Telemedicine in Germany has outgrown its early image as a digital novelty. Once a crisis tool during the pandemic, it has matured into a core infrastructure of modern healthcare connecting homes, hospitals, and health insurers through data, devices, and dialogue. In 2025, German telehealth finds itself at a pivotal juncture, where policy, technology, and human experience are gradually aligning.
This is no longer a story about replacing consultations with screens. It is about creating a living, learning healthcare ecosystem, where smartphones become diagnostic instruments, algorithms evolve into clinical allies, and patients transform from passive recipients into active participants in their care. Yet, as the network expands, so do the frictions: fragmented reimbursement, data silos, and a persistent digital divide threaten to blunt the momentum.
“Telehealth 2025” is therefore not just a headline — it is the tension between promise and policy, between what technology makes possible and what the healthcare system allows. Germany’s challenge is no longer invention; it is integration: translating innovation into sustainable, equitable, and evidence-based care for all.
Beyond the DiGA Horizon: How Private Telehealth Thrives in Germany
Germany’s digital health revolution has two speeds: one regulated, one entrepreneurial.
While the Digitale-Versorgung-Gesetz (DVG) and DiGA pathway dominate the headlines, a quiet parallel market is flourishing beneath it: telehealth systems that operate privately, legally, and profitably outside formal reimbursement.
From subscription-based cardiac apps to employer-funded teletherapy platforms, innovators are discovering that you don’t need a BfArM listing to deliver value, only clinical credibility, CE-mark compliance, and a direct path to patients. Explore how telehealth apps in Germany can operate outside the DiGA system through private payment, insurer partnerships, and selective contracts while remaining compliant with MDR and ready for future reimbursement
From Connection to Continuum: Toward a Living Continuum of Care.
Germany’s telehealth journey has outgrown its first chapter of hurried connections and improvised video calls. Once perceived as a technological solution, telehealth has evolved into a silent circulatory system of care, subtly influencing hospitals, homes, and health insurers.
Today, telemedicine is less about screens and signals and more about continuity, intimacy, and intelligence. It links not just doctors and patients but moments of vulnerability with data that remembers. Remote monitoring, asynchronous consultations, and app-based diagnostics now compose a digital choreography of care that runs through cardiology, neurology, and mental health alike.
Yet the rhythm is uneven. While most physicians now use telemedicine tools, a 2025 national survey from the Technical University of Munich found that interoperability failures, data silos, and brittle reimbursement logic still hostage the system. gehrmann-et-al-2025-current-use…. Many clinicians speak of progress that feels improvised — a symphony without a score, where innovation outpaces administration.
Still, the momentum is undeniable. Germany’s healthcare system is adapting to the digital age. The frontier now is not access but alignment—aligning codes with compassion, evidence with economics, and technology with the slow, deliberate rhythm of healing. Telehealth has ceased to be a bridge across distance; it is becoming the bloodstream of a connected, remembering healthcare system.
The Silent Syntax of Care: Germany’s Asynchronous Revolution
While video consultations brought visibility to telehealth, the subtler transformation unfolds in silence—through asynchronous, document-based medicine, where care is exchanged not in speech, but in syntax.
In Germany, platforms like Medexo and HMO AG have redefined the idea of the second opinion, allowing patients to upload records, scans, and questions and receive detailed written evaluations from distant specialists Benefits_and_challenges_of_asyn…. For many, this type of service is not merely telemedicine — it is tele-judgement, a fusion of algorithmic triage and human discernment.
The 2025 BMJ Open study on asynchronous second opinions revealed profound dualities: accessibility without immediacy and precision without presence. Patients valued the clarity and depth of written reports yet mourned the absence of empathy that only a gaze or a pause can convey. For some, this digital correspondence felt empowering; for others, alienating.
Still, the shift is irreversible. Asynchronous telemedicine extends the reach of expertise to rural geographies with fragmented schedules. It allows physicians to deliberate without haste, to think in paragraphs instead of seconds. It turns healthcare into a living archive — each consultation an annotated dialogue between data, diagnosis, and doubt.
