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					Healthcare Region Berlin-Brandenburg

             Masterplan




              Berlin 2007
     Healthcare Region Berlin-Brandenburg

                        Masterplan




                            adopted
              Inter-Ministerial Steering Group of
                     State Secretaries for
               Economics, Health and Science
as well as the Heads of the Senate Chancellery and the State
    Chancellery of the States of Berlin and Brandenburg
                       26 October 2006




                             Draft

                         prepared by
                       alpheios GmbH


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         Masterplan Healthcare Region Berlin-Brandenburg
                                Outline

Healthcare as Challenge and Opportunity                         5

Points of Departure for the Region                              7

Vision                                                         10

Strategic Goals                                                11

Strategic Action Clusters                                      13

01   Health Sciences as Foundation and
     Motor of the Development                                  13

02   Teaching, Training, Ongoing Education                     17

03   Transparency and Governance                               21

04   Developing the Brand, Exhibitions, Congresses             25

05   „Bio-Technology und Bio-Medicine“                         28

06   „Medical Technology“ and „Tele-Medicine“                  32

07   Offerings and Services for Senior Citizens
     including Nursing Care                                    35

08   Modernizing und Optimizing Healthcare Provision           41

09   Prevention, Support of Good Health, Medical
     Rehabilitation and Nutrition                              46

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             Masterplan Healthcare Region Berlin-Brandenburg
10   Lengthening and Strengthening
     the Value Added Chains                                    52

11   Healthcare Sites and their Development                    56

12   “Export of Health“ and “Medical Tourism”                  61

Concluding Remarks                                             65

Members HealthCapital Berlin-Brandenburg                       66

Glossary                                                       69




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             Masterplan Healthcare Region Berlin-Brandenburg
Healthcare as Challenge and Opportunity
Healthcare in nearly all respects is facing profound upheavals. This represents both a
challenge and an opportunity, which require innovation in the various areas of
healthcare, but which also provide the foundation for such innovation.

-   Demographic developments, especially the growing number of elderly persons,
    will mean that increasing numbers of people with age-related chronic diseases
    will be placing demands on the healthcare system. After 2010 the declining birth
    rate will lead to reduced demand for training in healthcare professions and this, in
    turn, means that manpower shortages can be expected to emerge before long.

-   Preventive medicine gains in importance, because there is no scientific doubt that
    the course of many chronic diseases can be positively influenced through
    preventative measures. In this regard other means of treatment – such as natural
    healing methods, healthful nutrition, wellness and fitness – can also be expected
    to increase in significance. A psychosomatic orientation can be expected to gain
    ground with respect to the purely somatic view which is prevalent in broad areas
    of medicine.

-   Innovation, especially from molecular-biological and medical-technical research,
    will increasingly be the motor of development. Thus the mapping of the human
    genome makes possible quantum leaps in the early diagnosis of potential
    illnesses and in their preventive and therapeutical treatment – and, quite soon, in
    regeneration as well.

-   Demographic developments, new work biographies, changing understandings of
    the principle of solidarity and medical progress require changes in legacy
    methods of financing and remuneration within the healthcare system; competition
    among suppliers of healthcare services will increase in this context and state
    planning will change its function.

-   Progress in microsystems technology, optoelectronics and information technology
    enable new forms of treatment and organization within the healthcare system.

-   Healthcare tasks which until recently were widely viewed as responsibilities of the
    public sector are already today increasingly being performed by private
    organizations. This necessitates changes in state healthcare planning and
    provision, but also in the ownership and governance structures of suppliers of
    public services. This results in increasing outsourcing to external suppliers of non-
    medical, but also of healthcare-related services.

-   The self-confidence and the desire for information on the part of (potential)
    patients are growing. Their right to autonomous decision-making as healthcare
    customers and as healthcare partners is gaining recognition. This results in a new
    relationship with respect to healthcare service providers with far-reaching
    consequences for process transparency and quality management, rights to
    information and questions of liability. Cooperative relationships, which are also
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                  Masterplan Healthcare Region Berlin-Brandenburg
   sensitive to gender-specific healthcare needs, replace the old culture of
   „paternalistic“ medicine.

The Healthcare Region Berlin-Brandenburg takes an active role in managing and
shaping these challenges and changes. It finds itself thereby in competition with
other regions of Germany and Europe. Success in this competition requires the
efforts of all actors and – in addition to appropriate state support – in particular the
engagement of private investors and institutions.

The Government (Senate) of Berlin resolved on 7 September 2004 that “the growth
potential of the economic and locational factor healthcare in the fields of the health
economy, health sciences and healthcare provision is to be realized more strongly
and to be developed further”. An Investigative Commission of the Berlin Parliament
“A Future for Berlin” (Drucksache 15/4000 vom 9. Mai 2005) identified the health
economy in its final report next to communications, media and culture as one of two
possible scenarios for the future development of Berlin.

Initiated by the Ministry of Employment, Social Affairs, Health and Family Affairs, on 8
November 2005 the Government of the State of Brandenburg discussed developing
healthcare economy in Brandenburg. The Ministry of Employment, Social Affairs,
Health and Family Affairs had presented a study of the structure and the economic
potential of healthcare economy in 2006 (IGES Institut für Gesundheits- und
Sozialplanung GmbH, Gesundheitswirtschaft Brandenburg. Stand und Entwicklung.
Expertise commissioned by the Ministry of Employment, Social Affairs, Health and
Family Affairs of the State of Brandenburg. Berlin July 2006).

The Inter-Ministerial Steering Group of the States of Brandenburg and Berlin, in
presenting the revised Masterplan with its Strategic Goals and Strategic Action
Clusters, seeks to involve the various actors and solicits their suggestions and inputs.
Concrete measures must now be developed and be implemented. This is not
something for the Senate of Berlin or the Government of the State of Brandenburg to
accomplish alone, nor should they even seek to play the leading role. The lead
should rather be taken by all those who are active in the area of healthcare in Berlin
and Brandenburg. Therefore the Masterplan names as coordinators and participants
persons and institutions already active in the areas of the health economy, health
sciences and healthcare delivery. The intention is to activate the potential of the
Healthcare Region for the achievement of the ambitious goals of the Masterplan. The
Senate of Berlin and the Government of the State of Brandenburg call upon all actors
play their part in the interest of all.




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                 Masterplan Healthcare Region Berlin-Brandenburg
Points of Departure for the Region
Berlin and Brandenburg already fulfil the requirements for a Center of Competence in
Healthcare: the number of actors and projects in various areas of health, such as, for
example, bio-technology, medical technology, tele-medicine and laser medicine
already transcends the “critical mass”. Berlin and Brandenburg already achieve top
performance in international comparisons in various areas of healthcare; they have
sufficient capacity to encompass the entire value added chain from research,
education and training to production, service provision and marketing.

Berlin and Brandenburg together dispose over important potential resources, which
complement each other nicely with differing points of emphasis, along the entire
length of the value added chain. Among these resources is a highly regarded
structure of healthcare provision for the population of the region. Networks already
exist which transcend the border between the jurisdictions, such as TSBmedici or
BioTOP Berlin-Brandenburg, in addition to innovative infrastructures which combine
research, business and partially also healthcare provision (Buch, Adlershof,
Charlottenburg, Golm, Hennigsdorf, Luckenwalde). Organizations from Brandenburg
participate actively in Berlin networks (e. g. TSBmedici) as well as the other way
around.

Berlin and Brandenburg host an unusual concentration of healthcare-related
university, extra-university and entrepreneurial research platforms. For many years
Berlin and Brandenburg have had a concentration of research potential in specific
areas, to which, in particular molecular medicine and bio-technology belong. Support
for interdisciplinary research clusters has contributed to networking scientists with
each other and with business. Examples are to be found in the areas of structural
biology, RNA-technology, clinical pharmacology, glycobiotechnology, auto-immune
diseases, human genome research. On the basis of scientific excellence – evidenced
by the universities, the Max-Planck-Institute for Molecular Genetics in Dahlem, the
Max-Delbrück-Centrum for Molecular Medicine, the biotechnology sites at Teltow-
Seehof and Potsdam-Hermannswerder etc. – Berlin and Brandenburg have
developed themselves to one of the leading locations for human genome research in
Germany. Brandenburg has set its own specific accents in nutritional sciences (at the
University of Potsdam and through the German Institute for Nutritional Research
Potsdam-Rehbrücke) in addition to specializations in bio-technology and medical
technology.

Berlin and Brandenburg dispose over a highly respected network of curative acute
healthcare institutions. The Charité is among the leading university hospitals in
Germany. Vivantes is the largest public hospital company in Germany. In terms of
quality, Berlin´s hospitals achieve results which compare favourably to the best in
Germany, Europe and – in some areas – even the world (examples: heart transplants
at the German Heart Center Berlin, organ transplants at the Charité, various areas of
oncology, minimally invasive surgery). In contrast to Berlin, the strengths of
Brandenburg lie above all in rehabilitative medicine, in the area of wellness and
health tourism as well as in nutritional sciences and economy. Both complement
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                 Masterplan Healthcare Region Berlin-Brandenburg
each other meaningfully. Berlin as a whole, as well as the twelve Berlin districts and
Potsdam are members of the WHO-“Healthy Cities Network” of the Federal Republic
of Germany, which strives to coordinate health-supporting structures and services in
the area of prevention.

Especially since the fall of the Berlin Wall (1989), several innovative and high-
performance hospital, medical rehabilitation clinic and nursing care companies have
emerged in Berlin and Brandenburg, which advance the development of qualitative
standards, make service offerings more transparent and engage in expansion
beyond Berlin and Brandenburg (German Heart Center Berlin, Clinics of the German
Red Cross Berlin, Society for Building Protestant Hospitals, Societies of the
Alexianer, Johanniter Corporation, Diaconical Group, Public Interest Parity
Association for Health and Social Services Inc., Schlosspark-/Park-Clinics
Weissensee, Trauma Center Berlin, Clinic for Minimally Invasive Surgery. Of the
estimated turnover of ca. 7 billion €uros per year for all 40 hospital companies
headquartered in Berlin, the above named together with Charité, the Vivantes
Network for Health Inc. and HELIOS Hospital Inc. have a yearly turnover of 5-6 billion
€uros).

Private investors are prepared to invest in the “Healthcare Region Berlin-
Brandenburg”. The attractiveness of Berlin for the health economy is documented in
the fact, among many others, that HELIOS Hospital Inc. has invested more than 200
million €uros in the new Buch Hospital and beside this has relocated its headquarters
to Berlin. In Brandenburg major private medical rehabilitation clinic companies are
engaged. The region of Berlin-Brandenburg has invested heavily into medical
rehabilitation as well as into the wellness and cure sector.

Already today there are approximately 344.500 people employed in the field of health
with its related areas in Berlin and Brandenburg. This means that 13.5% of the
workforce is working in the field of health (for this and the following data see D. A.
Ostwald/A.      Ranscht,    Wachstums-        und     Beschäftigungspotenziale     der
Gesundheitswirtschaft in Berlin und Brandenburg. A study commissioned by
HealthCapital Berlin-Brandenburg. Berlin April 2006). According to this study the
gross added value of the region resulted into 12.24 billions €uros in the year 2004 –
representing 10.2% of the total gross added value of the region. 80% of the
workforce is employed in Berlin, in the neighbouring counties and in the cities of
Brandenburg/Havel, Potsdam and Frankfurt/Oder; 85% of the gross added value is
produced here. Compared to the national average the percentage of healthcare with
a focus on healthcare provision is higher, while the percentage of health production
and trade is lower. The authors of the study consider the perspectives for long-term
growth of health economy to be good. The number of employees in this sector is
considered to increase to 374.100 and the gross added value is to grow to 15.08
billion €uros in 2020. Further networking between health sciences, health economy
and healthcare provision provides additional potential for development and growth. It
presupposes an interdisciplinary and holistic approach to healthcare. International
perspectives have to be developed. Promotional programmes have to be utilized
even more effectively for supporting the main focus, which is healthcare.

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                 Masterplan Healthcare Region Berlin-Brandenburg
The Federal Government of Germany – by means of different programmes of the
Federal Ministry of Health, the Federal Ministry of Sciences and the Federal Ministry
of Economy – as well as the EU support of projects in the health economy, health
sciences and healthcare provision provides considerable financial resources. In
addition to this, subsidies of the EU, the World Bank, the UN and other international
organizations are available for the modernization and reconstruction of the
healthcare provision in Central and Eastern Europe or in Iraq. Frequently interested
institutions or enterprises hear too late about invitations of tenders, sometimes they
are over-challenged by the complicated application forms.




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                 Masterplan Healthcare Region Berlin-Brandenburg
Vision
Berlin and Brandenburg develop the region into a knowledge-based reference area
for transparent, high-quality healthcare provision dedicated and focussed to the well-
being of the patients and oriented towards the fulfilment of their needs. Making use of
innovative scientific discoveries, Berlin and Brandenburg offer patients the most
gentle and affordable structures of healthcare available. Scientifically and
economically the potentials of health in research and higher education, in
professional education and training as well as in the development and the production
of products and services represent a unique profile. Berlin and Brandenburg will use
it more efficiently and will network it more intensively in the future. They view the
unique density of offerings along the entire length of the value added chain in
healthcare as an opportunity which allows this region to stand out in comparison to
other ones.




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                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Goals
-   The healthcare region Berlin-Brandenburg becomes the most innovative and
    effective magnet for the health economy in Germany.

-   Berlin and Brandenburg create a positive climate for investment in „healthcare“.
    Instruments for regional economic development are reoriented in a targeted way
    to support investments in the health economy.

-   Berlin and Brandenburg strengthen and expand regional networks such as
    TSBmedici or BioTOP and encourage further cooperation at the local level
    between the economy, science and healthcare delivery, following the positive
    example of Buch or Adlershof in Berlin and of Golm or Luckenwalde in
    Brandenburg.

-   Berlin and Brandenburg support innovative approaches to research (e. g.,
    translational research) and develop an integrative profile for the health sciences:
    in addition to medicine and nursing sciences, this will explicitly integrate health-
    oriented parts of the engineering sciences, the natural sciences, computer
    science, public health and business studies into its expanded purview of health
    sciences. A welcome side-effect is the strengthening of further and advanced
    education and training in the health field.

-   Berlin and Brandenburg use fully and strengthen the cooperation among the
    highly specialized hospitals and other partners in the region. Within this context
    the Charité – University Medicine Berlin and its potentials are of specific
    importance for the development of the region. They develop this resource to one
    of the leading university hospitals in all of Europe, with specializations in genome
    research and regenerative medicine, as well as clinical and therapy research. The
    Charité combines research and teaching in medicine with bio-technology, medical
    technology and tele-medicine.

