Reading the press releases around DMEA 2026, you could be forgiven for thinking German healthcare is about to reinvent itself. More platforms, more AI, more interoperability - and the next game changer behind every booth.
Talk in parallel to hospital managers, nurses, or physicians, and the tone shifts. The mood is tense: financial pressure, staffing shortages, structural uncertainty. Things have moved over the past years, just sometimes more slowly than the keynote stages suggest. That contrast is, for us, the most honest takeaway from this year's show. And it makes clear what matters now.
Inside the halls, the dominant mood was momentum: packed venues, AI, interoperability, platforms, startups, new business models. The focus was on solutions, scale, and the future. The tone: "What's possible?"
Outside, in the day-to-day of care delivery, it sounds different: uncertainty around the hospital reform, open financing questions, growing economic pressure. Existential worries instead of innovation rush. Many providers in reaction mode cautious, hesitant, in parts already resigned. The tone there: "What's coming at us?"
Both sides talk about the same reality but in completely different emotional states. And that is exactly where the danger lies: when one side is in crisis mode and the other in innovation rush, no real common ground emerges.
To put it bluntly: German health IT is celebrating the future, while care delivery is fighting to survive. We are digitalizing a system that isn't even sure it will continue to exist in its current form.
What's missing isn't another panel, another solution, or another pitch. What's missing is synchronization: between economy and innovation, between clinical reality and tech vision, between pressure and momentum.
After three days in Berlin, the picture is clear: solutions are becoming tangible. Patient-centered care is no longer a buzzword, it is being structured. The next generation of hospital information systems (HIS) is HTML-based, mobile, with certified billing and integrated speech recognition. Devices now feature telematics infrastructure (TI) connectivity, integrated video consultations, and AI-supported letter generation. Self-check-in on iOS, online appointment scheduling, cross sektor patient pathways: end-to-end is no longer just a slide; it is, at least in some projects, in actual implementation.
At first glance: a lot of movement. But precisely because so much is developing in parallel, one point becomes decisive: strategy before single solution.
A key driver of this movement will be the German Hospital Care Improvement Act (KHVVG) and the Hospital Transformation Fund (KHTF). Both create concrete reasons to engage strategically with care structures, mandates, and digital networking - and that tension is exactly what became visible at DMEA. The honest reading also includes this: a lot of the actual work still falls on the hospitals and care providers themselves, and the structural conditions make implementation anything but easy.
Telemedicine gains significant relevance in this context. Many hospitals are still hesitating to commit to specific platforms - whatever 'platform' is taken to mean in this context.
That, in itself, is not a bad thing as long as the time is used. Not to wait, but to sit down with other hospitals and providers and work out how telemedicine networks can be built and scaled in a meaningful way. Driven by care outcomes and ROI, not by how polished individual solutions look. The task is not to start the next siloed solution, but to build structures that hold up regionally and work across sectors.
That was also the core of our session "EHDS – The European Path to Digital Healthcare: Data Spaces, Identities and True Interoperability." Our position is this: EHDS turns health data into a central care resource and, through regulation and governance, redefines how that data is permitted to flow across Europe.
What was previously a national discussion is becoming a European obligation. The 2029 and 2031 deadlines feel far away. They are not. Anyone who waits to address architecture, semantics, and governance until shortly before will be too late.
One message from the panel that stuck with us: "True Interoperability" is not a technical detail. It is the precondition for data exchange to actually translate into care.
KHVVG, KHTF and EHDS may look like three separate topics at first. At DMEA, it became very clear that they all lead to the same place: providers are no longer thinking in single systems, but in regional structures, care networks, and data strategies.
We see this reflected in our own work - projects like H3 Initiative in Hamburg - and across many conversations at DMEA and since. Telemedicine networks, cross-sector care models, and the build-out of real regional structures are moving to the center driven by regulation, but just as much by a new mindset of "How did you solve this?" instead of "We'll build it ourselves, reeinvent the wheel and we know better."
That is the most important development of the show. It is the precondition for 16 federal states and thousands of institutions ultimately becoming one shared care SYSTEM.
And it leads to the one question that was more interesting at DMEA than any demo: not "Which HIS is best?", but "What does your data strategy look like?"
With all this movement, it is worth taking a step back. Instead of "Which new solution fits us?", here are some questions our industry asks too rarely:
And honestly: as long as we keep treating symptoms instead of tackling the root cause, innovations will barely reach the clinics even when they could help address exactly the financial problems we keep talking about. Synchronization would be possible. But it requires pragmatic policy steps and the will to follow through.
Digitalization will not solve the staffing shortage in the short term. But it can ease the load exactly where care is currently slowed down by missing information. The precondition: honest prioritization and the courage to decide together what we will no longer try to deliver.
If KHVVG, KHTF, and EHDS all lead to the same point, the honest answer is not "the next platform." It is: data availability has to become reliable infrastructure.
That is exactly what we work on at Founda -through open standards (IHE, HL7, FHIR, DICOM), vendor-agnostic and EHDS-ready, building the data availability infrastructure that healthcare networks need. Our platform is built for the next generation of connected care. Not as a technical exercise, but because the real answer to the state of the care system is this: progress will not come from a single new platform, but from reliably connecting the ones already in place and new ones.
Three takeaways from Berlin and what we recommend to hospitals, networks, and partners for the next 18 months:
The direction is right. Solutions are getting better, more concrete, in parts genuinely innovative. But the real challenge remains execution technically, organizationally, and politically. And above all, it requires one thing: that the reality of care delivery and the ambition of innovation find their way back together.
The question is: how long can a system afford to think in two parallel worlds?
We believe: it doesn't have to. If we stop talking only about the next solution, and start doing the unspectacular, hard work of data availability properly.