In this new syntax of care, time is no longer a barrier; it becomes a collaborator. Medicine learns to listen in delay—and in that delay, sometimes, it listens better.
Seeing at a Distance: The Optics and Pulse of Digital Trust
Telehealth’s most profound test is not technological — it is sensory. It asks patients to trust the unseen. It requires patients to believe that care can exist without physical proximity.
In ophthalmology, that experiment is already underway. A 2025 population study found that one in two Germans would entrust their eyes to remote examination—a statistic that speaks not of convenience, but of cultural evolution. Attitudes_towards_telemedicine_…. Younger, urban citizens embrace tele-ophthalmology for its precision and speed; older patients still long for the reassurance of the clinician’s gaze.
The issue is not resistance but reflex — the human instinct to equate seeing with believing. Tele-ophthalmology, therefore, is not just about retinas and imaging — it is about re-educating trust itself.
Cardiology tells a parallel story, though its rhythm is measured in heartbeats, not pixels.
Germany’s Telemonitoring Herzinsuffizienz program—now reimbursed through the EBM catalogue and supported by the G-BA—has transformed heartfailure management into a living feedback loop. Patients wear connected devices that transmit ECG, pulse oximetry, and weight data to certified Telemedizinzentren (TMZs), where cardiologists interpret trends and intervene before crisis strikes.
Here, telemedicine is no longer an adjunct to care; it becomes the circulatory system of prevention.
These successes are prototypes for a broader chronic-disease telehealth architecture taking shape across Germany. Diabetes, COPD, and Parkinson’s disease are following similar digital trajectories — integrating remote monitoring, app-based adherence tools, and structured reimbursement pathways. Under §140a SGB V, selective contracts between hospitals and sickness funds allow innovative models to bypass traditional bottlenecks, while DiGA-listed applications offer scalable tools for lifestyle and medication management.
This architecture is more than policy scaffolding — it is the embryonic nervous system of a learning healthcare ecosystem. Data from telemonitoring feeds into clinical algorithms; algorithms refine risk prediction; and reimbursement frameworks, once rigid, begin to flex toward outcomes rather than activity.
Germany’s telehealth experiment is thus writing the early chapters of longitudinal digital medicine — a medicine that does not wait for illness to declare itself but listens for its prelude in data.
The Grammar of Movement: Digital Biomarkers and the Economics of Evidence
Telehealth’s maturation in Germany is not measured only in connections but in what those connections can prove.
As policymakers and payers demand evidence of benefit, telemedicine has entered a new scientific dialect: the language of measurable motion, digital biomarkers, and quantifiable outcomes.
At the German Centre for Neurodegenerative Diseases (DZNE), researchers have redefined what remote evidence looks like.
In their 2025 study, patients with Parkinson’s disease performed a video-based Timed Up and Go (vTUG) test through a smartphone app, producing 700 data-rich recordings analysed for gait, balance, and motor stability [DZNE-2025-00724].
The project proved not only technical feasibility but also regulatory readiness — combining ethics approval, data security, and CE conformity.
It is a glimpse of how telehealth becomes reimbursable: by turning lived movement into validated evidence.
Germany’s reimbursement system, long bound by paper and precedent, is learning to translate such evidence into tariffs.
The G-BA’s 2022 decision on telemonitoring in heart failure marked a historic precedent: the first nationwide inclusion of a digital service into the EBM (Uniform Value Scale).
Under these rules, physicians and Telemedizinzentren can bill for remote monitoring, data interpretation, and patient contact, provided that clinical utility is proven and process quality certified.
This shift — from anecdotal benefit to algorithmic proof — is redefining telehealth not as an experiment, but as a reimbursable science of observation.
At the same time, DiGA-listed applications extend this economic logic to the patient’s palm.
Once an app demonstrates positive healthcare effects — improved glycaemic control, reduced hospitalisations, enhanced adherence — it earns national reimbursement under the Digital Health Applications Act (DVG).
Every data point becomes a micro-currency of credibility, each remote measurement an invoice written in outcomes rather than procedures.
Selective contracts under §140a SGB V add yet another layer: regional agreements where sickness funds reimburse hospitals and practices for innovative, telemonitored chronic-disease management.