-   Berlin and Brandenburg sensitize their citizens with respect to questions of health
    consciousness. They offer the highest level preventive, curative and rehabilitative
    medicine in the region and they open the door to treatment of patients from other
    parts of Germany and – especially within the framework of city partnerships – to
    treatment of patients from abroad. Preventative medicine becomes a hallmark of
    the region.

-   Berlin and Brandenburg create (health)-“Lighthouses” (e. g., particle therapy, the
    fully digital hospital, molecular imaging).

-   Berlin and Brandenburg measure the success of their political processes and
    decisions according to whether these adequately reflect the strategic goals of this
    Masterplan.


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                  Masterplan Healthcare Region Berlin-Brandenburg
-   Berlin and Brandenburg measure the transparency and quality of healthcare
    provision, the excellence of health sciences and the market significance of the
    health economy as well as the respect of gender issues - based on continuous
    gender analysis and on a gender conscious data collection and data processing -
    according to generally recognized criteria.

-   Berlin and Brandenburg create trust among the important actors in health
    economy by assisting them within the frame of their possibilities to identify
    synergies, to secure the necessary demand and to avoid superfluous capacities.

On the following pages these strategic goals are collated and analyzed with respect
to Strategic Action Clusters and Discrete Measures. Persons responsible to develop
further the Strategic Action Clusters and to implement the Discrete Measures are
appointed and listed in the annexe (Note of the translator: The annexe is not
attached in the English translation). The order of the Strategic Action Clusters is not
an expression of priorities. The setting of priorities will be a task of HealthCapital
Berlin-Brandenburg, the project cluster management, in cooperation with the various
actors. Discrete Measures, on the other hand, are ordered according to priority to the
extent possible. For the realization of the Discrete Measures, a structure of
leadership responsibility and a sliding time-frame − until 2008 (short-term), until 2010
(mid-term) and until 2015 (long-term) − are proposed.




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                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Clusters

Strategic Action Cluster 01: Health Sciences as Foundation and
Motor of the Development

Present Situation

Berlin and Brandenburg are investing an important part of their science and research
budget into health-related teaching and research: In addition to medicine and nursing
sciences this includes engineering sciences with a focus on medical technology or
microsystems technology, natural sciences with a focus on biotechnology or
bioinformatics, nutritional sciences, business studies with a focus on healthcare
economics or healthcare management and computer sciences with a focus on
telemedicine, health information systems, or e-health. Genome research and
research in nutrigenomics is one of the strengths of the region.

A broad and performing spectre of extra-university research institutions financed by
Federal and State Governments is located in the region: Molecular medicine and
genetics, molecular pharmacology, nutritional sciences, rheumatism research,
bioanalysis, bioinformatics, biotechnology, biomaterial research and regenerative
medicine.

The universities in Berlin and Brandenburg are making life sciences with different
profiles one important element of their structural planning – e. g. the Technical
University Berlin is concentrating its health science activities in the Center for
Innovative Health Technologies (Zentrum für innovative Gesundheitstechnologien –
ZIG). The FH Lausitz is integrating different age-related sciences into interdisciplinary
and innovative courses.

The Charité faculty of medicine is focussing on molecular and regenerative medicine
as well as on genome research, on clinical and therapy research and finally on
telemedicine. The faculty is planning to set up centers for clinical studies, for
molecular imaging and for particle therapy.

The Institute for Public Health – formerly at the Technical University Berlin, now
renamed “Berlin School of Public Health” and transferred to the Charité – is focussing
on optimizing structures and processes of healthcare delivery including clinical
pathways and quality development.

Possibilities to improve and develop health-related sciences exist in the following
areas:
   - Integration of comprehensive information on health sciences at universities
       and at extra-university research institutes
   - Intensifying the interdisciplinary cooperation among different sciences –
       especially if they are located at different institutions
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                  Masterplan Healthcare Region Berlin-Brandenburg
  - More intensive economic analysis of healthcare in face of the growing need of
        innovations at the level of national economy as well as at the level of the
        individual businesses
  - Strengthening and networking age-related sciences into interdisciplinary
        activities in face of the growing need in teaching and research because of the
        demographic developments and their consequences
  - Closer cooperation between health-related sciences, health economy and
        healthcare provision
  -     Strengthening the value added chains especially in the area of clinical
        application of new research results
  -     Taking better advantage of the potentials of Berlin-Brandenburg as densely
        populated region with a high density of hospitals as field and center for clinical
        research

Goals

  -     To realize more transparency of existing health-related sciences (basic and
        applied research at universities, at extra-university research institutions,
        research divisions of companies, networks)
  -     To strengthen and to develop the top position in the different fields of health-
        related sciences
  -     To network existing competences and to develop incentives to direct those to
        be applied in healthcare delivery and in health economy
  -     To realize and strengthen the interdisciplinary organization of “age-related”
        sciences at selected universities in Berlin and Brandenburg

Discrete Measures

  -     Concentrating and integrating the potentials

           o in medicine, pharmacology and health-related natural sciences:
             Promotion of the development of centers for clinical studies, for
             translational research, for molecular imaging, for regenerative medicine
             (in connection with the Berlin-Brandenburg Center), for therapy and
             clinical research, for physical medicine and medical rehabilitation and
             finally for particle therapy
             Coordination: Charité
             Time frame: short-/mid-term
           o in engineering sciences: Promotion of networking the technical
             universities in Berlin and Brandenburg
             Coordination: TU
             Time frame: short-/mid-term


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                   Masterplan Healthcare Region Berlin-Brandenburg
       o in computer sciences: Strengthening the area of possible applications
         of telemedicine and e-health, development of health information
         systems
         Coordination: TU
         Time frame: short-/mid-term
       o in health-related business studies: Development of healthcare
         economics and public health with a focus on optimizing structures and
         processes of healthcare delivery, of quality development and of
         healthcare management
         Coordination: Health economics: FHW/Steinbeis Hochschule/University
                                            Potsdam
                       Public health: Charité
         Time frame: short-/mid-term
       o in nursing sciences: Promotion of cooperation between the Alice-
         Salomon-University, the Protestant University and the FH Lausitz with
         (secondary) schools for nursing professions and with health and
         nursing companies
         Coordination: ASFH
         Time frame: short-term
       o in nutritional and food sciences: Promotion of the cooperation of the
         relevant disciplines at Potsdam University, Humboldt University Berlin,
         Technical University Berlin, Technical University of Applied Sciences
         Berlin and the extra-university research institutions (e. g., German
         Institute for Nutritional Research, the Institutes for Agricultural
         Technology as well as for Vegetables and Flowers, the Institute for
         Molecular Plantphysiology, the Institute for Applied Polymer Research,
         the Institute for Grain Processing, the Milk Research Center
         Oranienburg, the Federal Institute for Risk Evaluation and the Robert-
         Koch-Institute
         Coordination: DIfE, TU
         Time frame: mid-term

-   Strengthening of the age-related focus at the FH Lausitz, development of
    age-related programs with a technological and with a medical-/social scientific
    orientation at at least a technical university and at at least a university with a
    focus on medicine and social sciences and concentration of age-related
    sciences at other universities
    Coordination: FH Lausitz, ASFH
    Time frame: mid-term




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               Masterplan Healthcare Region Berlin-Brandenburg
   -   Planning of a virtual interdisciplinary center for age-related sciences
       integrating gerontology, geriatrics, physical medicine, medical rehabilitation,
       therapies and related medical, nursing and medical rehabilitation technologies
       including smart-home technologies as well as health and living technologies,
       e-health, telemedicine and architecture
       Coordination: FH Lausitz in cooperation with medical rehabilitation clinics
       Time frame: short-/mid-term

   -   Using the potential of high patient numbers in the region and the high density
       of healthcare delivery institutions to make Berlin the center for clinical studies
       in Germany
       Coordination: Charité
       Time frame: long-term

   -   Developing the Center for Biomaterial Research at the Institute for Applied
       Polymer Research in order to realize a complete cycle of polymer-based
       biomaterials from the synthesis over the processing up to the bio-compatibility
       as well as the translation of results of this development
       Coordination: Institute for Applied Polymer Research
       Time frame: short-/mid-term

Actors

Universities, research institutes, nursing schools, healthcare and nursing companies,
mandatory health insurance organizations, SenBildWiss, SenWiTechFrau,
SenGesUmV, TSB, BioTOP, Berlin Partner, Campus Buch, WISTA Adlershof,
MASGF BB, MW BB, MWFK BB, Reha-Research Project Berlin-Brandenburg-
Sachsen, ZAB, Institute for Applied Polymer Research




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                  Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action          Cluster      02:    Education,       Training,      Ongoing
Education

Present Situation

1. Education (Academic Study Programs)

Berlin and Brandenburg dispose of a broad spectre of various study programs in
health sciences: In addition to medicine, nursing and pharmacology, students can
enroll in medical technology, medical information technology, clinical trial
management, healthcare management, international health, public health, health and
society, international gender studies, biotechnology, biosystems technology/-
information technology, biomedical instrumentation technology, biochemistry,
nutritional sciences, patholinguistics, clinical linguistics, as well as for medical
pedagogy, nursing pedagogy, or optometrics. Study programs as biology, chemistry,
or physics are also important for the healthcare region. The “Berlin School of Public
Health” – recently transferred to the Charité and renamed – is conducting research in
different fields of health and illness and is offering interdisciplinary study programs of
international calibre. Recently dual study programs integrating training at the
secondary level into academic programs have been introduced for physio- and
ergotherapy as well as for nursing in Berlin and in the Lausitz region. The (private)
Steinbeis-Hochschule recently has introduced a bachelor in “physician assistance”,
the Potsdam University a MBA-program “biomedical technology”. The FH Lausitz is
developing an age-related focus with interdisciplinary courses in gerontology,
rehabilitation technology, tumor diagnosis, physiotherapy and architecture.

Over the last years education and research – as well as training and ongoing
education – are considering more and more the complex relations between gender
aspects and globalisation for a better understanding of and dealing with health and
illness.

2. Training

Berlin and Brandenburg are offering dual and secondary school training programs for
over 80 healthcare professions: Nurses for young and adult patients and for senior
citizens, opticians, surgical mechanics, audiomechanics (hearing aids), orthopaedic
mechanics, dental technicians, ergotherapists, physiotherapists, podologists,
biological -, chemical -, physical - and medical-technical assistants, health insurance
administrators and healthcare accountants. In order to strengthen the secondary
schools for healthcare professions economically and professionally comprehensive
schools (Verbundschulen) meeting compulsory quality standards are in the process
of being planned. At present a holistic training program in nursing, not differenciating
according to life cycles (sick children, sick adults, senior citizens – Wannseeschule e.
V.) as well as an integrated study program with a basic training in nursing for
children, for adults and for senior citizens (Charité – Training Center for Medical
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                  Masterplan Healthcare Region Berlin-Brandenburg
Professions/Training Center for Nursing of Senior Citizens of the Diaconical
Foundation Lazarus/Protestant Geriatric Center Berlin) are being tested.

3. Ongoing Education

Despite the broad spectre of training possibilities and study programs new and
changing qualifications are increasing in demand. Demographic change and rapid
changes in healthcare delivery by biotechnology, medical technology, telemedicine
and e-health as well as optimising the workflow are leading to new qualification
profiles. The education of medical doctors is in the process of being reformed – the
Charité with its reform study program for medical doctors has taken a forward looking
decision. The increasing importance of health promotion and prevention will also
have consequences for training and ongoing education: Qualified programs for these
areas with a special focus on fitness and wellness are necessary. The Brandenburg
Technical University Cottbus offers courses in “Smart Home Technologies“ and in
“Health and Living Technologies”. E-learning is opening new possibilities for
universities and other training and ongoing education institutions to offer their
courses independently of their location thus reaching out for new customers.

Goals

   -    To develop the healthcare region Berlin-Brandenburg into the international
        and national competence center for health-related education, training and
        ongoing education as well as for necessary reforms and their development

   -    To make the competence of the region in health-related education, training
        and ongoing education transparent and accessible to potential users

Discrete Measures

   -    Establishing a health portal with information on programs and courses in
        education, training and ongoing education for healthcare professionals using
        already existing data banks
        Coordination: SPI Consult, LASA BB
        Time frame: short-term

   -    Identifying needs for reforming existing programs and of new study and
        training programs (e. g., global medical engineering, social gerontology, health
        economics, study/research nurse, medical product advisor – technical level,
        vital manager)
        Coordination: study programs: Charité and universities
                      Training: Chambers of Commerce
        Time frame: short-term




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                  Masterplan Healthcare Region Berlin-Brandenburg
-   Developing one or several study programs at universities for applied sciences
    in Berlin and Brandenburg to qualify for occupational activities with senior
    citizens
    Coordination: ASFH, FH Lausitz
    Time frame: mid-term

-   Coordinating the planning process of new training programs for healthcare
    professions with the Federal Agency for Employment and developing planning
    instruments for both states taking in consideration the Brandenburg study on
    qualified employees
    Coordination: Berlin-Brandenburg Regional Office of the Federal Agency for
    Employment
    Time frame: short-term/continuously

-   Developing new and qualifying existing health-related and/or health-relevant
    study programs as medical technology, medical processing technology,
    medical information technology, clinical trial management, healthcare
    management, international health, public health, biotechnology, biosystems
    technology, biomedical instrument technology, biochemistry, but also biology,
    chemistry and physics and integrating various study programs in medical
    technology and in biotechnology each into an interdisciplinary center
    Coordination: Universities
    Time frame: short-term

-   Developing of training and ongoing education programs for prevention, health
    promotion, wellness and fitness
    Coordination: Chambers of Commerce Berlin, Potsdam, Frankfurt/Oder,
    Cottbus (later replaced by Standing Conference on Ongoing Education Berlin-
    Brandenburg)
    Time frame: mid-term

-   Developing and implementing a concept for ongoing education of advisors in
    medical prevention and wellness integrating ergo- and physiotherapy
    Coordination: International Union for Social Work
    Time frame: mid-term

-   Harmonizing legislation for ongoing education between the States of Berlin
    and Brandenburg in the area of mutual recognition of certificates and joint
    further development of courses
    Coordination: SenBildWiss, MBJS BB, MWFK BB
    Time frame: mid-term

-   Coordinating the various training programs for healthcare professionals with
    regard to content, integrating them and developing quality standards
    respecting the requirements for the recognition of certificates and degrees
    within Europe
    Coordination: International Union for Social Work
    Time frame: mid-term
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              Masterplan Healthcare Region Berlin-Brandenburg
   -   Improving the intercultural competences of healthcare professionals by rising
       the percentage of participants with a migration background and specific
       promotion of transnational exchange of educational experts and participants
       Coordination: Gesundheit Berlin e. V.
       Time frame: mid-term

   -   Developing training and ongoing education courses by using e-learning and
       the Brandenburg e-learning platform
       Coordination: Chambers of Commerce Berlin, Potsdam, Cottbus,
       Frankfurt/Oder
       Time frame: mid-term

   -   Further developing and supporting the training in health-related skilled trades
       Coordination: Chambers of Trade
       Time frame: short-term

   -   Developing training and ongoing education courses in the fields of health
       tourism
       Coordination: Chambers of Commerce and Tourism Academy Brandenburg
       (TAB)
       Time frame: mid-term

   -   Further developing training and ongoing education for civil engagement and
       self-help activities
       Coordination: SEKIS
       Time frame: mid-term

Actors

SenWiTechFrau, SenGesUmV, SenBildWiss, Berlin Partner, Berlin-Brandenburg
Regional Office of the Federal Agency for Employment, universities, training and
ongoing education institutions, chambers of trade, chambers of commerce,
Employers Union Region North-East, TSB, healthcare companies, mandatory health
insurance organizations, International Union, MW BB, MASGF BB, MWFK BB,
Tourism companies and associations (Hotel and Restaurant Association
Brandenburg e. V., Brandenburg Cure Site and Bath Association), SEKIS, Institute
for Tourism and Marketing, German Society for Medical Rehabilitation




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                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 03: Transparency and Governance

Present Situation

The market for health-related services with regard to its actors, their respective
activities and the quality of their services is not very transparent. To the degree that
health services are increasingly exposed to the market and to competition the
necessity for market transparency is growing. There are data banks for certain fields,
but they are not interconnected and most of them are structured differently.

