Digitalization and Deep Structural Change: Is the Platformization of the Healthcare Sector Inevitable?

数字化和深层次的结构变革：医疗保健行业的平台化是不可避免的吗？

• 批准号: 523945592
• 负责人: Professor Dr. Kai Reimers
• 金额: --
• 依托单位: Institut für Wirtschaftsinformatik
• 依托单位国家: 德国
• 项目类别: Priority Programmes
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/523945592?language=en
• 关键词: Digitalization; Deep; Structural; Change; Platformization

Digitalization is believed to deeply affect all sectors of society. A particularly interesting sector in this regard is pharmaceutical distribution. Its deep institutional structure has evolved over centuries and has shaped healthcare systems in all Western societies. At its core lies the institutional separation of the professions of pharmacists and physicians. The current wave of digital technologies has led to the so-called platformization of various industries, including the healthcare sector. Platforms are currently being built which offer medical consultation and drug delivery as a ‘one-stop-shop’ and, to support such integration of pharmaceutical and medical services, the abolishment of the ‘historical separation’ of the professions of pharmacists and physicians has been called for. European history is replete with challenges to this deep institutional structure of the healthcare sector which, so far, have been fended off. This sector is therefore particularly interesting for the study of digital transformation of society as a whole since it provides a ‘critical case’. Studying the way in which it has responded to challenges in the wake of societal disruption in the past and in the present will therefore provide clues to the underlying mechanisms and dynamics of societal transformation, including the present such period driven by the arrival of a new generation of digital technologies. This project will study three periods in which the organization of pharmaceutical distribution has experienced significant change. In the first period (1800-1850), a joint practice of pharmacist and physician to formulate complex medicines has reached a climax, within the boundaries of the institutional separation of the two professions. In the second period (1910-1938) health insurance organizations became a proto-form of modern platforms in that they contracted pharmacists and physicians, imposed strict restrictions on drugs to be prescribed and dispensed, and negotiated prices with pharmacists. This resulted in the complete separation of the two professions in the sense that the joint practice of formulating medicines was lost. In the third, the current period (2010-2025), the possibility has arisen again to develop a joint practice that brings the two practices of pharmacists and physicians closer together again, this time focusing on medication as such. Increasingly, the safety of medication becomes a major public health issue and managing medication therapies is seen as a way to improve and optimize medication therapies. Will pharmacists and physicians once again learn to cooperate within the boundaries of the institutional separation of pharmacists and physicians or will platforms succeed in overthrowing this separation in order to employ big data analytical techniques to centrally oversee and optimize medication therapies?

数字化被认为深刻影响着社会各行各业。在这方面，一个特别有趣的领域是药品分销。其深层的制度结构已经发展了几个世纪，并塑造了所有西方社会的医疗保健系统。其核心在于药剂师和医生职业的制度分离。当前的数字技术浪潮导致了包括医疗保健行业在内的各个行业的所谓平台化。目前正在建立提供医疗咨询和药品配送的“一站式”平台，为了支持药品和医疗服务的一体化，人们呼吁废除药剂师和医生职业的“历史性分离”。欧洲历史上充满了对医疗保健行业深层制度结构的挑战，但迄今为止，这些挑战都被抵御住了。因此，该领域对于研究整个社会的数字化转型特别有趣，因为它提供了一个“关键案例”。因此，研究过去和现在社会颠覆后应对挑战的方式，将为了解社会转型的根本机制和动态提供线索，包括当前由新一代数字技术到来推动的时期。该项目将研究药品分销组织经历重大变化的三个时期。在第一个时期（1800-1850），药剂师和医生在两个职业的制度分离范围内联合实践配制复杂的药物达到了高潮。在第二个时期（1910-1938年），健康保险组织成为现代平台的雏形，它们与药剂师和医生签约，对处方和配药实行严格限制，并与药剂师协商价格。从某种意义上说，这两个职业完全分离，配制药物的联合实践消失了。在第三阶段，即当前阶段（2010-2025年），再次出现了开发联合实践的可能性，使药剂师和医生的两种实践再次更加紧密地结合在一起，这次的重点是药物本身。药物安全日益成为一个主要的公共卫生问题，管理药物治疗被视为改进和优化药物治疗的一种方法。药剂师和医生是否会再次学会在药剂师和医生的机构分离的范围内进行合作，或者平台是否会成功推翻这种分离，以便利用大数据分析技术来集中监督和优化药物治疗？