Through these pathways, cardiology, diabetes, COPD, and even oncology pilots are moving from project status to permanent reimbursement, provided their data streams align with economic logic and patient safety.
Thus, Germany’s telehealth is no longer funded by novelty — it is funded by demonstrable causality.
Evidence has become currency; reproducibility, the exchange rate.
Each dataset, once a by-product of care, now functions as a regulatory artefact, a negotiator between science and solvency.
Telemedicine has evolved into a marketplace of validated motion — a grammar where care, code, and cost finally learn to speak the same language.
The Architecture of Reimbursement: Between Law and Lifeline
Behind every teleconsultation in Germany lies an invisible lattice of economics and ethics — a structure where evidence becomes currency and law becomes the architecture of care.
Telehealth does not flow freely; it travels through meticulously engineered corridors of approval, coding, and contracting.
To understand its trajectory is to glimpse the bloodstream of a digital health economy in motion.
The Multi-Tiered Economy of Telehealth
Germany’s reimbursement model for telemedicine is a mosaic of overlapping jurisdictions, each designed for a different rhythm of care:
- The Outpatient Sphere the EBM (Einheitlicher Bewertungsmaßstab)
- The EBM catalogue governs payment for physicians within statutory health insurance (GKV).
- Since 2022, it has included explicit billing items for video consultations, remote patient monitoring, and structured telemedical data interpretation.
- For example, Telemonitoring Herzinsuffizienz (TM-HF) allows certified Telemedizinzentren (TMZs) and cardiology practices to bill for continuous observation of heart-failure patients.
- These codes are the product of G-BA resolutions, which require that each telemedical act demonstrate medical necessity, measurable patient benefit, and data security compliance.
- The Inpatient Sector includes Selective Contracts and Special Authorisations for telemonitoring services.
- Hospitals, historically excluded from ambulatory reimbursement, now access telehealth funding through §140a SGB V selective contracts and special-needs approvals (Sonderbedarfszulassung).
- These contracts—negotiated directly between hospitals and sickness funds like BARMER or TK finance telemonitoring pilots in cardiology, diabetes, COPD, and oncology.
- Once these programs demonstrate reduced readmissions or improved outcomes, they may transition into national EBM or DRG systems.
- Digital Therapeutics and Apps – The DiGA Pathway
- Introduced under the Digitale-Versorgung-Gesetz (DVG), this framework reimburses prescribable digital health applications that show positive healthcare effects in clinical or real-world studies.
- Once listed in the BfArM DiGA Directory, these tools achieve national reimbursement parity with pharmaceuticals.
- The first wave targeting depression, diabetes, obesity, and insomnia has paved the way for chronic-disease self-management ecosystems that complement telemonitoring.
- Research and Innovation Funding is provided through the Bridge Mechanisms.
- Until formal listing, innovators often rely on G-BA Innovationsfonds, Telemedizin@NRW, or regional ARS and GHT pilots.
- These serve as testing grounds where we stress-test economic models, data flows, and patient-reported outcomes prior to their mainstream reimbursement.
Evidence as Economic Syntax
At the heart of this architecture lies a principle both elegant and unforgiving:
Without evidence, there can be no reimbursement.
Every new telemedical service must traverse a procedural triad—clinical validation, economic modelling, and dataprotection certification.
Health-economic evaluations — typically cost-utility or cost-consequence analyses — translate scientific outcomes into economic grammar: avoided hospital days, reduced therapy costs, and quality-adjusted life years (QALYs) gained.
Germany’s payers, the Kassenärztliche Vereinigungen (KVs) and GKV-Spitzenverband, increasingly demand real-world evidence (RWE) over randomised trials.
This signals a paradigm shift: from proving efficacy in isolation to proving value in practice.
As the DZNE’s vTUG study demonstrated, digitally captured patient activity can function as a reimbursable endpoint, bridging the traditional gulf between science and finance.
Policy Meets Philosophy
This architecture of reimbursement is more than bureaucratic scaffolding; it is a moral technology.
By binding funding to outcomes, it aligns medicine’s oldest ethic — benefit to the patient — with the economics of sustainability.