Because of the upheavals in various health sectors a careful observation of the
developments is of great importance in order to identify trends early and in order to
have a basis for evaluating future developments.

Networks – especially those established by the Technology Foundation Berlin – the
foundation of Health City Berlin (Gesundheitsstadt Berlin) and independent networks
as the Network for Better Medical Care Berlin (NBMC) offer a platform for mutual
information and cooperation. The purposeful development needs a cooperation
coordinating the states of Berlin and Brandenburg and including the public as well as
the private sectors of healthcare. For coordination and governance both State
Governments together with various companies have set up “HealthCapital Berlin-
Brandenburg”, which became operational a short time ago.

Important parts of the healthcare infrastructure are operated by public organizations
– the Senate of Berlin is a major and for the development of the healthcare region
important (healthcare) entrepreneur: The City of Berlin is owner of the Charité and of
Vivantes – Network for Health GmbH. Both institutions offer more than 40% of
inpatient services in Berlin. Vivantes is providing 30% of the hospital beds in Berlin;
its budget exceeds one billion €uros – including its nursing homes. The Charité is
operating 15% of the hospital beds in Berlin and its budget – including expenses for
teaching and research - exceeds 1 billion €uros as well. The Senate of Berlin is also
operating the penitentiary hospital.

The Senate of Berlin is running several universities with a focus in health sciences. It
is financing various research institutes owned by the city (e. g., Rheumatism
Research Center, Konrad-Zuse-Institute). It is operating several training and ongoing
education institutions. It has set up several technology parks with a focus on health
economy, health sciences as well as healthcare delivery as at the technology park
Buch. It is offering public health services at the district level. It is managing the Berlin
Agency for Central Health Issues (Berliner Betrieb für Zentrale Gesundheitliche
Aufgaben – BBGes: Institute for Food, Drugs and Clinical Toxicology, Poison
Emergency Number, Pharmacovigilance Center, Advice Center for Embryonal
Toxicology, Laboratory Medicine at the Trauma Center Berlin), the State Agency for
Health and Social Affairs, the Joint Cancer Register, the State Agency for Labor

                                                                                         21


                  Masterplan Healthcare Region Berlin-Brandenburg
Protection, Health Protection and Technical Safety and the State Institute for
Forensic Medicine)

Compared to the State of Berlin which is integrating functions of a German state as
well as of a city, the State of Brandenburg not responsible for communal functions is
operating several universities with a focus on health sciences, after having privatized
its four psychiatric hospitals.

Goals

   -    To develop and strengthen transparency in the health sector

   -    To identify and evaluate systematically and continuously growth areas and
        potentials for innovation

   -    To strengthen coordination and governance of the cluster by HealthCapital
        Berlin-Brandenburg

   -    To develop coherent strategies and structures for the “(healthcare)
        entrepreneur” Berlin

   -    To strengthen the profile of the Charité in applied research (especially in
        genome research, in regenerative medicine, in clinical research and in public
        health), to develop it into the motor of innovation and into the leading research
        center as well as to promote the profile of Vivantes as innovative and
        performing hospital company

   -    To exploit optimization of processes and functional coordination among the
        activities and the institutions of the State of Berlin

Discrete Measures

   -    Strengthening the coordination and governance of the healthcare cluster
        (cluster management) for the States of Berlin and of Brandenburg by
        HealthCapital Berlin-Brandenburg
        Coordination: Competent ministries of the States of Berlin and of Brandenburg
        Time Frame: short-term




                                                                                      22


                  Masterplan Healthcare Region Berlin-Brandenburg
-   Focussing and coordinating government subsidies, the respective programs
    and the institutions administering subsidies in the area of health between the
    States of Berlin and Brandenburg
    Coordination: Competent ministries of the States of Berlin and of Brandenburg
    Time Frame: short-term

-   Identifying, networking and unifying as much as possible existing internet offer
    and data banks in the area of healthcare
    Coordination: HealthCapital Berlin-Brandenburg
    Time frame: short-term

-   Development of a user-oriented health portal
    Coordination: HealthCapital Berlin-Brandenburg
    Time frame: short-term

-   Continuously updating the data concerning growth and employment of
    healthcare economy
    Coordination: HealthCapital Berlin-Brandenburg
    Time frame: continuously

-   Establishing an observatory “Healthcare” for analysis and identification of
    strengths and weaknesses as wells as trends and potential growth sectors
    Coordination: HealthCapital Berlin-Brandenburg
    Time frame: short-term

-   Organizing an annual conference with important actors to evaluate the
    development and to define goals and actions for the future
    Coordination: HealthCapital Berlin-Brandenburg
    Time frame: short-term

-   Organizing regular workshops focussing on important growth sectors and
    innovation potentials (e. g., regenerative medicine, e-health, prevention,
    wellness, fitness)
    Coordination: HealthCapital Berlin-Brandenburg, ZAB
    Time frame: short-term, continuously

-   Attracting investors - including venture capital – as well as other financial
    institutions ready to finance healthcare activities
    Coordination: BC, IBB, Berlin Partner
    Time frame: mid-term


                                                                                 23


              Masterplan Healthcare Region Berlin-Brandenburg
   -   Strengthening specialized consultancy in order to profit from various
       government subsidies programs
       Coordination: IBB, ILB, ZAB
       Time frame: mid-term

   -   Supporting Vivantes and Charité coordinating and developing their strategies
       Coordination: SenBildWiss, SenGesUmV
       Time frame: short-term

Actors

SenWiTechFrau, SenBildWiss, SenGesUmV, SenFin, Projekt Zukunft, Chambers of
Commerce, MASGF BB, MW BB, MWFK BB, universities and research institutes,
companies and their associations, mandatory health insurance organizations and
insurance companies, healthcare companies, Berlin Partner, IBB, ILB, Inter-
Ministerial Steering Group of State Secretaries, banks, ZAB, Berlin Buch
Managementgesellschaft, Steering Group Buch, BioTOP Berlin-Brandenburg,
TSBmedici, Liegenschaftsfond, WISTA Adlershof, Potsdam University, Campus
Golm, Institute for Applied Polymer Research Teltow, Charité, Vivantes, BC




                                                                                  24


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 04: Developing the Brand, Exhibitions,
Congresses

Present Situation

A convincing brand is an important prerequisite to market the healthcare region
Berlin-Brandenburg successfully. The region will become active with the brand
“HealthCapital Berlin-Brandenburg”. Berlin Partner and ZukunftsAgentur
Brandenburg (ZAB) as well as other actors will assist HealthCapital Berlin-
Brandenburg in the process of developing and establishing the brand.

Structures and delivery of healthcare services are changing fundamentally and
rapidly. Even for healthcare professionals they are not always very transparent. The
dynamism of health sciences and their applications e. g. in the field of (healthcare)
information and communication technologies will have far-reaching consequences for
diagnosis and treatment, but also for efficiency. “Medica” – the medical fair in
Düsseldorf – has become worldwide the leading platform for these topics. Berlin and
Brandenburg are regularly participating in the “Medica”. The healthcare region Berlin-
Brandenburg will intensify its presence at the “Medica” (this is also true for the
participation of the region in the leading European exhibition in biotechnology – the
Biotechnica in Hannover – and Bio-Europe as partnering). In addition to “Medica”
there is a need for more exhibitions focussing on the described developments.

The decision of the organizer of IteG (IT-Exhibition and Dialogue in Healthcare) to
transfer this exhibition from Frankfurt to Berlin from 2007 onwards is an important
signal in this direction. With “RehaFair” and other events with a focus on healthcare
the importance of Berlin as exhibition site is increasing.

The healthcare region is participating actively in international exhibitions in order to
market topics and objectives of the healthcare region abroad. Decisive criterium for
the participation is the potential of such exhibitions in the areas of cooperation,
investments, export of products and services and medical tourism. In this sense the
healthcare region is participating regularly in the BIO International Convention, the
largest international biotechnology exhibition and in the Arab Health in Dubai. It is
considering to participate in the Zdravoochranenie in Moscow – the largest and most
important exhibition for Western Russia – and in exhibitions in Asia.

Approx. 10 important national or international medical congresses take place in
Berlin annually attracting each between 5.000 and 15.000 participants. The “Capital
Congress Medicine and Health” has developed into the national meeting point for
important actors in healthcare. In addition to these congresses many small and
middle-sized congresses take place in Berlin and Brandenburg.



                                                                                     25


                 Masterplan Healthcare Region Berlin-Brandenburg
The healthcare region Berlin-Brandenburg disposes of a performing infrastructure to
organize congresses, seminars and exhibitions of any size.

Goals

   -    To establish and to strengthen the brand “HealthCapital Berlin-Brandenburg”
        and to develop marketing strategies for the healthcare region Berlin-
        Brandenburg

   -    To strengthen and to develop further Berlin´s position as important location for
        health congresses

   -    To establish Berlin as location for health exhibitions

Discrete Measures

   -    Studying and taking decisions on the marketing concepts of “HealthCapital
        Berlin-Brandenburg” including drafting information material, deciding target
        groups and languages
        Coordination: HealthCapital Berlin-Brandenburg, ZAB, Berlin Partner
        Time frame: short-term

   -    Intensifying the participation of the healthcare region Berlin-Brandenburg at
        the “Medica” and the “Biotechnica”
        Coordination: Berlin Partner, ZAB, BioTop
        Time frame: short-term

   -    Intensifying the participation of the healthcare region Berlin-Brandenburg at
        international exhibitions (especially Arab Health Dubai, Zdravoochranenie
        Moscow, BIO USA)
        Coordination Berlin Partner, ZAB
        Timeframe: short-term

   -    Developing information possibilities for professionals and non-professionals on
        age-related technologies (show-room, exhibitions, congresses)
        Coordination: ZAB, Berlin Partner
        Time frame: mid-term

   -    Identifying and attracting health-related associations and societies
        Coordination: Berlin Partner, ZAB
        Time frame: short-term
                                                                                     26


                  Masterplan Healthcare Region Berlin-Brandenburg
   -   Approaching and cooperating with international and national scientific
       societies as well as other congress organizers in order to attract and plan
       congresses and other events related to healthcare
       Coordination: Messe Berlin
       Time frame: mid-term

   -   Using reputed health scientists from Berlin for (health) congress marketing
       Coordination: BTM, TMB
       Time frame: short-term

   -   Attracting new and profiling existing health exhibitions in order to strengthen
       Berlin as exhibition location
       Coordination: Messe Berlin
       Time frame: short-term

   -   Integrating the healthcare region into the tourism marketing strategies of the
       States of Berlin and Brandenburg
       Coordination: BTM, TMB
       Time frame: short-term

Actors

HealthCapital Berlin-Brandenburg, Health City Berlin, Berlin Partner, ZAB, Messe
Berlin, IKHs, SenKzl, SenGesUmV, SenBildWiss, SenWiTechFrau, MW BB, MASGF
BB, BTM, TMB, BioTop




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                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 05: “Biotechnology and Biomedicine”

Biotechnology/biomedicine is one of the outstanding competence fields of Berlin and
Brandenburg; a specific masterplan for this competence area has been developed. In
coordination with the administration and with the business development agencies of
both states, the action center for both states BioTOP Berlin-Brandenburg is
coordinating     the    activities    to    develop     the   competence       area
biotechnology/biomedicine.

1.        Defining the Position

Biotechnology includes all technologies belonging to life sciences (biology/chemistry)
which allow to develop and to produce various products in the growth sectors
pharmaceuticals, diagnosis, health, nutrition, plant protection and environment.
Actual studies presume that the percentage of biotechnology will increase from 15%
of the turn-over in pharmaceuticals today to 30% in 2020, in chemistry from 5% to
12% and in food from 15% to 25%. Boston Consulting Group is expecting a global
added value of 433 billion $ per year by biotechnology in 2010. Approx. 80% are
made up by the markets in pharmaceuticals, diagnostics and nutrition. In this context
one has to keep in mind that the transformation of biotechnologies into products with
high added value as diagnostics, serums and therapeutical products needs a time
frame of 5 to 12 years to develop products. Developed nutrition-related products can
only be marketed successfully after a long period of time, because the acceptance by
the market is only growing slowly. The development of a self supporting biotech
sector is a long-term task.

Biotechnology in Berlin-Brandenburg has developed since the middle of the nineties
at a very fast pace and today it is one of the top performers in Germany. The
developing bioregion with more than 12.000 jobs (3.500 at small and middle-sized
companies, 5.000 in research, 4.000 in pharma industry and in the service sector) is
a model for the success of the capital region competing with other regions, for the
transformation towards a knowledge-based economy and for the integration of the
States of Berlin and Brandenburg. The region has become – as shown by the growth
rates of the last years – an attractive site expecting growth above average for the
next future:
-      Excellent research institutions and established networks in especially relevant
       technology sectors represent a basis for the development of the sector which
       is unique in Europe.
-      6 technology parks with a focus on biotechnology and 3 others with a strong
       focus on life sciences, the largest university hospital of Europe and large scale
       instrumentation e. g. for structure biology result into an optimal infrastructure in
       the region.




