as a larger hospital will in doubt achieve more service groups and therefore also a higher level than a smaller one - although the quality of treatment in the smaller units could even be better. The principle of proportionality could also be affected here, as it is questionable whether the level categorisation is suitable as an isolated criterion in any case. 

However, new legal issues also arise from the published data itself. Recently, it has been criticised that some of the information in the Hospital Atlas is outdated, incomplete and inaccurate. Several parties can potentially be responsible for incorrect data, including hospitals that provide inaccurate data, the IQTIG, which prepares and analyses the data, or the InEK, which assigns the levels.

Patients could make an inappropriate choice of hospital for the treatment of their illness due to incorrect information. This would be to the detriment of both patients and the hospitals concerned.The law itself does not expressly regulate who is liable for incorrect information in the hospital atlas and on what basis. The general civil law bases for claims therefore apply. The prerequisite for a claim for damages would be proof of damage caused to patients or hospitals by the incorrect information in the hospital atlas. However, it is likely to be difficult to provide such proof.  

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