Yet it also reveals fragility: each code, each clause, is a temporary treaty between innovation and inertia.
Where the system once paid for presence, it must now learn to pay for performance.
Where the physician’s time was the currency, data-validated health gain is becoming the new denomination.
Germany thus finds itself in a quiet revolution of accountable telemedicine.
Reimbursement has evolved from passive payment to active proof — a framework where every transmitted heartbeat, every asynchronous consultation, must justify its cost in improved outcomes.
In this architecture, law is not the opposite of life — it is the geometry through which life is sustained.
Telehealth, once a technological promise, is now a legal organism — alive, adaptive, and learning to grow within the boundaries of reason.
The Ecology of Chronic Care: From Data Streams to Living Systems
In chronic disease, time itself becomes the most powerful diagnostic.
Unlike acute medicine, which chases crises, chronic care listens to patients, patient by patient, dataset by dataset, breath by breath.
Telehealth, in Germany, is turning that act of listening into an organised, reimbursable science.
Across cardiology, neurology, diabetology, pulmonology, and psychiatry, the country is constructing what might be called an ecosystem of digital vigilance – a nationwide nervous system that detects physiological change long before it becomes pathology.
The architecture is not centralised but rather organismic: regional Telemedizinzentren (TMZs), certified disease management programs (DMPs), insurer-led contracts under §140a SGB V, and DiGA-enabled self-monitoring apps all feed data into the same evolving continuum of care.
Cardiology: Telemetry as Therapy
The model begins with cardiology.
Since the 2022 G-BA decision, Telemonitoring Herzinsuffizienz has been fully integrated into the EBM catalogue — a decisive leap from pilot project to standard benefit.
Patients transmit ECG, weight, and oxygen-saturation data to TMZs staffed by cardiologists and specialist nurses.
Every deviation from baseline is not a statistic but a call to preempt deterioration.
Clinical studies now show that such systems can reduce hospital readmissions by up to 30 %, transforming monitoring itself into a reimbursable therapeutic act.
Pulmonology and Metabolism: Breathing and Balancing in Code
Inspired by cardiology’s success, TeleCOPD and digital-diabetes programmes are emerging through selective contracts between hospitals and sickness funds.
Continuous glucose sensors, spirometry-enabled home devices, and adaptive apps record millions of data points — data which no human could ever read unaided.
Artificial-intelligence triage and algorithmic pattern recognition convert these torrents into actionable insights, alerting clinicians through secure TI-integrated dashboards.
Each intervention avoided, each exacerbation predicted, accumulates health-economic weight, reinforcing the legitimacy of telemonitoring tariffs.
Neurology and Mental Health: From Motion to Emotion
In neurology, the DZNE’s vTUG has shown how smartphone cameras can quantify mobility in Parkinson’s disease, creating digital biomarkers that align seamlessly with reimbursement models.
Meanwhile, telemental-health platforms – now part of Germany’s national mental-health strategy – enable cognitive-behavioural therapy, depression management, and suicide prevention remotely, reaching patients in regions where psychiatrists are scarce.
Here, outcome-based reimbursement intertwines with ethics: the system pays not for conversation but for clinical transformation.
RWE and the New Contract Between Data and Decision
At the centre of this ecosystem lies a quiet revolution in evidence generation.
Germany’s health insurers and HTA bodies increasingly recognise real-world evidence (RWE) as equivalent, and sometimes superior, to trial data for evaluating digital interventions.
Aggregated patient-generated data — anonymised, quality-audited, and longitudinal — now feed into Versorgungsforschung networks and economic models submitted to the G-BA.
Each dataset strengthens the case for sustained reimbursement; each verified outcome adds another tile to the mosaic of trust between innovators and payers.
A Living, Learning Health System
When viewed from above, this is more than reimbursement — it is co-evolution.
Technology adapts to clinical workflow; policy adapts to evidence; patients adapt to agency.
Every data stream becomes a tributary in a larger river of predictive, personalised care.
What once were isolated telemedicine pilots are merging into a biosphere of chronic-care intelligence, capable of learning, forecasting, and self-correcting.
Germany, long cautious in digital transformation, has found its proving ground.