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                  Masterplan Healthcare Region Berlin-Brandenburg
-     So called “enabling technologies” as optical technologies, mathematics or
      microsystems technologies are represented excellently in the region. This
      opens unique chances for interdisciplinary cooperation and completely new
      categories of products.
-     Contrary to other competing regions in Europe, the healthcare region Berlin-
      Brandenburg has implemented already today all important parts of a complete
      value added chain in biomedicine. A direct evaluation of new products in
      healthcare is possible.

But the following weaknesses have to be kept in mind:
-      The region is the leading biotech location of Germany and is perceived as
       such within Germany. Internationally this perception still needs to be
       developed. One reason for this is the fact that the commercial development of
       the biotech sector in Germany started much later than in the USA and in the
       UK.
-      Primarily relatively young small and middle sized companies with little capital
       have engaged in this sector. These companies partially provide services
       successfully worldwide, but are only in the early stages of developing
       products.

2.        Action Clusters

It is of central importance to develop the health region into a leading European center
for the development, production and application of biotechnological products. In this
sense 9 action clusters were defined.

2.1 Technologically Oriented Action Clusters

Approx. a dozen networks in different areas (e. g. bioinformatics, RNA-technologies,
glycobiotechnologies) are the technological backbone of the bioregion Berlin-
Brandenburg. They represent focuses characterized by supraregionally subsidized
joint projects and extraordinary research fields and underlaid by a major number of
concrete joint projects. They “live” technology transfer daily through the cooperation
between science and business.

During the last years the development of white biotechnology and the implementation
of biotechnological processes in industrial production have gained speed. New tools
– screening methods, metabolic engineering, results from genome and proteome
research as well as from bioinformatics – are available to organize processing
procedures more time-saving, more effectively and more economically. Because of
the positive development of this sector, its important potential in science and
business and the development of more complex structures of cooperation it is
evident to continue this process by a concentrated network management and to
improve networking with other areas of biotechnology.

                                                                                    29


                 Masterplan Healthcare Region Berlin-Brandenburg
Action cluster 5.1: Innovative biotechnologies as motor for the development of
products in pharma, nutrition, health, agriculture and environmental protection

Action cluster 5.2: Biotechnological production procedures for the industry of the
future

Central objective in these action clusters is to sustain existing network structures and
to qualify these and to build up new ones for biotechnological production. New joint
projects are to be identified and implemented by interdisciplinary networking between
science and business in order to strengthen the technological leadership of the
healthcare region Berlin-Brandenburg.

2.2 Product Oriented Action Clusters

It is expected that 80% of the added value will be produced by pharma, diagnostics
and nutrition. These markets are characterized worldwide by strong growth on one
side and by radical structural change on the other side:
-       Demographic development
-       Increasing importance of prevention
-       Pathogenesis of many illnesses is understood more and more – causal and
        regenerative therapies for many illnesses are becoming possible
-       Personalized medicine

This opens the possibility for the life science cluster Berlin-Brandenburg - up to now
primarily with a profile in science - to become the metropolis for the development of
diagnostica, therapeutica and functional food.

Action Cluster 5.3: Innovative diagnostic procedures

Action Cluster 5.4: Development of biomedical active agents and therapeutica

Action Cluster 5.5: Regenerative medicine, tissue engineering, stem cells

Action Cluster 5.6: Functional food

Central objective in these action clusters is to draft with the actors long-term road
maps and to establish transfer centers for the joint development of products at the
interface of business, science and hospitals. The value added chains for the most
important product categories in biomedicine - functional food, diagnostica,
therapeutica in molecular and regenerative medicine - are to be strengthened


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                 Masterplan Healthcare Region Berlin-Brandenburg
sustainably. User of these products in healthcare should be integrated into the
development of these products at an early stage.

2.3 Strategic Action Clusters Respecting the Specific Requirements of the Sector

Products and services in biotechnology are characterized by complex, long lasting
and cost intensive time frames for their development (e. g., for medication 10-12
years, amounts of three digits millions), highly regulated admission procedures,
global competition and restrictive reimbursement policies of the mandatory health
insurance organizations. Therefore the success of biotechnology companies
depends largely on an efficient technology transfer, available financial means and
qualified specialists. These topics are pointed out specifically in three action clusters:

Action Cluster 5.7: Speeding up the innovation process in life sciences, technology
transfer and financing

Action Cluster 5.8: International networking of the bioregion by cooperation,
acquisition and marketing

Action Cluster 5.9: Education, ongoing education, qualification

Central objective in these action clusters is to identify promising scientific results of
research institutions (scouting), to provide the financing for the “proof of concept”
(maturation) and to realize the transfer into industry (dissemination). These objectives
cannot by solved by and in the region itself. High priority therefore is given to the
acquisition of international resources through cooperation, commissions, acquisitions
and financial investors.




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                  Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action           Cluster     06:     “Medical       Technology”         and
“Telemedicine”

The gross added value of the Berlin-Brandenburg health economy including its areas
medical technology and telemedicine amounted to approx. 12.5 billion €uros with
344.500 employees in 2004; that corresponds to 10,2% of the total Berlin-
Brandenburg added value. Approx. 7.800 employees in medical technology in the
narrower sense produced a turn-over of about 1 billion €uros in Berlin-Brandenburg.

Defining the Position

The capital region of Germany with Berlin as its center is nationally unique in higher
education and research in the area of medical technology. In acquiring research
funds for medical projects it has a top position. Among the renowned institutions are
the Charité – University Medicine Berlin, the Max-Delbrück-Ceter for Molecular
Medicine as well as the German Heart Center Berlin and the German Institute for
Nutritional Research at Potsdam. There are other renowned institutions active in
Berlin and Brandenburg.

In the process of the future development, competence areas are broken down into
priorities, which according to their present and their future importance in science and
business as well as their economic relevance are to be developed intensively.

These priorities are
-     imaging
-     oncology
-     cardiovascular problems
-     telemedicine/medical information technology.

Furthermore there are potentials for developing the region Berlin-Brandenburg into a
center of medical technology in priority-bridging areas, which cannot clearly be
integrated into the above mentioned priorities or which overlap with other prospering
economic sectors as telemedicine does with IT. First and important goals are here:
-      Documentation and marketing of the attractiveness of Berlin-Brandenburg as
       location for medical technology
-      Improvement of the international competitiveness of the region
-      Measures to keep and create innovative qualified jobs.

Priorities

Imaging: Imaging is a technical priority concerning different medical activity areas as
cardiovascular problems, oncology and telemedicine. It is especially fit to integrate

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                 Masterplan Healthcare Region Berlin-Brandenburg
other technologies as optics, micro-systems technology and nanotechnology having
a certain importance for medicine and medical technology in Berlin.

In a first step the dispersed activities of imaging and image processing in scientific
institutions, hospitals and companies are integrated and coordinated by the Imaging
Network Berlin (INB). This will result into an increasing engagement of producers of
large instrumentation of imaging systems in the region with the participation of
regional business and the scientific community.

Oncology: Together with cardiovascular diseases oncological diseases represent the
most common cause of death and their incidence rate is high. In 2000 27% of all
deaths among persons over 65 years were caused by oncological diseases.
According to the World Cancer Report of the WHO there are 10 mio new oncological
patients annually worldwide; the number of new patients will increase to 15 mio in
2010.

In order to optimize diagnosis and therapy it is planned to network molecular
medicine and medical technology in the area of science and economy. In this context
the establishment of a proton therapy center in Berlin is supported and promoted in
order to guarantee the national and international competitiveness in this sector.

Cardiovascular problems: Cardiovascular diseases are the leading cause for death –
ahead of oncological diseases. They affect especially the working population.
Industrial products as pacemakers, defibrillators and pumps are highly innovative
products integrating technologies like microsystems technologies. New non-invasive
diagnostic procedures increasingly complement traditional examining methods and
are reducing risks for patients. Internal and external heart supporting systems offer
possibilities to bridge the time until a transplant and represent for many patients the
only chance to survive.

The priority of cardiovascular problems is excellently represented in business of the
capital region. These companies are active internationally and are among the
technologically leading companies in the area of heart supporting systems. The
development of the region into a center for research, development and production of
heart supporting systems is being planned. This is including to initiate and to
coordinate joint projects and networks.

Telemedicine/medical information technology: The healthcare system is facing
profound changes by the introduction of the electronic patient card, by the
consolidation of diagnosis related groups (DRG) and by the increasing establishment
of quality management. The use of information and communication technologies will
improve the efficiency of healthcare delivery significantly. Networking actors in
healthcare services for inpatients and outpatients is clearly underdeveloped; this
situation is offering interesting opportunities for innovative solutions. Restructuring
healthcare delivery and moving into the direction of integrated care will lead to more
                                                                                    33


                 Masterplan Healthcare Region Berlin-Brandenburg
telemedical services – especially when facing the fundamental demographic
developments affecting a state like Brandenburg which is considered as a model
region for the delivery of medical services for an aging and decreasing population in
a territorial state.

The activities in Berlin and Brandenburg are to be merged progressively into a
national competence cluster for telemedical applications. This means that the
activities of research institutions and of information and communication technology
companies have to be reoriented towards the needs of the users in healthcare. When
developing these measures they have to be coordinated narrowly with similar
measures of the masterplan for the development of the IT-location Berlin-
Brandenburg.




                                                                                  34


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 07: Offerings and Services for Senior
Citizens including Nursing Care

Present Situation

The consequences of demographic change hitting Berlin-Brandenburg as well as the
entire Federal Republic of Germany are result of the increasing life expectancy on
one side and of decreasing birth rates during the last decades on the other site: The
older generation is the fastest growing age population in Berlin and Brandenburg. In
2020 each fourth Berliner and Brandenburger will belong to the group of senior
citizens/retired persons – with a continuously growing life expectancy. At the same
time the percentage and the number of the labor force is decreasing.

This demographic change will have different consequences for different parts of
Berlin-Brandenburg. Specific for Berlin will be the significantly more important
“singularisation”, the percentage of one-person-households, important social
differences among the older generation, a homogenisation as well as a multiethnicity
of the older generation in certain districts of the city. Especially structurally weak
regions of Brandenburg are hit already today by an “emigration” of younger and
active persons; this is weakening social networks and tearing them apart; economic
development is hindered by this migration process. The migration is supposed to
continue over the next years.

The major part of the older generation – even when becoming of old age - is
psychically and physically fit: In 2003 almost 90% of the age group over 65 was fit,
only 11,5% needed nursing care. It is important to know that in general the older
generation of today is economically affluent and has high incomes – this is also true
for Berlin and Brandenburg where the older generation has important economic
means at its disposal and is able to satisfy its needs with its proper means.

The economic situation as well as changes in the approach and in living patterns are
leading to changes in needs of many elderly people which they want to satisfy and
which – for the major part - they can satisfy by themselves: The higher percentage of
free time after the work life results into an increasing demand for travelling and other
leisure activities. Health is becoming a focus of interest: health promotion, healthful
nutrition, wellness, fitness, health tourism are increasingly in demand by the older
generation. Self help activities and civil engagement are becoming fields of activities
of senior citizens. In order to avoid the risk of social isolation, new and other forms of
living are becoming more interesting for elderly persons: Barrier-free living for elderly
persons, assisted living, serviced living, apartment-sharing communities, cross-
generational living projects and other new forms of living are “in the making”. The
demand for new differenciated and flexible forms of living will increase. New
household technologies (smart home, health and living technologies) are supporting
the independence of the older generation offering chances to stay in the familiar
environment as long as possible. To live with illness and needing nursing care in the
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                  Masterplan Healthcare Region Berlin-Brandenburg
familiar environment is facilitated by homecare, telemonitoring, emergency call
systems and other technologies. The demand for these technologies has not been
identified, addressed and met yet. To satisfy this demand is a challenge for social
policy and at the same time an economic opportunity. Berlin and Brandenburg are
prepared to face this challenge in science, business and service provision; they
dispose of the necessary prerequisites for this.

The demographic change however will see an increasing number of elderly persons
needing nursing care. Compared to today nursing services need to be more flexible
and more differenciated; flexible and individualized services will be growing in
demand. In 2003 approx. 75% of all elderly persons needing nursing care received
care within their family; of these persons two thirds were taken care of without
professional support; 25% of all elderly persons were living in nursing homes.

Many concerned persons have difficulties to find their way in the “jungle” of services
and rights to these services and need information, counsel and assistance when
planning individual services and adapting them to the changing needs. The States of
Berlin and Brandenburg dispose of a dense and performing network to inform and to
counsel persons needing care as well as their relatives – but this can still be
improved.

Many nationally or supraregionally active nursing companies have moved their
headquarters to Berlin (e. g., Kursana GmbH, Marseille Kliniken AG, Procurand
AG/Cura AG, Vitanas GmbH & Co KG as well as non-profit organizations). Being
close to politics is an important aspect to move headquarters to Berlin. It is
advantageous for the development of new forms of living for senior citizens that large
primarily communal housing companies in the region are interested to keep or win
senior citizens as tenants.

An advantage is also the high density of scientific institutions dealing with or
beginning to become interested in these issues (e. g., German Center for Aging
Issues, Charité – University Medicine Berlin, FH Lausitz, various schools of social
work and of nursing). Technical universities are dealing with “design of living spaces”
with the assistance of new technologies (e. g., steering devices for household –
smart home, health and living technologies, telemonitoring, transmission of vital data
via mobile phones and other means of communication, architectural planning and
constructing). The extent of these activities hardly corresponds to the importance of
the demographic change and its consequences. Furthermore the majority of
universities do not integrate these and other age-related sciences and do not
organize them interdisciplinarily. An overview of what is available today does hardly
exist. Improving information possibilities for professionals and non-professionals is an
issue.

The States of Berlin and Brandenburg have developed and adopted guidelines for a
senior citizen policy intended to activate senior citizens and improving the use of their
potentials. Berlin is organizing regularly senior citizen-related consumers´
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                  Masterplan Healthcare Region Berlin-Brandenburg
conferences, identifying and coordinating needs, wishes and interests of senior
citizens and transmitting them to business. Furthermore in 2003 the “Network
Consumer Protection” - offering independent information and counsel on products
and services for interested persons and promoting communication between senior
consumers and business - was founded.

