Digital patient education: well prepared for the procedure

In Germany, Section 630e of the German Civil Code (BGB) governs patient education: oral, timely and understandable, given by the treating person or a person with the necessary training. In addition, it may refer to documents in text form. This is exactly where digital patient education comes in. It provides these documents, makes them understandable and documents what patients have seen and asked.

How far digitalisation goes depends on the approach. A generic video shows all patients the same content. A continuous workflow connects medical history, personalised patient education, consent and documentation. medudoc is the complete solution for preoperative patient management (PPM) and follows this second approach.

The story of Mrs Berger shows what this means in everyday hospital practice. She is a fictional example; the workflows and figures are not.

Mrs Berger is 68 and is due to have gallbladder surgery in three weeks. Today she is sitting in the corridor of the pre-anaesthesia clinic with a clipboard. The medical history form has four pages; her medication plan is at home.

Inside, the anaesthetist reviews incomplete information and holds the consent discussion under time pressure. Whatever is missing is asked about again or repeated as a precaution – laboratory tests, ECG, sometimes a second appointment. Missing records are the most common source of disruption in the workflow.

With her appointment confirmation, Mrs Berger receives a personal link. She opens it on her tablet in the evening – with no app and no new password. She signs the privacy notice, consents and treatment contract electronically straight away.

Next comes the digital medical history. One joint questionnaire for surgery and anaesthesia records each piece of information only once. If she mentions a pre-existing condition, targeted questions about it follow. She takes a photo of her medication plan.

Anyone who prefers to read in their native language can choose one of 23 languages. Font size and contrast can be adjusted.

In the Healthcare Professional Dashboard (HCP Dashboard), the case is complete: pre-existing conditions, medication with active ingredients and interactions, findings with source references. The platform has calculated the BMI, and conspicuous information is flagged.

The anaesthetist carries out the classification herself, for example according to ASA. She also chooses the appropriate type of patient education. The principle is “flag, don't assess”: medudoc flags, the physician decides.

Because the information is complete, fewer tests need to be repeated as a precaution. The goal is less overdiagnosis and more guideline-compliant diagnostics.

After clearance, Mrs Berger receives her personalised patient education video. It is created in a few seconds from many short sequences, matched to the procedure, the anaesthesia and her information. Surgery and anaesthesia are covered in one video; shared content appears only once.

The language is deliberately plain. Chapters, subtitles and a reading version aid understanding. If something remains unclear, she flags the point and notes her question for the discussion.

She can watch the video as often as she likes – including together with the people who will accompany her on the day of surgery.

The consent discussion remains at the heart of patient education, legally and personally. But the physician no longer has to present every standard item. She sees which passages Mrs Berger watched again and which questions are open. That is where she begins.

The discussion takes place on site or telemedically, by phone or by video in the browser. The physician decides whether this is sufficient for the procedure and risk profile. If the discussion runs via medudoc, a summary is generated as a suggestion for the consent sheet, which she confirms.

The digital consent sheet is created for the individual patient from general content and the information in the medical history. If needed, it is bilingual: German original on the left, translation on the right. The physician adds her annotation, then Mrs Berger signs in the browser or on a signature pad.

The hospital chooses the level of electronic signature under eIDAS for each procedure. The result is a single PDF/A with the consent sheet, medical history and consent trail – the record of who saw which content when, which question was asked and when the sheet was signed.

If questions about the patient education arise years later, its full history is available. The documents go to the HIS or archive system, and Mrs Berger finds her copy in the patient portal.