Through the interplay of science, economics, and empathy, Germany is crafting a healthcare ecosystem that not only treats disease but also anticipates it as a unified system that feels, learns, and reimburses.
The Sentience of Systems: Telehealth as Germany’s Living Infrastructure
Telehealth in Germany was never born from a single act of legislation or invention.
It grew out of crisis, collaboration, and constraint — from the pandemic’s forced experiments with remote care to the Digital Healthcare Acts (DVG and KHZG) that gave technology a formal seat at the policy table.
It began as an emergency bridge and has evolved into an organism of observation, connecting hospitals, sickness funds, regional agencies, and patients through a mesh of evidence and reimbursement.
How It Came About: The Fusion of Policy and Practice
The first structural breakthroughs came with the 2015 E-Health Act, which mandated the expansion of telemedical infrastructure and secure data exchange.
Then, the Digitale-Versorgung-Gesetz (DVG) of 2019 created a pathway for prescribable digital apps (DiGA) — the world’s first model where algorithms could be reimbursed like medicines.
Next, the Hospital Future Act (KHZG) and TI 2.0 reforms invested billions into digital hospital infrastructure, making interoperability not just a technical preference but a regulatory expectation.
By 2022, telemonitoring for chronic heart failure had moved from pilot to policy — the first nationwide telehealth service embedded in the EBM.
Each step was incremental, yet together they formed a genetic code for digital care — law, evidence, and reimbursement evolving in feedback with one another.
Examples of the Living Infrastructure in Motion
- Cardiology: Telemonitoring Herzinsuffizienz and pilot projects in Telekardiologie NRW now serve as the national blueprint for other chronic-disease pathways. Their data demonstrate measurable reductions in hospitalisation and mortality, providing the foundation for G-BA’s expansion into hypertension and post-MI follow-up.
- Neurology: The DZNE vTUG study is laying the groundwork for Parkinson’s remote monitoring to enter structured care, bridging academic research with future reimbursement dossiers.
- Diabetology: Digital glucose platforms such as mySugr and HelloBetter Diabetes Prävention—both DiGA-approved—are now reimbursed nationally, linking behavioural data with metabolic outcomes.
- Pulmonology: Regional TeleCOPD models in Bavaria and Saxony are being evaluated by the G-BA for potential EBM inclusion, combining spirometry data, medication adherence, and exacerbation prediction.
- Mental Health: Telepsychiatry programmes and telemental health apps have extended reach to underserved regions, blending teleconsultation, cognitive therapy modules, and DiGA reimbursement under SGB V.
Together, these examples demonstrate a distributed intelligence: data flowing upward to inform policy, and policy flowing downward to refine practice.
The system, once reactive, is now reflexive— capable of learning from its own outcomes.
The Road Ahead: Integration, Evaluation, and Engagement
Germany’s telehealth future rests on three converging frontiers:
- Integration The integration of EBM, DRG, and DiGA principles into hybrid reimbursement frameworks enables seamless cross-sectoral funding. The planned Gesundheitsdatennutzungsgesetz (GDNG) and Digitalgesetz 2025 will facilitate secondary data use, enabling evidence-based tariff updates in real time.
- Evaluation — The G-BA and IQWiG are refining methods for digital health technology assessment, focusing on real-world effectiveness, economic sustainability, and equity metrics. This will likely give rise to a “Digital NUB” process for fast-track reimbursement of innovative telemedical systems.
- Engagement — The next evolution is social, not technical. True integration demands the active involvement of clinicians, patients, and innovators. Universities, KVs, and sickness funds are launching “Digital Health Labs”—collaborative spaces where app developers, telemedicine centres, and payers collaborate todesign data standards, usability metrics, and economic models.
In parallel, the European Health Data Space (EHDS) promises to weave Germany’s efforts into a continental fabric of shared, privacy-secured data exchange – a step toward evidence without borders.
How to Engage with the Living System
For innovators and clinicians, the invitation is clear:
- Anchor innovation in reimbursement logic early. Design studies with endpoints that map to EBM or DiGA criteria.
- Collaborate with sickness funds and regional HTA bodies to pilot selective contracts under §140a SGB V.