In Brandenburg ministries, associations, interest groups and persons have formed
the voluntary “Brandenburg Supraregional Network – Living in Old Age and with
Handicaps”. It is intended to become a meeting place for as much actors as possible,
to network projects from different sectors and to safeguard the communication with
other actors in science, business and practice.

Facing the demographic change and the challenge to guarantee supervision of and
nursing for an increasing number of especially very old persons at an adequate
quality, the State of Brandenburg has started an initiative with the slogan “Later is
Beginning Now”. Topics of this initiative are to strengthen the civil responsibility for
care and nursing, for education, training and ongoing education in nursing as well as
to safeguard quality standards for care and nursing.

The approach to illness, dying and death reveals the human image of a society. The
civil discussion how to develop a human aging society must not neglect social ethical
question. The States of Berlin and Brandenburg are promoting to strengthen
palliative medicine, hospice services and hospices and to improve the right of
concerned persons to access specialized ambulant palliative services financed by
the mandatory health insurance organizations. Berlin has decided to establish a
round table on hospice- and palliative care provision.

Goals

   -    To consider demographic change primarily as an opportunity rather than a
        problem

   -    To strengthen interdisciplinary research

   -    To identify and to satisfy the interest of elderly persons to stay in their familiar
        environment, to develop strategies against social isolation and to compensate
        changing personal competences by new technologies

   -    To strengthen the awareness of elderly persons to accept more responsibility
        for their own well-being as well as to pay for services and technical devices
        out of their own pocket

   -    To give an overview of services for elderly persons in general and for persons
        needing nursing care in particular and to set up a portal
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                   Masterplan Healthcare Region Berlin-Brandenburg
  -   To develop care and nursing for elderly persons respecting their differenciated
      needs and including care and assistance in their living environment

  -   To develop new forms of medical services (e. g. by telemedicine) assisting
      elderly people in case of illness and nursing care

  -   To develop the healthcare region Berlin-Brandenburg into the location for
      national and supraregional nursing care companies as well as of business
      producing age-related products and to attract these to move their
      headquarters to the region

  -   To promote and to develop barrier-free apartments, environment and
      infrastructure as well as specific research

  -   To promote health tourism of elderly persons to the region by attractive
      offerings

  -   To promote and to strengthen self help activities and civil engagement among
      elderly persons for elderly persons as well as elderly persons needing nursing
      care

  -   To develop Berlin and Brandenburg as top location for issues and topics of the
      older generation as well as for an aging society

Discrete Measures

  -   Making an inventory of existing services and offerings for elderly persons in
      the region and establishing a portal
      Coordination: Welfare organizations of Berlin and Brandenburg
      Time frame: mid-term

  -   Developing offerings and services for elderly persons needing support and
      nursing care and adapting walk-in and residential nursing services to changing
      needs
      Coordination: Nursing companies
      Time frame: short-term

  -   Developing and implementing projects of telemonitoring for short- or long-term
      control of vital data of elderly persons
      Coordination: DGTelemed, Telemed-Initiative Brandenburg
      Time frame: mid-term

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                Masterplan Healthcare Region Berlin-Brandenburg
-   Developing and implementing projects for fast transmission of data of elderly
    persons in case of emergencies as brand of the healthcare region
    Coordination: DGTelemed, Telemed-Initiative Brandenburg
    Time frame: mid-term

-   Developing and implementing telemedical projects providing medical care
    especially to elderly persons in areas without sufficient ambulant medical
    services
    Coordination: DGTelemed, Telemed-Initiative Brandenburg
    Time frame: mid-term

-   Further developing and implementing the guidelines for senior citizen policy,
    especially further developing the support system of care at home and care by
    relatives
    Coordination: SenIntArbSoz, MASGF BB
    Time frame: mid-term


-   Developing new forms of living and creating adequate environments and
    infrastructure for elderly persons as well as extending assisted shared
    apartment communities for elderly people needing nursing care
    Coordination: BBU, LFW
    Time frame: mid term

-   Promoting the development and provision of consumer oriented age-based
    products and services by adequate subsidized programs
    Coordination: TSB, ZAB
    Time frame: mid-term

-   Attracting nursing care companies and companies producing age-related
    products to move their headquarters to the region
    Coordination: Berlin Partner, ZAB
    Time frame: mid-term

-   Extending consumer counseling to better inform elderly persons about age-
    based products and services as well as the consumer protection
    Coordination: Consumer counsel Berlin and Brandenburg
    Time frame: mid-term




                                                                              39


              Masterplan Healthcare Region Berlin-Brandenburg
   -   Developing need-oriented touristic complex offerings for elderly persons in
       order to strengthen senior citizen tourism
       Coordination: TMB, BTM
       Time frame: mid-term

Actors

Alzheimer Society Berlin and Brandenburg, Federal Association of Private Providers
of Social Services, Federal Working Group Care at Home, LASV, Brandenburg
Council for Handicaps, Berlin-Brandenburg Council for Nursing Care, Berlin Senior
Citizen Council, Local Authority Assembly, Assembly of Welfare Organizations Berlin-
Brandenburg, MDK Berlin-Brandenburg, Brandenburg Senior Citizen Council,
Brandenburg Union of Cities and Counties, VPK, Associations of mandatory nursing
care insurance organizations Berlin and Brandenburg, MASGF BB, MWFK BB, MW
BB, MIR BB, SenKzl, SenWiTechFrau, SenBildWiss, SenIntArbSoz, SenGesUmV,
SenStadt, TMB, BTM, consumer protection associations, TSB, ZAB, Berlin Partner,
DGTelemed, Telemed-Initiative Brandenburg, TSBmedici, BBU, LFW




                                                                                 40


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 08: Modernizing and Optimizing Healthcare
Provision

Present Situation

Trends in healthcare politics focus on competition, on optimisation of processes and
healthcare provision systems, on integration of different healthcare sectors separated
up until now and on strengthening the rights of patients. The introduction of diagnosis
related groups (DRG), modern medical technology and other developments permit to
shorten the treatment of inpatients or even to treat them as outpatients. Progress in
medical technology and the development of e-health will result in relocating the
boundaries between acute care on one side and prevention and health promotion on
the other side in favour of the latter. The implementation of modern information and
communication technologies for the modernisation of healthcare provision – e. g. by
introducing the electronic patient card and patient record or by fully digitalised
hospitals – is leading to further innovations. Cooperation and networking of hospitals
- even when operated by different organizations - by means of telemedicine (e. g.
telemedical cooperation in pathology or radiology as in the “Eastern Region” with the
Berlin Trauma Center, Königin Elizabeth Herzberg Hospital, Sana Klinikum
Lichtenberg) will improve quality and efficiency of inpatient services. The Unions of
Outpatient Doctors approved by the mandatory health insurance organizations
(kassenärztliche Vereinigungen) in the region are improving technical platforms to
optimize the processes of treatment for outpatients. Compared to other regions in
Germany the expenses for the treatment of inpatients in Berlin are still higher –
despite successful joint efforts to reduce them: the Berlin base rate has approximated
the national average in the last years and has dropped to less than 3.000 €uros.
However the mandatory health insurance organizations of Berlin are spending more
for inpatients than other regions in Germany do, are needing higher contributions and
depend on subsidies from other regions. These developments have led Berlin to
merge the public hospitals to the Vivantes GmbH (company of limited liability by
private law) and to reorganize the processes of treatment. The Charité – after
merging the four campuses into one organization – has introduced a new structure
with 17 interdisciplinary centers; the provision of medical services as well as the
efficiency is to be improved by outsourcing certain activities.

Over the last years several performing hospital companies have developed, partially
expanding supraregionally and providing high quality services. HELIOS Kliniken
GmbH has acquired in Berlin the Buch Hospital, the Emil von Bering Hospital and in
Bad Saarow (Brandenburg) the Humaine Hospital; the company is “importing” its
know-how and its experience especially in quality management to the Berlin-
Brandenburg region.

The structure of “hospital owners” is changing currently fundamentally and rapidly.
The percentage of public ownership is diminishing in favour of private for profit
hospital companies. Especially for profit, but also non-profit private hospital
companies are growing by taking over public hospitals and develop into performing
                                                                                    41


                 Masterplan Healthcare Region Berlin-Brandenburg
supraregional or even national players with an increasing market power. Partially
these companies engage in different areas of healthcare and dispose of financial
means unheard of in healthcare until recently. Similar developments are becoming
apparent in the outpatient sector. The past strict separation of the outpatient and the
inpatient sector in Germany, but also of acute care and medical rehabilitation is
“softening”. Hospitals and outpatient doctors are developing integrated projects.
Hospitals are developing outpatient clinics (Medizinische Versorgungszentren –
MVZ) and are engaging in the treatment of outpatients. On one side new forms of
cooperation between different actors lead to these developments, on the other side
these developments allow new forms of cooperation. These developments allow and
need new strategies when modernizing and optimizing healthcare provision in the
region. The different actors in the healthcare region Berlin-Brandenburg have to keep
this in mind.

The relocation of inpatient and outpatient services have resulted in reductions of
hospital beds and various model projects for a better cooperation of outpatient and
inpatient services. This will lead to respective changes for professionals in these
sectors. An example for this is the project of integrated medical and therapeutical
outpatient services in nursing homes which is jointly managed by the mandatory
health insurance organizations, the Union of Outpatient Doctors approved by the
mandatory health insurance organizations, the Association of Private Hospitals (VPK)
and the Berlin Hospital Association; the integration of in- and outpatient services is
attracting attention nationwide. An increasing importance and diffusion of nowadays
legally admitted polyclinics is to be expected attracting more patients as outpatients.
Various service providers are using the legal possibilities of integrated services and
develop suprasectoral service concepts including suprasectoral clinical pathways.
For example, the Union of Outpatient Doctors approved by the mandatory health
insurance organizations is developing a suprasectoral services networking different
sectors in order to optimize the treatment of population-related diseases. Based on
the proven division of work between the states of Berlin and Brandenburg, other
projects of integrated services between acute care and medical rehabilitation are
indicated, as they are practised successfully since 1990.

Healthcare services in the region – as well as in other parts of Germany - do not
meet all requirements of gender equity and interculturality. Patients with chronic
diseases are making high demands on a holistic medical diagnosis and treatment –
these demands are not met in all aspects by the present sectorized system of
services. Not all health services are barrier-free.

Goals

   -    To make the healthcare region the cutting edge of medical quality
        management

   -    To develop the healthcare region as platform for integrated services

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                  Masterplan Healthcare Region Berlin-Brandenburg
  -   To develop the healthcare region as model region for quality-oriented modern
      and efficient as well as integrated health services, respecting aspects of
      gender equality, interculturality and specific demands of patients with chronic
      diseases

  -   To establish transparency in healthcare delivery

  -   To improve preclinical emergency services

  -   To realize selected priorities of medical services

  -   To modernize and to optimize workflow and healthcare delivery systems, to
      improve the efficiency especially of the hospital sector, to establish and to
      improve the quality of healthcare services in general

  -   To adapt the regional base rate to the national average rapidly by improving
      the efficiency of hospital care and by other measures

  -   To improve information and rights of patients involving consumer protection

  -   To establish and to safeguard barrier-free access to healthcare services and
      institutions

  -   To deepen existing cooperations between service providers in order to
      guarantee and to optimize high quality efficient services for inpatients
      especially by telemedical applications and to develop new forms of
      cooperation

Discrete Measures

  -   Evaluating systematically qualitative data on health services, defining quality
      parameters for important areas of activity, establishing measurement
      procedures, standardized evaluation and comparative reporting, developing a
      benchmarking system and publishing relevant data by a portal
      Coordination: Hospital companies, mandatory health insurance organizations
      Time frame: mid-term

  -   Developing a patient oriented web-based Berlin-Brandenburg health portal
      Coordination: HealthCapital Berlin-Brandenburg
      Time frame: short-term



                                                                                    43


                 Masterplan Healthcare Region Berlin-Brandenburg
-   Introducing – especially integrated suprasectoral – clinical pathways in all
    disciplines based on targets (e. g., treatment results, patient satisfaction,
    efficiency) as well as case-management (health career management) as brand
    of the healthcare region
    Coordination: Hospital companies
    Time frame: long-term

-   Developing a common Berlin-Brandenburg quality standard based on a
    patient-oriented scientific evaluation
    Coordination: Hospital companies
    Time frame: mid-term

-   Promoting projects for integrated services especially between acute care and
    medical rehabilitation and in the area of chronic diseases (e. g., rheumatism,
    diabetes, cancer, allergies)
    Coordination: Hospital companies
    Time frame: mid-term

-   Developing and implementing model projects of integrated population-oriented
    healthcare provision for at least one major provider of mandatory health
    insurance organizations by a management company
    Coordination: Mandatory health insurance organizations
    Time frame: mid-term

-   Promoting telemedical cooperation among providers of inpatient care in order
    to provide high quality and efficient inpatient care
    Coordination: Hospital companies
    Time frame: short-term

-   Equipping all ambulances with state of the art telemedical systems and
    implementing a fast and universal medical information chain
    Coordination: DGTelemed, Telemed-Initiative Brandenburg
    Time frame: mid-term

-   Intensifying the cooperation between Vivantes and the Charité (see also
    Strategic Action Cluster 03)
    Coordination: Charité, Vivantes
    Time frame: mid-term




                                                                               44


              Masterplan Healthcare Region Berlin-Brandenburg
Actors

SenWiTechFrau, SenBildWiss, SenGesUmV, MASGF BB, MW BB, Charité,
Gesundheitsstadt Berlin, State Health Conference (Landesgesundheitskonferenz),
Berlin and Brandenburg Hospital Associations, mandatory health insurance
organizations, medical rehabilitation clinic companies, physicians´ networks, Union of
Outpatient Doctors approved by the mandatory health insurance organizations,
Patient representatives, Network Womens´ Health, mandatory retirement and
accident insurance organizations, DGTelemed, Telemed-Initiative Brandenburg




                                                                                   45


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 09: Prevention, Health Promotion, Medical
Rehabilitation and Nutrition

Present Situation

Berlin and Brandenburg offer good opportunities to make prevention, health
promotion, medical rehabilitation and nutrition a brand of the region.

