[Translate to English:] Ältere Dame mit Arzt

What we’ve achieved: Weisse Liste: The guide to Germany’s health-care system


The Weisse Liste (White List) Internet portal is designed to help patients and their families identify the health-care services that meet their needs. It increases transparency by providing information on the quality of doctors, hospitals and nursing facilities – in a way that even non-professionals can understand. The project is organized by the Bertelsmann Stiftung. Its strategic partners and co-initiators are Germany’s major patient and consumer organizations: Bundesarbeitsgemeinschaft Selbsthilfe (BAGS), Sozialverband Deutschland (SoVD), Verbraucherzentrale Bundesverband and Sozialverband VdK Deutschland. These associations support the project by representing the interests of patients and consumers. Approximately one million people visit the Weisse Liste portal each month.

The Bertelsmann Stiftung: A driver of reform in the health-care sector

For approximately 20 years, the Bertelsmann Stiftung has been involved in projects and initiatives designed to reform the country’s health-care sector. It is committed to creating an effective system based on social solidarity that guarantees everyone access to appropriate care regardless of their social status. As a result, the foundation’s programs consider the various perspectives people have as patients, consumers and members of health plans. A key objective is increasing the transparency and quality of care and providing the public with facts and figures that can guide them as they look for service providers.

Using facts, figures and digital applications to create a transparent, people-centered system

 

One of the program’s first projects was the  Gesundheitsmonitor (Health-Care Monitor). In cooperation with health insurer Barmer GEK, this tool was deployed between 2002 and 2016 to survey members of the public about their experiences using Germany’s health-care system. Findings from the survey were then introduced into the policy debate. The Bertelsmann Stiftung uses its Faktencheck Gesundheit (Health-Care Fact Check),  to both align health-care services to both align health-care services more closely with patients’ actual needs and make more efficient use of limited resources. It also helps improve doctor-patient relationships by  promoting shared decision making. The project "Der digitale Patient“ is designed to offer patients guidance and ensure new technologies are used to serve health needs.

Weisse Liste as a catalyst for health-care reforms

Weisse Liste is a prime example of the Bertelsmann Stiftung’s approach to reform in the health-care sector. The project’s Internet portal www.weisse-liste.de supports patients and their families by helping them overcome feelings of uncertainty and confusion. Weisse Liste is designed to assist individuals in deciding which are the right health-care services to meet their needs. It does so by providing transparent information on the quality of doctors, hospitals and nursing facilities – in a way that non-professionals can understand. It therefore promotes competition by shedding light on which providers offer the best services. This, in turn, benefits the public by increasing overall quality.

Goal: A reliable health-care guide

The Weisse Liste portal, the project’s core element, has been online since 2008. It offers users practical support as they search for the right provider in their own community or, if necessary, nationwide. It differs from other (mostly commercial) sites in that it does not accept advertising, is free of charge and is not influenced by the interests of health-care providers. It offers high-quality content, for example by using information based on scientifically developed surveys and by setting robust standards that prevent manipulation.

Credibility thanks to trustworthy partners

Weisse Liste is conceived not only as a portal, but also as a project platform. Its goal is to realize its objectives in cooperation with like-minded, trustworthy partners. This is true both for the development of new topics and for disseminating findings. The project is organized by the Bertelsmann Stiftung, and its strategic partners and co-initiators are Germany’s major patient and consumer organizations: Bundesarbeitsgemeinschaft Selbsthilfe (BAGS), Sozialverband Deutschland (SoVD), Verbraucherzentrale Bundesverband and Sozialverband VdK Deutschland. These associations support the project by representing the interests of patients and consumers.

Germany’s Federal Commissioner for Patients’ Affairs serves as the patron for Weisse Liste. Since 2011, Weisse Liste gemeinnützige GmbH , a wholly owned subsidiary of the Bertelsmann Stiftung, has been responsible for the portal’s operation and ongoing development. 

Weisse Liste as nonprofit business model

Weisse Liste finances its nonprofit business model largely through its licensing model. Seven licensing agreements have now been signed with the following health insurers: AOK, Barmer, KKH, AXA, Bertelsmann BKK, Debeka and Union Krankenversicherung. As the AOK website shows, health insurers include Weisse Liste in the services they themselves offer online: weisse-liste.krankenhaus.aok.de. In addition to making the site’s information available through a variety of channels, the licensing model also covers a large part of the operating costs.

Weisse Liste target groups

Patients and their families looking for suitable, high-quality medical or nursing care are the primary group targeted by Weisse Liste. The project develops and realizes (digital) information solutions for patients which are designed to serve at the national and state levels as models for consumer-oriented quality reporting on health-care services. To that extent, policy makers and other health-care actors are also part of the target group.

One example of reform: Quality reporting in nursing care

 

One example of the project’s practical suggestions is the Weisse Liste proposal for reforming how nursing care is evaluated in Germany. Until now, the quality of the country’s nursing homes has been described using marginally meaningful “report cards.” What Weisse Liste suggests instead is issuing warnings and recommendations on the quality of care, disseminating information on staffing and various structural characteristics, and including input from people who have experienced care. The reform proposals and a video presenting a prototype of an online application can be found at: 

www.weisse-liste.de/public-reporting-pflege

Impact of Weisse Liste

In 2017, the Weisse Liste project activities were extensively evaluated and their impact assessed. Key elements were a qualitative analysis of public awareness, reach and user engagement, and stakeholder interviews on strategic positioning and effectiveness. Another aspect examined was whether project goals are being reached on the patient level (individual benefit) and to what degree Weisse Liste contributes to the further development of quality of care (system improvement). The findings in both areas were essentially positive.

Key findings from the impact analysis

  • Public awareness: one in six online users is familiar with Weisse Liste, as are 90 percent of quality managers at clinics and 80 percent of doctors. 
  • Use: One million users visit Weisse Liste each month (an increase of approx. 300 percent since 2014)
  • The recommendation rate is 74 percent among patients and 80 percent among patient consultants.
  • 80 percent of users say their expectations were fulfilled
  • 50 percent of quality managers in hospitals use Weisse Liste.. 
  • 37 percent of patients say that they have reconsidered their decision about a health-care provider after using Weisse Liste.
  • The majority of health-care researchers and health insurance representatives say that Weisse Liste increases quality by promoting competition.
  • The project’s success has been limited among the target group of doctors in private practice, who continue to exhibit low levels of acceptance for quality comparisons.

Result: Since its launch in 2008, the Weisse Liste project has undergone considerable further development and proven successful in a sometimes challenging environment.


Outlook

Thanks to a dedicated funding model, Weisse Liste will be able to continue serving as a guide to Germany’s health-care system in coming years. One of the primary goals for the future is accessing new sources of data, particularly in the area of nursing care and physician practices, and integrating the project’s valuable information into new digital solutions such as electronic medical records. Another focus will be on expanding the project’s reach using search engines and social networks. A “mobile first” strategy has recently been adopted as part of the ongoing drive to optimize the portal’s usability. More than 60 percent of users already access Weisse Liste using mobile devices.