By Miriam Friedmann
02. September 2025

The KHVVG: Roadmap for the digital clinic of the future

The German Hospital Care Improvement Act (KHVVG), which came into force on January 1, 2025, marks a fundamental upheaval in the German hospital landscape. This is because it is far more than just a legal adjustment: it is the blueprint for the future direction of medical care in Germany. For hospital managers and IT directors, this means not only a series of new challenges, but also an enormous opportunity to make their own facilities fit for the future. Those who set the right course now will secure a decisive advantage in the modernization of hospital care.

Hospital Care Improvement Act - setting the course for German hospitals

The Hospital Care Improvement Act - KHVVG in short – primarily pursues three core objectives that have a profound impact on the strategy, structure and organization of a clinic:

Quality improvement through performance groups: A central pillar of the law is the introduction of around 65 service groups. These define minimum requirements for the structural and process quality of medical services. The federal states must assign these service groups to hospitals by the end of 2026. For your hospital, this means a precise analysis of the service portfolio and, if necessary, an adjustment of internal processes in order to meet the new quality standards.
Securing supply and structural adjustment: The law aims to ensure comprehensive medical care, particularly in rural regions. This is achieved by restructuring and concentrating hospital locations and promoting new forms of care. For hospital managers, this means that they must re-evaluatee the strategically position of their facility in the regional care network and, if necessary, intensify cooperation with other institutions.
Reducing bureaucracy and promoting innovation: The KHVVG promises to reduce bureaucracy through standardized and harmonized inspection procedures. At the same time, it is intended to create incentives for innovation and modernization, particularly in the area of digital solutions. This is a direct challenge to hospital managers in Germany to tap into the potential of new technologies for more efficient and higher quality patient care.

In order to achieve these goals, the law provides for important financial and structural measures, including the establishment of a transformation fund to financially secure the necessary restructuring and to secure liquidity for hospitals.

A key innovation of the Hospital Care Improvement Act is also the establishment of cross-sector care facilities, which are intended to enable better integration of outpatient and inpatient care.

KHZG vs. KHVVG: The differences

The KHZG (Hospital Future Act) aimed to provide hospitals with financial support for digitization and to modernize medical care. The KHVVG focuses on a structural reform of the hospital landscape. It aims to improve the overall quality of care and reorganize hospital financing.

Simply put, the KHZG was about the digital equipment of hospitals, while the KHVVG focuses on the entire organization and financing.

Performance groups require stronger networking

It is already clear that the classification of hospitals into the various service groups will lead to shifts in the services offered by individual facilities. Some, particularly more complex services, will be concentrated in specialist centers in the future.

As a result, new regional care networks must be created to ensure the medical treatment of patients in the area. This requires closer cooperation between different facilities and a smooth, cross-sector exchange of relevant patient data. In order to achieve this, the electronic patient record (EPR), digital tools including AI applications and telemedicine solutions play a central role. They promote and facilitate cross-institutional collaboration and form the basis for efficient communication and workflows.

In contrast to the Hospital Future Act (KHZG), in which individual measures such as a patient portal were funded, the KHVVG requires the submission of holistic concepts and strategies in order to reorganize patient care through clinics and financially support the digital transformation in German hospitals.

Hospital managers and IT directors need to identify where their facility still has digital weaknesses and how the funding opportunities provided by the legislator can be used in a targeted manner to close these gaps. They must evaluate the existing IT infrastructure of their facilities holistically and develop holistic, future-proof concepts in order to benefit from the funding pots. Cloud and SaaS solutions can make an important contribution to these concepts and strategies: they are easy to implement, allow cross-institutional data communication based on modern technology standards and offer a high level of IT security.

The TMD Cloud from Telepaxx, for example, can contribute to the digitization of image management workflows: it is modularly configurable and enables the administration of user and access rights as well as the option to share individual image data with patients and downstream facilities via the associated web portal. It is also possible to import external image data into the TMD Cloud with just a few clicks. Integration and implementation can be completed in just a few weeks, without the need for a lengthy IT project. In combination with other SaaS solutions such as AI classifiers for the automatic evaluation of defined DICOM data, this creates a holistic concept for the digitalization of image management workflows.

Digitization at the heart of the KHVVG

The digitization of hospitals is the driving force behind the objectives of the KHVVG. The law is pushing for a far-reaching digital transformation in hospitals in order to increase the efficiency of processes, improve the quality of care and reduce the workload on staff.

Process optimization through technology: Digital solutions enable far-reaching automation of administrative and clinical processes - for example in patient admission, in the documentation of treatment processes or in data management. By reducing manual workflows, processes can be accelerated, errors minimized and valuable time gained for patient care.
The electronic health record (EHR): The EHR is more than just a digital filing system: it should be the central element for the efficient and transparent management of patient data. If this is successful, its full potential will unfold. Duplicate examinations can be avoided, diagnoses accelerated and the quality of treatment improved through an interface-free flow of information.
Artificial Intelligence (AI) and telemedicine The KHVVG promotes the targeted use of AI and telemedical applications such as the Teleradiology. For example, AI applications can support diagnostic findings, process optimization or predictive analysis. Telemedicine applications enable patients to be monitored remotely, relieve the burden on staff and can improve the care of chronically ill patients.

