Digitalization is shaping radiology throughout Europe - but while some countries are forging ahead with innovative solutions, Germany is still struggling with analogue legacies despite its great ambitions. The reasons for this, how radiologists are nevertheless leading the way and why it is worth thinking beyond national borders were revealed during the session "Digital Germany - between lagging behind and frontrunner" at RöKo 2025 in Wiesbaden.
Progress on paper - fax machine in practice
Germany likes to see itself as a driver of innovation in radiology. But everyday life in many clinics tells a different story: Fax machines and paper files are still an integral part of the IT landscape. Even at traditional locations such as Mainz, where digitalization began early on, the reality is sobering. “Healthcare IT in Germany is still largely screwed on,” is the assessment of PD Dr. Daniel Pinto dos Santos, Managing Senior Physician at the Mainz University Medical Center. While state-of-the-art digital solutions are presented at congresses and in research, they are often not transferred to the patient's bedside. The gap between aspiration and reality is wide - and also causes international astonishment.
Ethics and responsibility: why technology alone is not enough
The digital transformation of radiology is not only a technical challenge, but also an ethical one. Prof. Saskia Karl Nagel, an expert in applied ethics, warned: “What is responsible is what we can deal with in a morally justifiable way with a clear conscience.” Holding on to outdated technologies such as the fax machine is hardly justifiable from an ethical point of view. At the same time, she warns against pursuing digitalization for the sake of technology: “We have to ask ourselves what goals we are really pursuing in the clinic and what technologies we actually need.” Innovation must always be measured in terms of its benefits for patients and society. This perspective is becoming increasingly important in the European debate.
Innovation needs team spirit and interoperability
Fragmentation remains a key problem: in Germany, as in many European countries, digital solutions are often developed as isolated solutions that only cover individual workflows. “We think too small,” criticized Christian Zapf, Head of Business Line Digital & Automation (Imaging IT & Software), Siemens Healthineers. “Instead of selective tools, we need holistic approaches that make entire departments or even entire hospitals more efficient.”
Real innovation only comes about when technology and everyday clinical practice come together. Jan Beger, Global Head of AI Advocacy at GE HealthCare, emphasizes: “I believe that innovation in digitalization is a team sport and the whole thing will never work if everyone is not working towards the same goal.” The exchange between technicians and clinicians, between industry and science, is crucial. New standards, structured data formats and, above all, interoperability are the basis for sustainable innovation - a topic that is also becoming increasingly important at European level.
If this succeeds, radiology in particular can act as a catalyst for a comprehensive digital infrastructure. However, this would require a rethink of the role of imaging: radiology is not just a service, but an integral part of healthcare. This means that radiologists should be actively involved in process optimization and quality assurance. “Innovation is what matters,” said Marc Kämmerer, Head of Innovation Management at VISUS Health IT GmbH.
Europe's role: from isolated solutions to networked systems
A look at other European countries shows that many countries are facing similar challenges, but the exchange of best practices is gaining momentum. International initiatives, educational programmes and common standards offer the opportunity to drive digitalization across borders. There are already successful examples of networked, patient-centered radiology in countries such as the Netherlands and Scandinavia. Germany can benefit here - but also provide impetus, for example through its strong research landscape and high level of innovation in radiology. It is crucial that the European dialog is further intensified. After all, the digital transformation can only be mastered together.
The digitalization of radiology remains a joint task - in Germany and throughout Europe. Technology alone is not enough: it requires ethical guidelines, interdisciplinary cooperation and, above all, the will to think outside the box. If we succeed in combining innovation and responsibility and all players pull together, radiology can become a role model for the digital healthcare system of tomorrow.