Various actors organize and finance a great number of different projects in the areas
of prevention, health promotion and medical rehabilitation in the healthcare region
Berlin-Brandenburg. A complete overview of the prevention structures – e. g.,
regional working groups for health promotion, local coordination by the public health
administration, addiction counselling centers – as well as an overview of the variety
of prevention projects, organized by the states, local authorities and districts,
mandatory social insurances organizations, welfare organizations, sport associations,
self help groups, private organizations and other actors in various fields and reaching
from certified wellness and fitness activities to cancer prevention is lacking. A
comprehensive strategy for prevention and health promotion is only visible in
contours. Despite the great importance and effectiveness of prevention, self help,
health promotion and medical rehabilitation of chronic diseases, very often linked
closely to life style and conduct, their consideration has to be improved. High quality
and certified wellness and fitness offerings play only a minor role in the context of
prevention and health promotion; local coordination, which is organized - and should
be organized - by the local public health administration, can still be improved.

The importance of nutrition for upkeeping someone´s health and therefore for
prevention and health promotion is still largely underestimated. A third of all
expenses of the healthcare system – according to estimates of the Federal Ministry
of Health – is caused by diseases of which the origin and the development was
influenced directly or indirectly by nutritional factors. Recent findings on the causal
connection between nutrition and health form the basis for developing, producing,
processing and marketing high quality healthful and preventive food – and this should
be used purposely by the nutritional industry. The region should consider a
certification of food which corresponds to scientific findings about the causal
connection between the respective product and its preventive and health promoting
impact.

The Region Berlin-Brandenburg is aware of the importance of the relation between
food, nutrition and health. It has made systematically especially health-based food
and nutrition a priority in health sciences and in health economy over the last years.
Food science, food technology, nutritional science and biotechnology exist in an
impressive density and quality in the region.

The complete value added chain from the plant to the production of preventive food
is covered in this technology sector.
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                 Masterplan Healthcare Region Berlin-Brandenburg
In Brandenburg there are statewide cooperation structures for important parts of
prevention – e. g., for the health of children and youth, for addicted persons and
persons affected by HIV/Aids. These – as the alliance “Growing up Healthily in
Brandenburg”, the State Addiction Conference and the initiative “Brandenburg Jointly
against Aids” - are agencies of health target processes. Within these and other
networks the well established medical rehabilitation for in- and outpatients - focussing
not only on persons with a chronic and/or degenerative diseases, but also children
and youth with behaviour-based diseases and with other problems – is playing a
major role. Broad experiences in secondary and tertiary prevention are available and
can be integrated profitably into activities of primary prevention. This is also true for
after-care activities of the mandatory health and retirement insurance organizations
(Note of the translator: In Germany major part of medical rehabilitation is financed by
the mandatory retirement insurance organizations).

Berlin has a long-standing tradition in self help activities. This approach has been
strengthened by the appointment of a patient representative. Furthermore in Berlin
the state health conference and the district health conferences are considered to be
qualified instruments to improve healthcare delivery. They offer good chances to
attain the planned synergies. The state health conference has made prevention for
children and youth a priority and has developed a target system. The health situation
and health services for migrants as well as the transparency of health services are
other priorities.

In the field of health promotion for socially disadvantaged persons Berlin and
Brandenburg have established so-called knots among which a productive
cooperation has developed. Both states are looking back on a traditionally positive
cooperation in medical rehabilitation and at the interface of acute care and medical
rehabilitation. For example, hospitals of the region are cooperating with medical
rehabilitation services for outpatients in Berlin and Brandenburg as well as with
medical rehabilitation clinics for inpatients in Brandenburg with the intention to make
each patient with acute or chronic diseases fit for professional life as well as for every
day life. Of specific importance are medical rehabilitation treatments after
hospitalisation. Agreements between the States of Berlin and Brandenburg have
proven their worth.

Goals

   -    To make quality of life of the citizens of Berlin and of Brandenburg an
        essential criteria of the healthcare region

   -    To develop and to promote prevention, health promotion - especially in
        kindergardens, schools and enterprises – and medical rehabilitation as brand
        of the healthcare region Berlin-Brandenburg, respecting aspects of gender
        equality, interculturality as well as the demands of chronically ill persons

                                                                                       47


                  Masterplan Healthcare Region Berlin-Brandenburg
  -   To develop the Berlin-Brandenburg region into a science-driven model region
      for nutrition, health and food and to coordinate, to integrate and to network
      existing resources

  -   To improve the attractiveness of the region as location for food and nutritional
      industry

  -   To establish an inventory of structures, actors and projects in prevention and
      health promotion and to develop an overview

  -   To develop a comprehensive strategy of the healthcare region for evidence-
      based prevention, health promotion and medical rehabilitation

  -   To integrate consistently approaches and projects of the region into a
      comprehensive strategy for prevention, health promotion and medical
      rehabilitation and to develop it further

  -   To identify as early as possible chronic-degenerative diseases and socially
      caused inequality of health chances and to work against its growth

  -   To fight the consequences of chronic diseases with measures of secondary
      and tertiary prevention

  -   To establish suprasectoral integrated health services and clinical pathways
      between acute care, medical rehabilitation and nursing care according to the
      guidelines of the medical and medical rehabilitation societies – including the
      use of telemedicine – and to optimize clinical workflow in the interest of
      patients

  -   To establish and safeguard barrier-free access to the various services

Discrete Measures

  -   Developing a comprehensive strategy for prevention, health promotion and
      rehabilitation – including the development of quality standards – as well as for
      self help respecting aspects of gender equality, interculturality and specific
      demands of chronically ill persons
      Coordination: Gesundheit Berlin, HealthCapital Berlin-Brandenburg
      Time frame: short-term




                                                                                   48


                Masterplan Healthcare Region Berlin-Brandenburg
-   Developing an inventory of the projects in prevention, in health promotion, in
    nutrition and in medical rehabilitation in the healthcare region and establishing
    an overview
    Coordination: Gesundheit Berlin, regional knots
    Time frame: short-term

-   Developing the “Patient-Training and Counseling Center for Children and
    Youth” for outpatient treatment of obese (unhealthy overweight) children and
    youth aged 12 to 16 years
    Coordination: University Potsdam, mandatory health insurance organizations
    Time frame: mid-term

-   Developing the State Health Conference to a forum for the coordination of
    comprehensive objectives of prevention, health promotion and healthy
    nutrition and of their implementation
    Coordination: SenGesUmV, MASGF BB
    Time frame: short-/mid-term

-   Drafting and implementing prevention projects in living spaces as in
    enterprises (e. g. enterprise health management)
    Coordination: Chambers of Commerce, Chambers of Trade
    Time frame: mid-term

-   Supporting quality management of certified wellness and fitness offerings
    Coordination: DMGV
    Time frame: mid-/long-term

-   Improving the linguistic and cultural communication with migrants in healthcare
    Coordination: Hospital companies
    Time frame: mid-term

-   Coordinating and developing local services in health promotion and prevention
    by local health administrations
    Coordination: SenGesUmV with districts; Brandenburg State Health Agency
    Time frame: mid-term




                                                                                  49


              Masterplan Healthcare Region Berlin-Brandenburg
-   Networking medical rehabilitation clinics with providers of touristic services in
    order to develop and to offer health promoting services especially in places for
    cures and recreation in Brandenburg
    Coordination: DEGEMED, Brandenburg Association of Cure and Bath
    Locations
    Time frame: short-term

-   Founding scientifically the assumptions about the causal connection between
    nutrition and health, guaranteeing a healthful nutrition for specific population
    and risk groups and developing evidence-based measures
    Coordination: DIfE
    Time frame: continuously

-   Promoting scientifically based recommendations for nutrition
    Coordination: DIfE
    Time frame: continuously

-   Establishing a coordination agency “ Food, Nutrition, Health”
    Coordination: Brandenburg State Health Agency, Berlin State Agency for
    Health and Social Affairs, Consumer Counseling Berlin
    Time frame: short term

-   Developing information systems on food-relevant and nutrition-relevant issues
    to improve health by reducing nutrition-based diseases
    Coordination: BioTOP, Consumer Counseling Berlin and Brandenburg
    Time frame: mid-term

-    Establishing counselling agencies to improve the understanding of consumers
    with regard to the interrelationship between food, nutrition, activity and health
    Coordination: Brandenburg State Health Agency, Consumer Counseling Berlin
    and Brandenburg
    Time frame: mid-term

-   Developing counseling and support agencies in order to promote the
    foundation, relocation and development of food and nutrition companies in the
    region
    Coordination: Berlin Partner, ZAB
    Time frame: mid-term




                                                                                  50


              Masterplan Healthcare Region Berlin-Brandenburg
Actors

Berlin: Chamber of Commerce, Chamber of Trade, SenBildWiss, SenGEsUmV,
SenWiTechFrau, SenIntArbSoz, SenInnSport, LAGeSo, Healthy-Cities-Network,
Gesundheit Berllin, Landessportbund Berlin, Chamber of Medical Doctors Berlin,
Berlin Hospital Association, Union of Outpatient Doctors approved by the mandatory
health insurance organizations, mandatory health insurance organizations, hospital
and medical rehabilitation clinic companies, State and District Health Conferences,
mandatory accident insurance Berlin, mandatory retirement and accident insurance
organizations (Berufsgenossenschaften, Deutsche Rentenversicherung Bund,
Deutsche Rentenversicherung Berlin-Brandenburg), German Association for Medical
Rehabilitation, Association of Private Hospitals, TU Berlin, Charité, Humboldt
University, Berlin Technical University of Applied Sciences, Federal Institute of Risk
Evaluation, Robert-Koch-Institute, BioTOP, VZ Berlin, VZ BV, DMWV (German
Medical Wellness Association)

Brandenburg: MASGF BB, MBJS BB, MWFK BB, MLUV BB, MW BB, Chambers of
Commerce, Assembly of Counties, Cities and Local Authorities Alliance,
Brandenburg Chamber of Medical Doctors, Union of Outpatient Doctors approved by
the mandatory health insurance organizations, mandatory health insurance
organizations, hospital and medical rehabilitation clinic companies, Brandenburg
Hospital Association, Brandenburg Sport Alliance, Union of Welfare Organizations,
Professional Associations, Network Healthy Kindergarden, Network Healthy Schools,
Brandenburg Cure and Bath Locations Association, mandatory retirement and
accident     insurance     organizations     (Berufsgenossenschaften,     Deutsche
Rentenversicherung Bund, Deutsche Rentenversicherung Berlin-Brandenburg),
German Association for Medical Rehabilitation, Association of Private Hospitals,
Potsdam University, German Institute for Nutritional Research (DIfE), Institute for
Agricultural Technology, Institute for Vegetable and Flower Production, Institute for
Applied Polymer Research, Institute for Grain Processing, Milk Research Center,
Max-Planck-Institute for Molecular Plantphysiology, VZ BB




                                                                                   51


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 10: Lengthening and Strengthening the
Value Added Chains

Present Situation

Berlin and Brandenburg have all links of the value added chain at their disposal.

The healthcare region has numerous mostly excellent research and teaching
institutions in the different fields of health sciences as well as training and ongoing
education institutions for healthcare professions. 24 universities and extra-university
institutions for medical research and development as well as training institutions for
academic and non-academic professions represent strong and important links of the
value added chain. The healthcare region with its 180 medical technology companies
and its 170 biotechnology companies has strong links of the value added chain in
production and marketing. The major part of these companies is characterized by
their small size and their financial weakness, but also by their high innovative
competences and their flexibility. There are 20 pharmaceutical companies active in
the region: Among them internationally active companies as Bayer Schering,
Nycomed and Berlin Chemie. In addition there are many middle-sized businesses in
the area of health trade. Approx. 90 hospital companies and 45 medical rehabilitation
clinic companies have their headquarters in the region, representing an annual
turnover of approx. 10 billion €uros. In the field of inpatient and outpatient nursing
care there are many - approx. 1.200 - small and middle-sized companies active.
Hospital and nursing care companies often have a double function in the value added
chain: On one side they are customers of medical technology and other products, on
the other side they are interesting partners for clinical research. Furthermore they are
an important link in the (service) value added chain by “producing” services for
patients in diagnosis, treatment and nursing care. They contribute to the application
of medical and other health-related research and development. Finally they employ
important numbers of highly qualified academics. Medical rehabilitation clinics in
Brandenburg prolong the value added chain in the field of patient treatment.

Developing, testing, producing and marketing especially medical technology and
pharmaceutical products or biotechnological processing as well as developing,
testing and implementing new medical therapeutical methods has to respect some
specific particularities: First of all the healthcare sector is characterized by a high
density of regulations. This in combination with an innovation scepticism of many
concerned important institutions and actors is hampering the implementation of new
innovative and performing products and methods – or is making it difficult. The
requirements for clinical testing are high and the licensing procedures long. The
capital requirements for development and testing are as high as the entrepreneurial
risks. Without government subsidies or financially strong partners prepared to take
risks, most of the typically small and middle-sized companies in Berlin and
Brandenburg cannot “shoulder” these risks and cannot provide the necessary
financial means. This is a problem specific to the healthcare region Berlin
Brandenburg. There is a high risk for these companies – and for the healthcare
                                                                                     52


                 Masterplan Healthcare Region Berlin-Brandenburg
region Berlin-Brandenburg - that companies have to stop long-term developments
because of financial problems or that shortly before starting production they are
bought by larger financially strong companies from outside the region and that these
and not the healthcare region Berlin-Brandenburg is making the profit.

Berlin and Brandenburg because of their good infrastructure in all fields of healthcare
and Berlin because of its function as capital are highly attractive. Because of the
upheavals in healthcare on one side and because of the restructuring of healthcare
companies on the other side many of these newly founded and fast growing hospital
companies have not found yet their final location. This is also true for nursing care
companies. This is a chance for the healthcare region to attract these companies to
move their headquarters to the region. This is not only important in the sense of
business development, the relocation of these companies is also helping to close
gaps of the value added chains in the region and to strengthen them. Medical
rehabilitation clinics and hospitals have an annual turnover of more than 1 billion
€uros in medical technology alone, an amount of another three digits millions €uros
for other products for these hospitals and clinics has to be added. The high turnover
and the spatial concentration are not sufficiently exploited for the added value of the
region.

Research and development as well the innovative force and the flexibility of many
middle-sized (healthcare) companies are specific strengths of the healthcare region.
The potential of Berlin as “capital” of hospital companies as well as the high density
of performing hospitals offers itself for clinical research on one side, but is also
offering unexploited chances and potentials for the distribution of medical products
on the other side. That organizations consider the healthcare region Berlin-
Brandenburg to be an attractive center for clinical research is reflected by the fact
that a large number of performing companies of clinical research has moved to Berlin
and Brandenburg. It is also reflected by the fact that these companies invest directly
into the qualification of academic experts in clinical research (e. g. the Parexel
Academy is offering a bachelor of science in clinical research).

