Concept and product
What is APST?
APST is the acronym for Ambulanzpartner Soziotechnologie APST GmbH (Outpatient Partner Socio-Technology Ltd) and is a service and product concept for an outpatient care network for patients that administers and manages data and documents pooled in an electronic patient record (EPR).
APST offers a network and Internet platform for the provision of assistive technology devices, therapeutics and medication in complex neurological disorders. Network-based care provision is a suitable means of bringing together the key players involved in elaborate care tasks. Doctors are often too absorbed in the challenges of their daily practice or hospital duties so as to be able to keep track of all the care details for individual patients. One typical challenge often is the lack of necessary documents such as prescriptions, statements, test reports from care providers or cost absorption confirmation from health insurance companies. This task is now performed by an APST coordinator. One further objective is to avoid inappropriate health care provision. APST identifies care partners (occupational therapists, speech therapists, home and nursing care providers, physiotherapists, medical equipment and supply stores) and medical partners (doctors, nutrition therapists, home and nursing care advisors, social workers), contacts them and coordinates their respective interactions. With the pooling of patient information on the platform, assistive technology devices, therapeutics and medication are guaranteed to be harmonized and implemented in good time.
How did the idea for APST come about?
The notion of founding APST was formed by Professor Thomas Meyer, MD und Professor Christoph Münch, MD, at their outpatient department at the Charité - University Hospital, Berlin, in 2009. Both neurologists, they attend to outpatients with severe neurological disorders, such as Amyotrophic Lateral Sclerosis (ALS). A major hindrance in their daily routine activities with outpatients used to be the lack of coordination between patients, physicians, therapists, pharmacists, medicinal products and health care services which made their endeavors less successful than desired. APST was initiated to counter this deficit.
What role does APST play?
APST develops and operates the internet portal ambulanzpartner.de and offers services in managed care. Managed care serves the coordination and networking between patients (and their relatives), medical partners (doctors, social services), providers of assistive technology devise and therapeutics and providers of home and nursing care services.
What role does Charité – University Hospital Berlin play?
APST closely cooperates with Charité – University Hospital Berlin in the provision of the website ambulanzpartner.de and any associated services. APST and Charité jointly host the internet portal and collaborate on data privacy, data security and research into managed care.
Does APST entertain business relations with the health insurance companies?
APST works independently of the health insurance companies and is available to both patients with public and patients with private health insurance cover. Notwithstanding, the standardization and documentation performed within the APST network facilitates the various application submission and approval processes for assistive devices, therapeutics and services. The information collected here may prove useful for any queries from health insurance companies, the medical service of health insurance companies (Medizinischer Dienst der Krankenversicherung, MDK) addressed to patients, care providers and/or prescribing doctors.
What is the Internet portal ambulanzpartner.de?
The secured internet portal ambulanzpartner.de is an innovative instrument for the documentation and coordination of health care processes. The relevant care data for each patient are amalgamated in a personal file, the electronic patient record (EPR), thus creating an overview of all the required therapies, assistive technology devices, therapeutics, care services or prescribed medication that have either been delivered already or that have pending applications waiting for approval. The website structure is simple and easy to follow for all users. Go to the “Home Page”, click on “Login” and sign into your account. You will then see a 5-item menu: “Profile”, “Care Provision”, “Documents”, “Partners” and “Ratings” which will effectively give you access to the data stored for you.
How do I access the Internet portal?
To participate in APST and to log onto ambulanzpartner.de patients must fill in two forms entitled: “APST Participation Consent Form” and “Registration on the Internet portal ambulanzpartner.de” and send them to APST. APST will then create free access to the electronic patient record for the respective patient. Please go to “Participation” on our home page for detailed instructions on how to participate.
Who is granted authorized access to the Internet portal?
Authorized access the health care and patient data captured is specified and strictly limited. Care partners are granted access to the data for those patients only they are actually caring for. The same goes for doctors, care teams and other medical partners.
Are patients able to view patient data other than their own?
No. Patients do not have user rights for the data of other patients administrated via the Internet portal Ambulanzpartner.de. This particularity marks the platform apart from open social networks. Patients may revoke access rights for any party at any time.
How do patients rate care and service providers?
Via their electronic patient record on ambulanzpartner.de, patients may access short, structured online questionnaires allowing them to rate their assistive technology devices, therapies, medication and care providers. The ratings are strictly confidential. Ratings are anonymized and pooled and then analyzed, exploited and published by APST. No other patients, physicians, therapists or care partners may view individual ratings. Ratings are used exclusively for the analysis of treatment outcomes, services and products within the APST network with the objective of improving therapies and care. By giving their feedback online, patients assume a more active role in the treatment process, thus promoting patient autonomy within the network.
Who develops the Internet portal ambulanzpartner.de?
The site ambulanzpartner.de has been developed by APST in cooperation with Charité. In consideration of the specific requirements on an electronic patient record, IT specialists from APST and Charité are working to ensure the highest data privacy and data security standards for processing patient data on the Internet.
