Transforming the patient experience with telehealth in Europe


Pflegewerk Managementgesellschaft

HaendePflegewerkPflegewerk was founded 20 years ago as a private health service provider. Today, the group of companies employs about 1.500 employees all over Germany. The biggest service area is Berlin. Some further information about the company in Berlin:

Pflegewerk in Berlin is a carrier of six ambulant nursing services for about 1.000 patients who live on their own and partly share apartments with someone.

Additionally to the ambulant area Pflegewerk has more than 10 nursing homes with places for altogether 400 persons. For patients who want to live independently in a home environment but also need the frame of a residential care home Pflegewerk offers 560 residential care home apartments all over Germany. The composition and assistance of resident groups is of central importance as residents are requested to have social contacts and herewith the possibility to live self-paced and independently as long as possible.

In all health care areas intensive care patients and chronically ill patients can be taken care of. The medical treatment is assured by “Mediplus” the internal medical supply center (MVZ – Medizinisches Versorungszentrum) of the organizational institution Pflegewerk. Here general practitioners, ophthalmologists and specialists in internal medicine are accessible. The high investment for the builtup of the MVZ was necessary to assure a therapeutic chain without a gap on all levels.

Special doctors from the MVZ assure the ambulant on-call service at night in the care facilities.

Within the frame of case- and care-management the coordination center of Pflegewerk manages and concentrates all health services, gives advice to patients and their relatives and coordinates the different processes between the clinic, the emergency ambulance, the doctors, the social workers and the care services. Here, cooperation with the local authorities and the coordination center of the municipality in Berlin is very tight.

There are special cooperation contracts with all clinics in Berlin that regulate the seamless transfer of the patients to the ambulant care (aftercare management). The range of services is complemented by two hospices with together 30 places in Berlin which are run by full-time and voluntary employees.

The comprehensive care of chronically ill and seriously ill patients according to their physical, psychological, mental, spiritual and social demands are at the center of ambulant and stationary supply. Relatives, friends and acquaintances are also accompanied and given attention, welfare and sincerity. The work of Pflegewerk encompasses the qualified, voluntary psychosocial care at home as well as in the hospital or the hospice with a specifically trained treatment team.

The chronically ill patients of Pflegewerk are looked after in Disease Management Programs (DMP) within the frame of specific supply contracts with the health insurances. The doctors of Mediplus are qualified for DMPs.

A new, trendsetting branch of Pflegewerk, which was built up in the last two years, are the more than 150 “breathing stations” (for weaning patients) for the weaning off therapy of permanently ventilated patients within intensive care. Through targeted telemedical monitoring these chronically ill patients (COPD) can be supplied for mostly out-of-hospital. Here agreements, which were refined from the pilot project “hospital at home”, were concluded with different clinics.

The documentation of services is assured by an effective information management system. The electronic patient record, which has an integrated data controlling between clinics, doctors and care services, is currently realized in the pilot project “CareStation” for seriously ill and chronically ill patients.

Since 2004 it is possible to conclude special integrated supply agreements with health insurances. Here, within the frame of a regional supply contract with health insurances, Pflegewerk as managed care organization and provider takes the exclusive medical and economical responsibility. The allowance is funded by risk-adjusted capitation fees (”full-capitation“).

Just recently a new agreement for the supply for psychic chronically ill patients in Berlin was concluded with “Technische Krankenkasse”, Germany biggest health insurance. Here, the focus is on case management within the frame of need-adapted treatment. In the future, this contract will clearly improve the common psychiatric supply.

All facilities of Pflegewerk have a central quality management that works in tight cooperation with the sponsors (health insurances). The supply processes are continually evaluated and audited in regard to the resulting quality. All facilities are certified by DIN ISO. For different qualifying activities of the medical, nursing and therapeutic employees an internal educational academy, “CurAkad”, is available.


Pflegewerk –

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