Digital healthcare in Germany is developing thanks to a system of innovation hubs that bring together and facilitate the incubation of new healthcare technologies.

The "Digital ecosystems" list several German digital innovation "hubs". The digital health hubs are:

• Zollhof, Nürnberg hub: specializing in the development of business models for digital health, connected objects and artificial intelligence
• 5-HT, Mannheim/Ludwigshafen hub: specializing in the digital transformation of the German healthcare system
• Medical Valley, Erlangen hub: specializing in the development of innovations that meet the challenges of today and tomorrow . It provides its Medical Valley GmbH platform, which markets its companies' products and offers advice to help them access the German market . It also offers the Dmac (Digital Medical Application Center), which supports innovators in the development of their projects.

The preconditions for this gateway to the German market remain the required possession of the CE mark, sufficient for a product to be put into circulation in Germany, and the declaration of the putting into circulation of a medical device to the BfArM, in order to receive reimbursement .

The German insurance system is decentralized. There are 95 public and 42 private health insurance funds. The two funds with the largest number of policyholders are TK and Barmer. Health insurance companies choose which products they accept for reimbursement in addition tothose that have been validated by BfArM. They often have their own innovation hubs. This is the case of TK's innovation portal, which offers support for innovation.

The BfArMis the federal authority in charge of health technology assessment. It issues marketing permits for various finished medical products.

To gain access to reimbursement, a clinical study proving the therapeutic and economic efficacy of one's product on the German market is required. This test period lasts an average of 18 months, during which time it is possible to find intermediate reimbursement from the regions if doctors apply.The support of healthcare professionals and health insurance funds thus makes it easier to obtain a license from BfArM.

For entrepreneurs developing and marketing e-health applications, BfArM offers an accelerated evaluation procedure enabling faster market access called DiGA.

To be registered in the directory of reimbursable digital health applications (DiGA directory), you can follow an accelerated procedure:

1. You submit your application here declaring the product's quality, effectiveness and impact on the German healthcare system
2. In the event of a favorable BfArM assessment, your healthcare solution is included in the public DiGA directory.
3. Patients will be able to benefit from DiGA in the presence of a prescription or medical proof

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The G-BA is a public legal entity comprising the 4 main coordinating organizations of the German autonomous healthcare system:

• The national associations of public health insurance physicians;
• The German Hospital Federation;
• The Central Federal Association of Health Insurance Funds and the national associations of public health insurance dentists
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The G-BA defines the specific healthcare services that are covered by compulsory health insurance (GKV). It is also responsible for funding projects on new forms of healthcare delivery and research. The G-BA Innovation Committee defines priorities and funding criteria for projects.