Goal

   -   To strengthen all links of the value added chain of the regional health
       economy and to close gaps


Discrete Measures

   -   Identifying, analysing and strengthening value added chains starting from the
       idea and ending with the marketable product/service, closing gaps as well as
       complementing lacking links in value added chains and evaluating these with
       the objective to speed up procedures and results
       Coordination: TSB, ZAB, BioTOP
       Time frame: mid-term


                                                                                    53


                 Masterplan Healthcare Region Berlin-Brandenburg
-   Attracting new companies to the region
    Coordination: Berlin Partner, ZAB
    Time frame: mid-term

-   Developing new priorities in health sciences in order to close gaps in the value
    added chains
    Coordination: TSB, Berlin Partner, ZAB
    Time frame: mid-term

-   Strengthening and developing networks and discussion forums between
    science and business as well as between producers and customers in
    healthcare
    Coordination: TSB, LASA, ZAB
    Time frame: mid-term

-   Identifying and approaching investors – especially venture capital companies
    – and companies ready to move to the region also from abroad
    Coordination: Berlin Partner, ZAB, BioTOP, Ipal
    Time frame: short-/mid-term

-   Improving the access of small and middle-sized companies to clinical
    research/studies at hospitals appropriate to these activities
    Coordination: Charité
    Time frame: short-term

-   Training systematically and intensively medical doctors and other healthcare
    professionals to use new therapeutical methods and technology to speed up
    their implementation substantially
    Coordination: Brandenburg State Health Agency, LaGeSo
    Time frame: mid-term

-   Intensifying the training of professionals for clinical studies (e. g., study nurse)
    Coordination: Academy for Health
    Time frame: short-term

-   Intensifying the use of scientific institutions as “incubators” for the
    development of new companies (start-ups)
    Coordination: BioTOP
    Time frame: mid-term

-   Improving the general conditions for universities to become shareholders of
    spin-offs
    Coordination: SenBildWiss, MWFK BB
    Time frame: mid-term



                                                                                      54


               Masterplan Healthcare Region Berlin-Brandenburg
   -   Developing a regional (healthcare) logistical center Berlin-Brandenburg
       Coordination: MedTecNet
       Time frame: mid-term

   -   Establishing a center for the development of biomedical active agents
       Coordination: FMP
       Time frame: mid-term

Actors

TSB, MedTecNet, Berlin Partner, ZAB, BioTOP, Charité, Akademie für Gesundheit,
IBB, ILB, mandatory health insurance organizations, Hospital Associations, FMP,
MASGF BB, MW BB, MWFK BB, SenBildWiss, SenWiTechFrau, SenGesUmV, Ipal




                                                                                 55


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 11: Health Sites and Their Development
Present Situation

Health with its aspects provision, business and science is an important part of the
regional and local infrastructure. Furthermore reputed health clusters are
internationally important. In this sense health is influencing largely local, regional and
national development as well as structure policies and is related closely to regional
and urban development. Berlin and Brandenburg have recognised this interrelation
and have conducted the development of health-related technology parks also as
infrastructural regional and urban development (e. g., Berlin-Buch, Adlershof,
Charlottenburg, Potsdam, Luckenwalde). Another aspect of the infrastructural
regional and urban development is to provide sufficient healthcare in the region – this
is becoming an important topic for structurally weak regions in Brandenburg.

Within the region several different centers of providers of health-related services
have emerged.

Especially important is the biotechnology campus Berlin-Buch proving to be a
groundbreaking infrastructural decision and representing in many aspects the future
picture of the healthcare region. The campus is bringing together researchers –
especially from the Max-Delbrück-Center for Molecular Medicine, from the Research
Institute for Molecular Pharmacology as well as from the Charité – with innovative
and performing biotechnological companies. With the glass laboratory and the
“Academy for Health Berlin-Brandenburg” Berlin-Buch at the same time is a site for
training and ongoing education. A paper presenting strategies for the healthcare
region Buch has been prepared.

Of importance is also the dynamic development of the science park Potsdam-Golm
bringing together research and teaching with business incubators with the support of
the potentials of both Max-Planck-Institutes for Colloid- and Interface Research
(Kolloid- und Grenzflächenforschung) as well as for Molecular Plantphysiology, of the
Fraunhofer-Institutes for Applied Polymer Research and for Biomedical Technology
as well as of the Faculty of Natural Sciences of the Potsdam University.

The Industry and Science Park Adlershof is bringing together on the same site the
departments of natural sciences and mathematics of the Humboldt University - with
the exception of biology - and extra-university research institutes with companies
especially in optoelectronics, medical technology and software development.
Contrary to Berlin-Buch hospital care is not provided at Adlershof.

More technology parks are to be found at the Benjamin-Franklin-campus in
cooperation with Focus Mediport, at Jungfernheide with the production-oriented
Biocampus Charlottenburg and at different sites in Brandenburg (Hennigsdorf,
Teltow-Seehof, Potsdam-Hermannswerder, Luckenwalde).

Among the locally less impressive structures of health economy there are locations
which are important for healthcare delivery as well as for the growth of business and
                                                                                       56


                  Masterplan Healthcare Region Berlin-Brandenburg
for the development of new services for the health sector. The large number of
performing hospitals and medical rehabilitation clinics in the region play a major role
in this context, especially for the development of health locations in Brandenburg
outside the capital region. In Berlin and Brandenburg these sites are focal points for
the extension and attraction of health relevant institutions in research, development,
production and services and therefore for the development of clusters.

The increasing interest of health economy in cooperation with clinical partners is
opening up chances for the development of healthcare sites in Brandenburg outside
the capital region around Berlin: In addition to university medicine non-university
performing hospitals are gaining importance as partners for cooperation; at the same
these are improving their profile and their performance through the cooperation with
health economy. Especially for clinical research the cancer registers of the region
represent another potential. They can contribute to the clinical validation of innovative
products in the areas of diagnosis, biotechnology and medical technology.

Cottbus with the Carl-Thiem-Klinikum, with the Sana Heart Center and with the
Brandenburg Technical University has a correspondent focus. Networks and
cooperations in developing medical technology products are in the making, but still
have to be developed. For example small and middle-sized companies, medical and
research institutions have set up the NEMO-Network BiomeG in order to initiate
research, development, production and marketing in the area of biomedical
instrumentation and to encourage innovative products. The value added chain at
Cottbus includes all essential parts beginning with teaching and research and ending
with production, certification and marketing. Being close to Berlin and to Poland is
making the location even more attractive. The FH Lausitz at Senftenberg has a focus
on age-related sciences and the Brandenburg Technical University at Cottbus on
medical technology – this can be combined with correspondent local focus in
inpatient care and nursing care. Potsdam is featuring a high density of life science
companies and research institutes (Golm, Hermannswerder). The Ernst von
Bergmann Klinikum is building up contacts with local companies and universities and
is planning a health park according to American standards. Acute, palliative and
medical rehabilitation care will be networked with health companies at this site.
Cooperations with the Hasso-Plattner-Institute as well as with the sport institute of
the Potsdam University and the German Institute for Nutritional Research are
intended. Additionally Potsdam can boast a nationally and internationally reputed
focus in nutritional and food sciences (German Institute for Nutritional Research,
Potsdam University, as well as other extra-university research institutions). At
Brandenburg/Havel the Telemedical Center Brandenburg has developed out of a
cooperation between the Brandenburg Klinikum and a medical technology company.
It is supporting patients and physicians to supervise disease-related parameters of
chronic diseases. In the near future the University of Applied Sciences at
Brandenburg in cooperation with the Brandenburg Klinikum will initiate a bachelor in
“Medical Information Technology”. The city of Brandenburg is supporting this
development actively and has founded an initiative. There are performing large
hospitals at Frankfurt/Oder and at Schwedt with a supraregional attraction. Formerly
their location at the Polish border was considered to be a disadvantage. In the
context of the European integration this can turn out to be a chance for border-
                                                                                      57


                  Masterplan Healthcare Region Berlin-Brandenburg
crossing healthcare provision projects and telemedicine. Whether the European
University Viadrina at Frankfurt/Oder can play an active role in this process has to be
seen.

The area of the “northern city” of Berlin beyond the central station – the circle from
the Technical University of Applied Sciences Berlin over the Technical University
Berlin, the Charité with a focus on its campus Mitte and Virchow, the German Heart
Center, Bayer-Schering Pharma and the Military Hospital to the Humboldt University
– can develop into a particular cluster because of its high special density and its
excellence.

In addition to the regional focus and projects with relevance for the entire region
Berlin-Brandenburg there is a multitude of local and communal health initiatives and
activities. Especially enterprises and healthcare delivery institutions as well as county
and district administrations participate in these activities with different objectives. The
Berlin districts of Lichtenberg and Hellersdorf-Marzahn have developed a sector-
profile health economy. The districts of Reinickendorf and Treptow-Köpenick are
elaborating at present an analysis of their potentials and the district of Friedrichshain-
Kreuzberg is planning to become active in the area of health economy. In
Brandenburg health networks have been set up in the Fläming region, in the Barnim
region together with the Uckermark region as well as in the Märkisch-Oderland
region: In Barnim the Telemedicine Network North-East Brandenburg is being
established – members of this network collaborate actively in the border-crossing
telemedicine network for cancer services of the Euroregion Pomerania subsidized by
the European Union. Similar activities are initiated by the Ruppin Hospital in the
region of Neuruppin. The Health Network Southwest Brandenburg has created a
specific cooperation among hospitals.

The exchange among these initiatives and networks, the reciprocal presentation of
their projects, the cooperation across state and communal borders, the competition
and cooperation for best practice for similar challenges as well as the promotion of
health-related economic activities are hardly taking place.

The analysis of health data clearly shows geographical particularities in the region as
well as in urban areas down to the level of certain districts and living quarters of the
city. The cancer registers of Berlin and Brandenburg are showing different numbers
of cases and incidences for certain oncological diseases. Other epidemiological
analysis (e. g., HIV, syphilis) is showing significant areal particularities and different
geographic distribution of risks.

The life expectancy of the population in Berlin and in Brandenburg varies depending
on the living site. The individual health status is showing a close relation to the local
healthcare provision. In rural areas as well as in urban centers there are areas and
population groups which could better be taken care of. Especially the healthcare
provision in rural areas of Brandenburg has to be observed carefully because of the
consequences of the demographic developments as well as of the migration. These
challenges oriented towards the local needs and target groups can be met by the
                                                                                        58


                  Masterplan Healthcare Region Berlin-Brandenburg
healthcare region Berlin-Brandenburg because of the specific interrelation of
metropolis and territory with approaches to realistic and model solutions.

Goals

   -    To integrate and harmonize infrastructural, regional and urban planning with
        the development of healthcare into an economic factor for the region

   -    To sharpen and to develop further the various technology parks as important
        basis and part of the healthcare region

   -    To intensify the inclusion of the Brandenburg Ministry of Infrastructure and
        Regional Planning and of the Berlin Senate Administration of Urban
        Development into the development of the healthcare region Berlin-
        Brandenburg

   -    To analyse the potential for development of local and regional healthcare sites
        and to use it for their development

Discrete Measures

   -    Identifying healthcare locations with potentials for development, analysing
        strengths and weaknesses of especially suitable sites with the objective to
        promote and to develop health economy purposely as well as to complete and
        to optimize regional value added chains
        Coordination: ZAB, Berlin Partner
        Time frame: mid-term

   -    Making the exchange of information among local initiatives and activities
        easier
        Coordination: HealthCapital Berlin-Brandenburg
        Time frame: short-term

   -    Accompanying model projects, identifying best-practice-examples and
        extending them into the region and/or to other districts and living quarters
        Coordination: ZAB, Berlin Partner, HealthCapital Berlin-Brandenburg
        Time frame: mid-term

   -    Intensifying the use of the capital region as heavily populated urban area for
        important national and European epidemiological and clinical studies
        Coordination: HealthCapital Berlin-Brandenburg
        Time frame: short-term
                                                                                    59


                  Masterplan Healthcare Region Berlin-Brandenburg
   -   Developing and implementing area- and population-based programs and
       projects for the healthcare region Berlin-Brandenburg and controlling effects
       and results
       Coordination: Brandenburg State Health Agency, LaGeSo
       Time frame: short-/mid-term

   -   Developing innovative structures of healthcare provision in undersupplied and
       thinly populated regions threatened by migration by using new technologies
       (e. g., telemedicine)
       Coordination: DGTelemed, Telemed-Initiative Brandenburg, HealthCapital
       Berlin-Brandenburg, ZAB
       Time frame: short-term

Actors

DGTelemed, ZAB, universities, research institutes, hospital and medical rehabilitation
clinics companies, local initiatives in Berlin and Brandenburg, mandatory health
insurance organizations, Hospital Associations, Union of Outpatient Doctors
approved by mandatory health insurance organizations, HealthCapital Berlin-
Brandenburg




                                                                                   60


                 Masterplan Healthcare Region Berlin-Brandenburg
Strategic Action Cluster 12: “Export of Health” and “Medical
Tourism”

Present Situation

The great interest in “German medical products” abroad is apparent, since Germany
and the healthcare region Berlin-Brandenburg profit from their good reputation
worldwide. Part of these “German medical products” are acute care and medical
rehabilitation for patients from abroad. While acute care in reputed hospitals in Berlin
is in demand, in Brandenburg performing and highly specialised medical
rehabilitation clinics with attractive offerings are available.

Furthermore innovative high quality health services and (health) education offerings
are in demand abroad – this is also available in Berlin and Brandenburg. The
performance of many (health and educational) institutions is unquestionable. But
these services are provided primarily by institutions – hospitals and universities –
concentrating up to now on local or regional needs. Many of them do not consider the
“export” of their services as part of their activities and not as part of their strategy. It is
important to convince these institutions to offer their (health- and educational)
services not only locally or regionally, but also internationally.

Berlin disposes of worldwide reputed performing medical centers for the treatment of
patients. Some of them have begun to treat international patients. It helps that Berlin
as city and Brandenburg as region are attractive for the company of the patients. The
presence of their embassies is advantageous for many international patients.

The interest of international patients in a treatment in Berlin is increasing and is
promoted. In the meantime 7 Berlin hospitals have formed the “Network for Better
Medical Care Berlin” (NBMC) to attract international patients to Berlin and to offer a
broader spectre of treatments than a single hospital can provide. Hospitals and
medical rehabilitation clinics from Brandenburg are cooperating. The initiative “Call-
a-Doc” is organizing medical treatment for international tourists in Berlin.