- Generate real-world evidence, not just technical performance; regulators now reward credibility over novelty.
- Build coalitions—between clinics, research institutes, and data scientists—to shape the algorithm for evaluation itself.
- Embed empathy in design. Asynchronous telemedicine and digital biomarkers are powerful, but they must be humanised through storytelling, consent, and clarity.
The Moral of the Machine
Telehealth’s triumph will not be measured by download counts or bandwidth but by trust per second — the degree to which a patient believes that an unseen system still sees them.
Germany’s digital transformation, with all its laws and ledgers, is ultimately a moral project: to turn data into dignity, to make care continuous, and to ensure that every transmission of information is also a transmission of empathy.
Telehealth in 2025 is no longer an instrument of convenience.
It is a sentient infrastructure that is adaptive, self-correcting, and aware of its responsibility.
If Germany continues to balance evidence with ethics and policy with imagination, its digital health system may yet become what medicine has always aspired to be: not just intelligent, but humane.
References
1. Gehrmann, J., Hahn, F., Stephan, J., Steger, A., Rattka, M., Rudolph, I., Federle, D., Heller, J., Wunderlin, G., Laugwitz, K.L., Barthel, P., Veith, S., & Martens, E. (2025). Current Use, Challenges, Barriers, and Chances of Telemedicine in the Ambulatory Sector in Germany—A Survey Study among Practising Cardiologists, Interns, and General Practitioners. The study focusses on telemedicine and e-health. https://doi.org/10.1089/tmj.2024.0528
2. Bruch, D., May, S., Könsgen, N., et al. (2025). Benefits and Challenges of Asynchronous Telemedicine in Obtaining a Second Opinion. BMJ Open, 15, e100287. https://doi.org/10.1136/bmjopen-2025-100287
3. Fink, D.J., Bittner, A., Schuster, R., et al. (2025). Attitudes towards Telemedicine in Ophthalmology: A Nationwide Cross-Sectional Survey in Germany. BMC Health Services Research, 25, 1202. https://doi.org/10.1186/s12913-025-13491-1
4. Grobe-Einsler, M., Gerdes, A., Feige, T., Maas, V., Matthews, C., Mendoza García, A., Comas Fages, L., Davies, E.H., Klockgether, T., & Falkenburger, B.H. (2025). Feasibility of an App-Assisted and Home-Based Video Version of the Timed Up and Go Test for Patients with Parkinson’s Disease (vTUG). Journal of Clinical Medicine, 14(11), 3769. https://doi.org/10.3390/jcm14113769
5. Neumann, A., et al. (2025). Patient Acceptance of Telemental Health in Germany: Predictors and Policy Implications. Poster presented at the European Health Psychology Society (EHPS) Annual Conference, 2025. Available at: https://www.ehps.net
6. Latifi, R. (2025). The Telemedicine and eHealth Framework for the 21st Century: Integration, Interoperability, and Ethical Sustainability. The article is published in the International Journal of Digital Health & Telemedicine, reference number WRP-IJDHT-2025.
7. The publication was published by the Bundesministerium für Gesundheit (BMG). (2015). The law is known as the E-Health-Gesetz. BGBl. I S. 2408. Available at: https://www.bundesgesundheitsministerium.de
8. Bundesministerium für Gesundheit (BMG). (2019). Digitale-Versorgung-Gesetz (DVG). BGBl. I S. 2562. Available at: https://www.bundesgesundheitsministerium.de
9. The information is provided by the Bundesministerium für Gesundheit (BMG). (2020). Krankenhauszukunftsgesetz (KHZG). BGBl. I S. 2466. Available at: https://www.bundesgesundheitsministerium.de
10. Gemeinsamer Bundesausschuss (G-BA). (2022). Beschluss zur Telemonitoring-gestützten Versorgung bei Herzinsuffizienz. Berlin: G-BA. Available at: https://www.g-ba.de
11. Sozialgesetzbuch Fünftes Buch (SGB V). (2025 Edition). § 140a Verträge zur besonderen Versorgung und zur integrierten Versorgung. Berlin: Bundesgesetzblatt.