"The KHVVG requires hospitals to make concrete strategic decisions and operational adjustments. Unlike the KHZG, it does not fund individual funding items, but rather holistic concepts and measures. This is why it is particularly important for the hospitals to actively shape this."

Andreas Dobler, Managing Director of Telepaxx Medical Data GmbH

Networking creates supply - interoperability is crucial

The KHVVG heralds the end of isolated solutions - not least due to the new service groups and the required structural adjustments. It is forcing comprehensive networking within hospitals, but also across sectors in outpatient clinics. Interoperability is becoming the decisive factor for sustainable care.

Intersectoral care facilities: The law promotes the emergence of facilities that integrate outpatient and inpatient services. This requires seamless digital communication and a smooth exchange of data between the different sectors. Only when systems can “talk” to each other can the dovetailing of outpatient and inpatient care be optimized.
Telemedical networks: The formation and use of telemedical network structures is an explicit funding object of the Transformation Fund. From robot-assisted telesurgery and virtual tumour boards to teleconsultation support in rural areas - these networks enable the exchange of expertise across geographical distances and improve the accessibility of specialized care.
Data integration and interoperability are key: Standardized interfaces and a robust data platform are essential to achieve this networking. They form the basis for seamless collaboration and a consistent flow of information. Such a platform can connect different IT systems and support uniform documentation and communication across multiple locations. In the area of image data management, the C5-tested TMD Cloud from Telepaxx, for instance, offers such a platform.
For clinics to have a chance of becoming part of a larger, more efficient care network, strategic planning is essential for the integration of systems and the establishment of communication structures that extend beyond the boundaries of their own facilities.

IT infrastructure as a foundation: investments and challenges

The ambitious goals of the KHVVG can only be based on a modern and efficient IT infrastructure. For IT managers, this means that they need a clear strategy and checklist to make their hospital fit for the future and take the necessary steps towards a resilient and efficient IT infrastructure.

The most important points and aspects from our point of view:

Comprehensive investments are unavoidable: Hospitals need to modernize their networks, hardware and software. Outdated WLAN infrastructures or insufficient server capacities are often the bottleneck for the use of digital patient records, mobile ward rounds or telemedicine applications. Prioritizing investments is crucial here.
Interoperability is becoming a must: As a result of the KHVVG, some treatments will no longer be provided as inpatient treatment in hospitals, but in outpatient clinics or so-called cross-sector care centers. Data must be able to flow securely but flexibly between these different facilities. Standards-based data communication and standardized interfaces from a software system will therefore become essential and no longer just a “nice to have”.
Cloud and SaaS solutions as enablers: Cloud-based solutions and Software-as-a-Service (SaaS) are becoming increasingly important in the context of the KHVVG. They enable hospitals to react more flexibly to new requirements, guarantee scalability and allow IT resources to be used more efficiently. A prominent example of this is the medical image data management in the cloudas image data makes up the majority of the data to be managed in a hospital. Instead of operating expensive local servers, image data (X-ray, MRI, CT) can be securely stored in the cloud and accessed from anywhere. This not only facilitates cross-site collaboration and the exchange of information with external specialists, but also contributes to data security and reliability within the framework of the Business Continuity Management while investment costs can be reduced at the same time.
Cyber security - non-negotiable: With increasing digitalization and networking, the attack surface for cybercrime is growing. The KHVVG and existing laws such as the IT Security Act (IT-SiG), the General Data Protection Regulation (GDPR) and now the NIS-2 are significantly tightening the requirements for cyber and information security in hospitals. The availability of patient data is crucial for treatment; if this data is encrypted or compromised in the event of a cyber attack, the consequences are far-reaching. Cyber security now has a similar status in hospitals as hygiene and quality management and must be an integral part of the hospital strategy.
Human resources development: The digital transformation requires not only a technical upgrade, but also an adaptation of task profiles and comprehensive training of employees in the use of new systems. Staff acceptance and competence are crucial to the success of the digital transformation.

Transformation fund of the KHVVG

The transformation fund is the central financing instrument of the hospital reform and is financed equally by the federal government and the federal states. It is intended to promote the necessary structural changes with up to 50 billion euros over 10 years.

As the federal states must submit applications for the following year by September 30, hospitals must submit all necessary documents to their responsible state ministry in good time in order to benefit from funding.

Conclusion & outlook on the KHVVG: opportunity to actively shape the digital future

The Hospital Care Improvement Act is an unmistakable wake-up call to all hospitals in Germany to place digitalization at the heart of their strategic orientation. It is a comprehensive reform that goes far beyond financial and structural adjustments and will fundamentally change the way medical care is provided.

Hospitals now have the opportunity to proactively align themselves with the new requirements if they succeed in seeing the KHVVG not as a burden, but as a strategic opportunity to reposition themselves and strengthen healthcare provision. The successful implementation of the digital transformation will not only improve the efficiency and quality of care, but also increase the attractiveness of hospitals as employers and establish them as innovative healthcare providers.

How do you ensure that your clinic benefits from the opportunities offered by the KHVVG?

Contact us to find out how our C5-tested, cloud-based Software-as-a-Service can support you in your digital transformation through efficient and networked image management.