How do patients benefit from APST?
APST offers patients coordinated support for elementary processes in the provision of assistive technology devices, therapeutics and medication. The coordinator is a contact person managing complex matters in outpatient care. The said coordinator liaises between the various care segments. The Internet portal hosts an electronic medical record for each patient on which all the processes, services and medicinal products can be identified and followed. The linking of coordination services and web-based electronic health care record is an innovation and strongly promotes patient autonomy.
Do patients incur any costs when using APST?
No. To patients and medical partners, ambulanzpartner.de can be offered completely free of charge. This is due to the fact that the various care partners are charged a fee which is used to maintain the portal’s IT structure.
Is the use of APST voluntary?
Yes, absolutely. One requirement for your participation in the APST managed care concept is that you or your health care proxy have read, understood and signed the patient information and consent form. This also entails the right for patients to withdraw their consent at any time without giving reasons.
Do I have to be resident in a certain area to be able to use APST?
The partners in the APST network are based in Berlin, Brandenburg, Dresden, Hamburg, Hanover, Thuringia and the Ruhr Area guaranteeing care provision in these regions. By cooperating with professional associations and federal institutions APST is in a position to find suitable care partners for you. Quality checks, documentation and care research conducted at the Charité all contribute to evaluating both established and new care partners thus driving the formation of associations with new care partners in previously underserved regions.
Is APST specialized in certain diseases?
The medical focus is on supporting people with Amyotrophic Lateral Sclerosis (ALS), Muscle Disease (Myopathies), Multiple Sclerosis (MS), various types of Movement Disorders (Parkinson’s disease, Multiple System Atrophy, Ataxia, Dystonia, etc.) as well as post-stroke neurological symptoms. In fact, the network is a result of our long-standing experience in highly specialized for people with ALS. Against this background, the care partners in the network are all highly familiar with the extreme challenges posed by severe and complex neurological diseases. Having said that, the provision of assistive technology devices to patients is based on symptoms rather than exclusively on diagnosis. Crucial factors are severity and progression of motor symptoms as well as the treatment goals jointly defined by doctors and patients. This facilitates individual therapeutics and assistive devices management for all conditions leading to impaired mobility and communication.
I am already cooperating with medical equipment and supply store. Can I still participate in the APST scheme?
Yes, you can in principle. Our nationwide network of cooperating partners ensures broad coverage with providers of assistive technology devices. Should you wish to work with a specific partner, APST can get in touch with your favorite medical equipment and supply store. Any certified provider of assistive technology qualifies for joining the APST network. Prerequisite is that the potential new partner consents to upholding the quality, care and documentation standards governing the APST network and to accepting to the APST General Terms and Conditions.
I already have a therapist. Can I still participate in the APST scheme?
Yes, you can in principle. Our network of cooperating partners ensures broad coverage with providers of therapeutics in the Berlin and Brandenburg areas. Should you wish to work with a specific occupational therapist, speech therapist or physiotherapist, APST can get in touch with your favorite therapist. Any certified therapist qualifies for joining the APST network. Prerequisite is that the potential new partner consents to upholding the quality, care and documentation standards governing the APST network and to accepting to the APST General Terms and Conditions.
Will my joining APST affect my independence?
No, it will not. You may withdraw your consent to having your health care needs managed by APST at any time without giving reasons. Giving your consent does not mean you are under any obligation whatsoever. APST is an open network initiated with the objective of supporting effective care provision in the complex coordination needs between patients, doctor, pharmacies, providers of assistive technology devices and therapeutics. You are not bound by contract; neither do you incur any additional costs. Your insurance policy remains unaffected thereby.
For medical partners
Who are our care partners?
Medical partners in the APST network are socio-medical professional entities that do not pursue any entrepreneurial activities. Hence, our medical partners comprise doctors, nutrition therapists, (nursing) care professionals, nursing care advisers, social workers, and teams in clinics and practices.
How do doctors and clinics benefit?
From a physician perspective, the APST concept is highly advantageous in terms of data management facilitation using an electronic patient record and quality enhancement as a result of highly specialized case management. The benefit for doctors are similar to the benefits experienced by other medical partners as their services are linked and coordinated on the APST management platform.
Do medical partner incur any costs by joining APST?
No, they do not. Medical partners do not have to pay a fee. APST is completely free of charge for medical partners as funding comes from user license fees charged for care partners, donations and care research projects thus guaranteeing optimum service operation.
For care partners
Who are our care partners?
Our care partners in the APST network are companies specialized in the provision of assistive technology devices and therapeutics, medication or nursing care services.
How do care partners benefit?
The Internet portal ambulanzpartner.de is a key instrument available to care partners for the coordination of care processes. The care data for all the key players in the APST network are captured on an electronic patient record and made visible to authorized care partners. APST is a no-obligation service offer for care partners outside standard care provision. APST services are designed to optimize patient care at the discretion of the competent care partners, comparable to other services and products purchased by care partners to operate their business (logistics or bookkeeping software; further training and education services; equipment. commodities, infrastructure).