Eight cure locations in Brandenburg accredited by government are providing the
whole spectre of services which health-oriented tourists need to upkeep their health.
The natural remedies extracted in Brandenburg like mudbaths or hot springs are
highly attractive in thermal baths, cure centers and medical rehabilitation clinics.
Vacation locations and wellness hotels accredited by government and situated in
beautiful environments enjoy an increasing popularity among health conscious tourist
from abroad. Networking medical wellness with medical rehabilitation and acute care
is of growing interest for tourists, but can be developed further.




                                                                                            61


                   Masterplan Healthcare Region Berlin-Brandenburg
Goals

  -     To develop an economic strategy for health services of the region to export
        health products, health services and health-related educational services as
        well as system solutions

  -     To develop the profile of the healthcare region Berlin-Brandenburg as highly
        performing and valuable healthcare region for better using, networking and
        qualifying existing potentials in health economy and to market these

  -     To develop high quality medical wellness services

  -     To attract international patients as well as international health tourists for
        treatment, medical rehabilitation and for health vacations in the healthcare
        region Berlin-Brandenburg and to transfer them to medical rehabilitation clinics
        in Brandenburg after acute care in a Berlin hospital

  -     To develop international health networks to support the marketing of health
        products and healthcare services abroad

  -     To develop value added chains abroad, e. g., by international cooperation

  -     To evaluate, to stabilize and to extend systematically the marketing of regional
        healthcare providers abroad

  -     To develop international best-practice in health economy

  -     To intensify the marketing of cure locations and medical rehabilitation clinics of
        Brandenburg for patients and tourists from abroad and to intensify the
        cooperation between these and regional hospitals as well as other healthcare
        providers

        Discrete Measures

  -     Defining target regions (Central and Eastern Europe, Gulf area and other Arab
        regions, China)
        Coordination: BTM, TMB
        Time frame: short-term




                                                                                       62


                   Masterplan Healthcare Region Berlin-Brandenburg
-   Developing further high quality treatment respecting international requirements
    of service quality and integrating accommodation for the company fulfilling the
    expectations of the target groups
    Coordination: NBMC
    Time frame: short-term

-   Providing information for patients from the Near and Middle East, Central and
    Eastern Europe as well as the USA and Europe on possible treatments in the
    healthcare region and developing patient marketing in these regions
    Coordination: NBMC
    Time frame: short-term

-   Evaluating and observing national and international trends in healthcare and
    healthcare markets
    Coordination: TMB, BTM
    Time frame: short-term

-   Promoting to establish branches of healthcare and educational institutions
    from the healthcare region in the target regions and/or cooperation with
    institutions from the target regions
    Coordination: Berlin Partner
    Time frame: mid-term

-   Promoting telemedical projects for diagnosis, treatment and second opinions
    with partners from abroad
    Coordination: NBMC, DGTelemed, Telemed-Initiative Brandenburg
    Time frame: mid-term

-   Simplifying administrative procedures and permits for patients from abroad
    Coordination: NBMC
    Time frame: short-term

-   Marketing holistic solutions (especially health technologies and healthcare
    service competences, e. g., hospital management) from the healthcare region
    abroad
    Coordination: HealthCapital Berlin-Brandenburg with Gesundheitsstadt Berlin
    Time frame: mid-term




                                                                                 63


              Masterplan Healthcare Region Berlin-Brandenburg
   -   Developing a network for health and wellness tourism as well as new offerings
       of health tourism and their marketing
       Coordination: Brandenburg Bath Association, HOGA, BTV, TMB
       Time frame: short-term

   -   Developing a broad, customer-oriented marketable package of health touristic
       offerings (in- and outdoor activities, relaxation, lifestyle, courses)
       Coordination: BBV, TMB, BTM
       Time frame: short-term

   -   Evaluating regularly the spectre of offerings
       Coordination: BBV, BTV, TMB, BTM
       Time frame: short-term

   -   Developing a target group-oriented thematical marketing, systematic customer
       service and developing further the service
       Coordination: BTM, TMB
       Time frame: short-term

   -   Creating a healthcare quality certificate as marketing instrument
       Coordination: BBV, HOGA, BTM, TMB
       Time frame: mid-term

   -   Developing information and marketing material for the healthcare region
       Berlin-Brandenburg and its offerings
       Coordination: BBV, HOGA, BTM, TMB
       Time frame: mid-term

Actors

NBMC, BTM, Gesundheitsstadt Berlin, Charité, Berlin Partner, SenWiTechFrau,
SenBildWiss, SenInnSport, IHK, IBB, hospital companies, universities, mandatory
health insurance organizations, Cure and Bath Locations Association Brandenburg,
TMB, BTV, HOGA




                                                                                 64


                  Masterplan Healthcare Region Berlin-Brandenburg
Concluding Remarks

Berlin and Brandenburg dispose over the potential and the ideas necessary to turn
the region into the Healthcare Region of Germany and Europe. This Masterplan
describes Strategic Goals, Strategic Action Clusters and, finally, Discrete Measures
to achieve this objective. The Senate of Berlin as well as the Government of the
State of Brandenburg can rely on many existing initiatives, such as “thinking about
tomorrow – Business and Science for Berlin”, “Gesundheitsstadt Berlin” (“City of Life
Science”) or the Chambers of Commerce and Industry and finally “HealthCapital
Berlin-Brandenburg”. In light of the complexity of the overall process and the large
number of sub-processes which must be integrated, success will depend upon
coordination and cooperation across various sectors and among various actors.
The revised draft of the Masterplan will be provided to all stakeholders for critical
discussion and further development with the invitation that they then participate
actively in implementation of the plan. As the Investigative Commission suggested, a
competent cluster management has been introduced. The Inter-Ministerial Steering
Group is extending its thanks to all actors participating actively in the realization of
the project “Healthcare Region Berlin-Brandenburg”. It welcomes the broad
participation in realizing the Masterplan step by step, but rapidly.




                                                                                     65


                 Masterplan Healthcare Region Berlin-Brandenburg
Members of HealthCapital Berlin-Brandenburg
AHG Allgemeine Hospitalgesellschaft AG
Fachklinik Wolletzsee
Zur Welse 2
16278 Angermünde

Akademie der Gesundheit Berlin-Brandenburg e.V.
Karower Straße 11
13125 Berlin

Alice-Salomon-Fachhochschule
Alice-Salomon-Platz 5
12627 Berlin

Alpheios GmbH
Krossener Straße 2
10245 Berlin

AOK Brandenburg – Die Gesundheitskasse
Potsdamer Str. 20
14513 Teltow

Bayer Schering Pharma AG
Müllerstraße 178
13342 Berlin

Berlin-Chemie AG
Glienicker Weg 125
12489 Berlin

Berlin Partner GmbH
Fasanenstraße 85
10623 Berlin

Berliner Krankenhausgesellschaft e.V.
Hallerstr. 6
10587 Berlin

Brandenburg Klinik
Bernau Waldfrieden
Brandenburgallee 1
16321 Bernau Waldsiedlung

Brandenburgische Betriebskrankenkasse
Werkstraße 10
15890 Eisenhüttenstadt
                                                                  66


                Masterplan Healthcare Region Berlin-Brandenburg
Carl-Thiem-Klinikum Cottbus GmbH
Thiemstraße 111
03048 Cottbus

Charité - Universitätsmedizin Berlin
Schumannstraße 20-21
10117 Berlin

Deutsches Rotes Kreuz Schwesternschaft Berlin,
Gemeinnützige Krankenhaus GmbH
Brabanter Straße 18-20
10713 Berlin

Deutsches Herzzentrum Berlin
Augustenburger Platz 1
13353 Berlin

Gesundheitsstadt Berlin e.V.
Französische Str. 23
10117 Berlin

GLG Gesellschaft für Leben und Gesundheit mbH
Rudolf-Breitscheid-Straße 100
16225 Eberswalde

Ipal GmbH
Intellectual Property Asset Management
Bundesallee 171
10715 Berlin

Immanuel Diakonie GmbH
Am Kleinen Wannsee 5
14109 Berlin

Jerini AG
Invalidenstraße 130
10115 Berlin

Klinikum Dahme-Spreewald GmbH
c/o Achenbach Krankenhaus
Köpenicker Str. 29
15711 Königs Wusterhausen

Max-Delbrück-Centrum für Molekulare Medizin
Robert-Rössle-Straße 10
13125 Berlin

                                                                   67


                 Masterplan Healthcare Region Berlin-Brandenburg
MEDIAN Kliniken GmbH & Co.KG
Carmerstr. 6
10623 Berlin

Meytec GmbH Informationssysteme
Akazienstraße 1
16356 Werneuchen OT Seefeld

PAREXEL International GmbH
Spandauer Damm 130
14050 Berlin

Philips Medizin Systeme GmbH
Französische Straße 24
10117 Berlin

Sana Kliniken Berlin-Brandenburg GmbH
Fanningerstraße 32
10365 Berlin

Siemens AG
Medical Solutions
Nonnendammallee 101
13627 Berlin

Technische Universität Berlin
Zentrum für innovative Gesundheitstechnologien
Straße des 17. Juni 135
10623 Berlin

TSB Technologiestiftung Innovationsagentur Berlin GmbH
Fasanenstraße 85
10623 Berlin

Verein zur Errichtung evangelischer Krankenhäuser e.V.
Griesingerstraße 8
13589 Berlin

VPK Verband der Privatkrankenanstalten Berlin-Brandenburg e.V.
Einemstraße 20
10785 Berlin

Vivantes Netzwerk für Gesundheit GmbH
Oranienburger Straße 285
13437 Berlin



                                                                  68


                Masterplan Healthcare Region Berlin-Brandenburg
Vanguard AG
Friedrichstraße 78
10117 Berlin




                                                                   69


                 Masterplan Healthcare Region Berlin-Brandenburg
Glossary

    ASFH                          Alice-Salomon-Fachhochschule Berlin (Alice-
                                  Salomon-University
    BBU                           Association of Private Property and Housing
                                  Companies
    BBV                           Brandenburg Bath Association
    BC                            Berlin Capital (Berlin Venture Capital
                                  Agency)
    Berlin Partner                Business Development Agency Berlin
    BiomeG                        Biomediocal Instrumentation Technology
    BioTOP                        Project of the Technology Foundation Berlin
                                  networking sciences and companies in
                                  biotechnology of Berlin and Brandenburg
    BTM                           Berlin Tourism Marketing Agency
    BTV                           Brandenburg Tourism Association
    Campus Buch                   Technology park at Berlin Buch with a focus
                                  on biotechnology (research institute and
                                  companies) as well as several hospitals
    DGTelemed                     German Society for Telemedicine
    DIfE                          Deutsches Institut für Ernährungsforschung
                                  (German Institute for Nutritional Research)
    DMWV                          German Association of Medical Wellness
    EFH                           Evangelische Fachhochschule Berlin
                                  (Protestant University)
    FH Lausitz                    Fachhochschule Lausitz (University Lausitz)
    FHW                           Fachhochschule für Wirtschaft Berlin
                                  (University of Economics)
    FMP                           Leibniz-Institute for Molecular Pharmacology
    HOGA                          Hotel and Restaurant Association
    IBB                           Berlin Investment Bank
    Ipal                          Ipal Intellectual Property Asset Management
                                  Berlin
    ILB                           Brandenburg Investment Bank
    LAGeSO                        Berlin Agency of Health and Social Affairs
    LASA BB                       Landesamt für Arbeit und Soziales
                                  Brandenburg (Brandenburg Agency for
                                  Social Affairs and Employment)
    LASV BB                       Brandenburg Agency for Social Service
                                  Provision
    LFW                           Association of Private Property and Housing
                                  Companies

                                                                           70


              Masterplan Healthcare Region Berlin-Brandenburg
Liegenschaftsfond              Berlin Agency for the Sale of Berlin Property
MDK                            Medical Services of the mandatory health
                               insurance organizations
MedTecNet                      Medical Technology Network Berlin-
                               Brandenburg
MASGF BB                       Brandenburg Ministry of Labor, Social
                               Affairs, Health and Family Affairs
MBJS BB                        Brandenburg Ministry of Education, Youth
                               Affairs and Sport
MIR BB                         Brandenburg Ministry of Infrastructure and
                               Regional Development
MLUV BB                        Brandenburg Ministry of Agriculture,
                               Environment and Consumer Protection
MW BB                          Brandenburg Ministry of Economy
MWFK BB                        Brandenburg Ministry of Science, Research
                               and Cultural Affairs
NBMC                           Network for Better Medical Care Berlin
SEKIS                          Selbsthilfe-Kontakt- und Beratungsstelle
                               Berlin (Berlin Agency for contacts and advice
                               for self-help-activities)
SenBildWiss                    Senatsverwaltung für Bildung und
                               Wissenschaft (Berlin Ministry of Education
                               and Science)
SenFin                         Senatsverwaltung für Finanzen (Berlin
                               Ministry of Finance)
SenGesUmV                      Senatsverwaltung für Gesundheit, Umwelt
                               und Verbraucherschutz (Berlin Ministry for
                               Health, Environment and Consumers`
                               Protection)
SenInnSport                    Senatsverwaltung für Inneres und Sport
                               (Berlin Ministry of Interior and Sport Affairs)
SenIntArbSoz                   Senatsverwaltung für Integration, Arbeit und
                               Soziales (Berlin Ministry of Integration,
                               Employment and Social Affairs)
SenStadt                       Senatsverwaltung für Stadtentwicklung
                               (Berlin Ministry of Urban Development)
SenKzl                         Chancellery of the Senate of Berlin
SenWiTechFrau                  Senatsverwaltung für Wirtschaft,
                               Technologie und Frauen (Berlin Ministry for
                               Economy, Technology and Womens´ Affairs)
SPI Consult                    Sozialpädagogisches Institut Consult
                               (Consultants)
TMB                            Brandenburg Tourism Marketing Agency

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           Masterplan Healthcare Region Berlin-Brandenburg
TSB                          Technologiestiftung Berlin (Technology
                             Foundation Berlin)
TU                           Technical University Berlin
VPK                          Association of Private Hospitals
VZ BB                        Consumer Proteczion Center Branbenburg
VZ BV                        Consumer Protection Federal Agency
WISTA Adlershof              Wirtschafts- und Wissenschaftsstandort
                             Adlerhof (Technology park at Berlin
                             Adlershof networking natural and optical
                             sciences, optoelectronics, medical
                             technology with correspondent companies)
ZAB                          Zukunftsagentur Brandenburg (Business
                             Development Agency Brandenburg




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         Masterplan Healthcare Region Berlin-Brandenburg

				
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