The "digital care applications" are here.
The "digital care application", or "DiPA" for short, has made its way into social law. "Digital applications" have been an integral part of the healthcare and care sector for some time now. There are already numerous apps for smartphones and tablets as well as browser-based applications for computers that help those in need of care, relatives and care facilities to make everyday care easier. Until now, there has been a lack of legal regulation to make these services available to those in need of care as part of "care assistance".
The introduction of three new regulations in SGB XII (from 01.01.2022) on "digital care applications" have extended the entitlement to benefits as part of "assistance for care". The list of benefits was supplemented in Sections 63, 64j and 64k.
Amendment 1: New Section 63 (1) (1g) (care degree 2-5) and (2) (3) (care degree 1) SGB XII ensures the entitlement to digital apps
The amendment to Section 63 SGB XII was regulated for the first time from 01.01.2022. It now also includes the entitlement to "digital care applications" and additional support with the use of "digital care applications" for all people in need of care who are entitled to benefits. This brings the benefits catalog of SGB XII into line with that of SGB XI and puts insured and uninsured people in need of care on an equal footing.
Amendment no. 2: Section 64j SGB XII defines what "digital care applications" are
"Digital care applications" are technologies that, for example as an app,
- used on the end devices of those in need of care, their relatives and those of care facilities or
- are made available via publicly accessible digital distribution platforms
- to reduce impairments to the independence or abilities of the person in need of care and to counteract a worsening of the need for care.
The DiPA directory does not yet contain any digital care applications. The directory is currently being compiled by the Federal Institute for Drugs and Medical Devices (BfArM).
Amendment no. 3: Section 64k SGB XII defines the entitlement to supplementary support
In order to facilitate the use of "digital care applications", people in need of care will in future also be entitled to the necessary "supplementary support services". It is not yet clear exactly what these will be. The Federal Institute for Drugs and Medical Devices will have to determine this and publish it in the "Directory for digital care applications" in accordance with Section 78a (3) SGB XI.
Practical examples of digital care applications
The "list of digital care applications" in accordance with Section 78a (3) sentence 1 SBG XI will therefore determine which "digital care applications" will be recognized as part of "care assistance" from next year. The prerequisite for recognition will be that the app or browser-based application has a nursing benefit.
Technological aids are conceivable in the following areas, among others:
- Body-related topics:
Through exercises or training, apps can help people in need of care to reduce suffering and cope better with everyday life. This includes, for example, memory training for dementia or exercises to reduce the risk of falling.
- Communication and support:
Technical services that improve communication between people in need of care, their relatives and mobile care services and thus facilitate care could also be recognized as "digital care applications".
- Reminder function for taking medication:
An app can help people in need of care to remember to take their medication on time and in full. If this is forgotten, relatives or the responsible care service can be informed to ensure that the medication is taken.
In future, social welfare administrators will have to decide on the granting of "digital care applications" and applications for additional support. The "directory for digital care applications", which has yet to be created, will show which specific benefits are to be granted.
Example: fall prevention
Digital applications in care are aimed directly at those in need of care. The focus is on stabilizing or improving the state of health of the person in need of care through exercises and training. For example, fall prevention is a key element in strengthening the autonomy of older people. They should be supported in remaining in their own four walls for longer.
The digital care applications are able to support individual fall prevention. This is done using the smartphone camera, which records the gait of the person in need of care. AI-based analyses and instructions can then be carried out to reduce the risk of falls.
Example: Dementia
Digital care applications can help people with dementia to cope better with everyday life in interaction with relatives. Therapeutic measures are guided by customized apps and tailored information is provided. Other services include personalized memory games.
Example: Pressure ulcer
An addition for digital care applications can be the very relevant care of pressure sores. This mainly affects people who are very weak, paralyzed or not fully conscious. They often lie or sit immobile in one position for a very long time. With the help of digital care applications, people in need of care and their relatives can be supported in better preventing, recognizing and caring for pressure ulcers.
What data protection requirements must be observed?
The test criteria of the Federal Institute for Drugs and Medical Devices also include data protection requirements for digital care applications.
The whole thing is based on the principles of lawfulness, processing in good faith, transparency and other criteria that are already known from the GDPR and the BDSG,
In addition, there are also the familiar requirements for controllers and processors with the data protection impact assessment and the record of processing activities.
A list of technical and organizational measures rounds off the list of criteria.
More interesting are the information security requirements as the basis for the TOMs for "digital applications", which I explained in my blog "Application security" in accordance with ISO/IEC 27034.
Gerd Grimberger,
Legal IT specialist
April 15, 2023