12. European Commission. (2024). European Health Data Space (EHDS) Proposal — COM(2022) 197. Brussels: European Commission. https://health.ec.europa.eu/ehealth-digital-health-and-care/european-health-data-space_e
Glossary: Telehealth & Reimbursement in Germany
Asynchronous Telemedicine
Clinical exchange without real-time interaction (store-and-forward). Patients upload records/images; experts deliver written evaluations later. Common in second-opinion platforms and dermatology. SEO: asynchronous telemedicine Germany, second opinion digital health.
BfArM (Federal Institute for Drugs and Medical Devices)
Regulator that evaluates and lists DiGA (Digitale Gesundheitsanwendungen) for nationwide reimbursement under SGB V. Maintains the official DiGA Directory.
Chronic Disease Telemonitoring
Continuous remote capture of physiologic data (e.g., ECG, glucose, SpO2) for heart failure, COPD, and diabetes. Reimbursed via EBM telemonitoring codes and G-BA quality standards for TMZ.
Cost-Utility Analysis (CUA)
Health-economic method comparing cost per QALY gained. Supports HTA decisions by IQWiG and G-BA for digital/telemedical interventions in Germany.
DiGA (Digitale Gesundheitsanwendungen)
Prescribable digital health apps demonstrating positive healthcare effects in trials or RWE. Once listed by BfArM, receive national reimbursement under SGB V.
Digital Biomarkers
Objective physiologic or behavioural signals from smartphones, wearables, or home devices are used to measure outcomes remotely (e.g., gait metrics in vTUG). Enable outcome-based reimbursement.
DVG (Digitale-Versorgung-Gesetz)
Germany’s Digital Healthcare Act (2019): created the DiGA fast track and accelerated digital integration across statutory insurance (GKV).
EBM (Einheitlicher Bewertungsmaßstab)
The outpatient reimbursement scale under GKV. Includes codes for video consultations, telemonitoring, and telecardiology based on G-BA decisions.
G-BA (Gemeinsamer Bundesausschuss)
Top decision body defining reimbursable services and quality criteria (e.g., Telemonitoring Herzinsuffizienz). Sets standards that flow into EBM.
GDNG (Gesundheitsdatennutzungsgesetz)
Health Data Utilisation Act (2025): enables secure secondary use of anonymised health data for research, AI, and dynamic tariff evaluation. Complements the EU EHDS.
IQWiG (Institute for Quality and Efficiency in Health Care)
Germany’s HTA institute evaluates efficacy, safety, and cost-effectiveness (e.g., CUA) to inform G-BA reimbursement decisions for telehealth and DiGA.
KHZG (Krankenhauszukunftsgesetz)
The Hospital Future Act (2020) funds digitalisation, cybersecurity, and telemedical infrastructure in hospitals, which is foundational for TI 2.0 readiness and interoperability.
Real-World Evidence (RWE)
Data from routine care (registries, claims, device/app telemetry) is used to prove real-world effectiveness and support reimbursement for telemonitoring and DiGA.
SGB V §140a (Selective Contracts)
Legal basis for innovative integrated-care agreements between providers and sickness funds (e.g., telemonitoring pilots) outside standard EBM/DRG pathways.
Telemedizinzentrum (TMZ)
Certified telemedicine centre authorised under G-BA rules to manage remote monitoring workflows and bill via EBM telemonitoring codes.
Telemonitoring Herzinsuffizienz
The flagship heart-failure telemonitoring service is reimbursed nationwide via EBM; it combines patient devices with expert review in TMZs under strict quality criteria by G-BA.
vTUG (Video Timed Up and Go Test)
Home-based, app-assisted mobility test validated by DZNE for Parkinson’s disease; produces digital biomarkers supporting RWE and reimbursement dossiers.
Versorgungsforschung (Health Services Research)
Empirical evaluation of care in real settings (effectiveness, equity, economics). Central to scaling telehealth from pilots to reimbursed standard care.
Telematikinfrastruktur (TI)
National e-health backbone (by Gematik) enabling secure data exchange, ePrescriptions, and integration of telemedicine and DiGA into routine workflows.