For many hospitals, the question of whether digital solutions are eligible for funding under the German Hospital Care Improvement Act (KHVVG) is currently arising anew. Unlike in the context of the Hospital Future Act (KHZG), the focus is no longer primarily on digitalisation as an individual measure, but on its contribution to structural changes in care.
Against this background, medudoc commissioned the law firm
Lyck+Pätzold. healthcare.recht to systematically examine the eligibility of the medudoc platform for funding under the KHVVG. The results of this short legal opinion are summarised below and placed in the context of the current funding logic.
The aim is not to evaluate individual strategies, but to provide a factual classification of the legal starting point and the possible points of reference within the defined funding categories (FTB).
Starting point: the funding logic of the KHVVG
The KHVVG created a transformation fund that specifically supports structural adjustments to hospital care. The focus is in particular on:
- cross-sector care concepts
- qualitative and economic efficiency gains
- sustainable organisational change
Digitalisation is not a funding purpose in its own right, but is only taken into account to the extent that it supports these structural goals. The specific design is set out in defined funding categories (FTB), each of which addresses specific requirements and target models.
medudoc in its functional context
The short legal opinion describes the medudoc platform as a cloud-based infrastructure for the end-to-end digitalisation of preoperative processes – from the structured medical history and video-assisted patient education to electronic consent and integration into clinical systems.
A central feature is its end-to-end structure: the platform connects several process steps that many hospitals have so far organised in a fragmented way, and integrates them into one consistent digital process.
The legal classification expressly emphasises that medudoc is not understood solely as a patient education solution, but as part of a more comprehensive clinical process system.
This distinction is important in the KHAG context, because eligibility for funding depends largely on whether a system performs isolated functions or is integrated into medical care processes.
Distinction: patient education solution vs. process-integrated platform
In the market, digital patient education is often regarded as a category of its own. Solutions in this area typically focus on:
- standardised provision of information
- documentation of consent
- legal protection of the consent process
By contrast, the short legal opinion places medudoc in a broader functional framework. The platform integrates patient education into an upstream and downstream clinical context:
- structured data collection as the basis for patient education
- individualised, modularly compiled video sequences
- direct feedback into medical decision-making processes
- use of the collected data for risk assessment and process control
As a result of this integration, patient education is not considered in isolation, but as part of an overall medical process.
With regard to the funding categories, this distinction is relevant, because pure information or documentation solutions typically do not fall under the structural objectives of the KHVVG, whereas process-integrated systems can be classified differently under certain conditions.
Funding category FTB 3: telemedical network structures
The central point of reference in the opinion is funding category 3 (FTB 3), which addresses the creation of telemedical network structures.
Legally, this category covers projects that:
- enable medical services using digital communication structures
- connect several healthcare providers with one another
- create qualitatively improved care through coordination and exchange of information
The opinion examines whether medudoc can be classified in this context and concludes that this is possible under certain conditions. The following are particularly relevant:
- the video-assisted consent discussion as part of the physician–patient contact
- the use of structured data for medical decisions
- integration into clinical information systems
- the possibility of cross-facility use
In this constellation, medudoc is not assessed as pure process digitalisation, but as supporting infrastructure for treatment processes with a telemedical character.
Significance of the network structure
An essential element of FTB 3 is the networking of several facilities. The opinion emphasises that medudoc is designed as a multi-client capable platform and is therefore in principle suitable for use beyond individual hospitals.
Technical features such as:
- standardised interfaces (e.g. HL7/FHIR)
- interoperable data models
- cross-sector use of data
support this classification.
Eligibility for funding does not arise solely from using the platform, but from the specific design of a project in which several parties are structurally connected with one another.
Overview of further funding categories
In addition to FTB 3, the opinion considers further categories that may be relevant in individual cases.
FTB 2: cross-sector care facilities
FTB 2 addresses the restructuring of existing hospital sites into cross-sector care facilities.
medudoc can play a supporting role in this context, for example through:
- digital networking between inpatient and outpatient areas
- structured patient intake processes
- standardised documentation and data availability
However, eligibility for funding depends on additional structural requirements, in particular the formal classification of the site as a cross-sector facility.
FTB 5: regional hospital networks
FTB 5 aims at the creation and further development of regional hospital networks.
Here, medudoc can contribute to harmonising processes, for example through:
- uniform intake and patient education structures
- a shared data basis across several facilities
- configurable but standardised workflows
In this constellation, the opinion sees a possible classification as supporting infrastructure within a network project.
FTB 6: integrated emergency care structures
In the area of integrated emergency care structures, by contrast, medudoc is not classified as a primary object of funding, as the platform is geared towards planned, preoperative processes. Indirect support is described, but without direct eligibility for funding in this category.
Classification of the application procedure
The procedure for applying for funding has two stages. In the first stage, the hospital or its operator registers its funding needs with the competent state authority. Operators cannot submit their own application to the Federal Office for Social Security (BAS). The state examines, among other things:
- eligibility of the project and its costs (§ 12b(3) sentence 1 no. 1 KHG)
- classification within the funding categories (§ 3 KHTFV)
- that the project did not start before July 1, 2025, and co-financing (§ 12b(3) sentence 1 nos. 2 and 3 KHG)
In the second stage, the state applies to the BAS for the funding (§ 4 KHTFV). The BAS decides by formal notice and pays the funds to the state (§ 5(1) KHTFV). The state then grants the funding to the hospital operator by its own funding notice (§ 5(2) KHTFV). The procedure thus combines regional prioritisation with central review.
Summary of the classification
The short legal opinion concludes that medudoc may, under certain conditions, be eligible for funding under the KHVVG – in particular in the context of telemedical network structures under FTB 3. What matters is not the individual function of the platform, but its integration into:
- medical care processes
- cross-facility structures
- specific transformation projects within the meaning of the Act
At the same time, the analysis shows that eligibility for funding is not an isolated feature of a software solution, but results from the interplay of technology, organisational context and regulatory requirements.