Do APST care partners incur any costs?
Yes, they do. The business partners in the care network must acquire a user license for the APST Internet platform and services. The license fees are applied to maintain and refinance the current IT and service structure and to develop the Internet portal further. This is an innovative, comprehensive, complex and costly platform offering services beyond the standard care provision. The costs arise as a result of the requirements and dynamics of internet technologies and associated services.
Why is research so important to APST?
APST and the cooperating universities have a strong interest in clinical, socio-medical and health care economic data captured via the APST portal. The real care data for each patient recorded thereon facilitates real research into patient care. The funding policy, structural and economic base are a result of the cooperation and service exchange between APST GmbH and Charité – University Hospital.
What type of research does APST conduct?
Research realized via APST includes the following:
1. Three research projects completed with the aid of funds from the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF) entitled „Mobile HybriCare“, „ServCare_ALS“ and„Innovationsdramaturgie nach dem Heldenprinzip“ promote the APST concept. Consequentially, the concept is subsumed under the aspects of health care and service research and business model innovation.
2. The Amyotrophic Lateral Sclerosis (ALS) care research project („MND-NET“).
3. In May 2014, the EU joint venture „CarE-ALS“, investigating transferability of the APST concept to ALS care in the Netherlands, Belgium and the Republic of Ireland (EU Joint Programme – Neurodegenerative Disease Research, JPND) was initiated.
4. The German Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) has looked into the innovation potential of the APST concept and included in the “National Plan of Action for People with Rare Diseases „Nationalen Aktionsplan für Menschen mit seltenen Erkrankungen“ (NAMSE) under the item “Information Management”; NAMSE is a joint activity of BMG and BMBF.
Data Privacy and Data Security
Are my data safe with APST?
Yes, they are. The data privacy concept implemented by APST meets all the stringent regulatory requirements of the County of Berlin and the Charité. Inherent to the Data Privacy regulation is the right to revoke user rights for the exploitation of patient data. Each patient is given the option of withdrawing their informed consent for the utilization of their personal data at any time without giving reasons. Any issues with data security have been resolved prior to developing and programming the APST portal. As the data are stored on the servers of Charité University Hospital, their data privacy regulations apply. Authorization was granted accordingly in March 2011 following a joint development and evaluation process. The documentation of data contained on the patient information and consent form was performed in strict adherence to data privacy regulations. For network partners, it is mandatory to sign data privacy agreements.
Where are my data stored?
The entire IT architecture is located on the Charité servers. It is provided on the basis of a cooperation agreement. Patient and care data are thus stored on the Charité servers. Via a secure link, APST and all the other authorized parties may access the data sets required for the provision of care to the respective patients.
What does APST do with the data?
The Internet portal ambulanzpartner.de is password secured and strictly not available to the public or any unauthorized person. After reading and acknowledging the patient information leaflet and signing the informed consent form (ICF) patients authorize APST to collect, store and process their patient, medical and care related data. Accordingly, selected data are forwarded to medical partners and care partners so that appropriate care can be provided to the patient. The Charité reserves the right to systematically analyze data sets to elucidate any care research and health care economic issues. Please read the data privacy declaration for managed care via APST and the utilization of the secure Internet portal ambulanzpartner.de for details on the data privacy and security concept.
How is APST financed?
The services and the Internet platform are financed with licenses granted to the business partners we cooperate with (providers of assistive technology devices and therapeutics and nursing care services). These partners are willing to pay for this setting as they benefit from an increase in efficiency in case management, quality enhancement, improved resource management and the creation of unique selling points. Care management and the services on the Internet portal ambulanzpartner.de are thus based on a revenue model linking socio-medical added value with a business model innovation. The core principle governing this financing structure is independence from the current health care and nursing care insurance companies. This so-called “Social Entrepreneurship“ is a business model that creates social values financed from revenue gained in the setting of a competitive organizational structure.
Who supports APST?
Initial financing came from the Technology Foundation Berlin (Technologiestiftung Berlin, TSB) innovation support fund in cooperation with Investment Bank Berlin (Investitionsbank Berlin, IBB). IBB is the investment and development bank for the County of Berlin. It promotes Berlin as a thriving economic center by supporting business development projects. The foundation Steelworks Georgsmarienhütte (Stiftung Stahlwerk Georgsmarienhütte) is running a project entitled “Conception, Development and Operation of a Web-Based Care Centre for People with Amyotrophic Lateral Sclerosis (ALS) (Konzeption, Entwicklung und Betrieb eines Web-unterstützten Versorgungszentrums für Menschen mit Amyotropher Lateralsklerose (ALS)“ for the nationwide provision of the APST portal service architecture and the development of a highly specialized care network for ALS. The foundation Stahlwerk Georgsmarienhütte wants to support projects and initiatives for sustainable contributions to successful communal life in our society.