Datum: 19.09.2019

Prof. Dr. Erika Raab

[Translate to English:] Erika Raab

Prof. Dr. Erika Raab
Professor for Medical Controlling

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Biography

Erika Raab studied law at the University of Greifswald. During her studies, she worked as a student assistant at the Chair of Civil Law and Civil Procedure Law (Prof. Dr. Jürgen Kohler). After initially working as a lawyer specializing in medical law in Rostock, she moved to the hospital sector in 2006, where she gained first professional experience in the management of a healthcare company as a management assistant at a Kreiskrankenhaus Kirchberg. When the new case flat rate system was introduced in hospital billing, the focus of her activities was on the development of medical controlling in the hospital sector and in 2005 she joined the still young German Society for Medical Controlling. In 2009, she became head of the Department of Medical Controlling, Documentation, Complaints Management and Social Law in a physician-dominated interface function in the hospital as the first lawyer and non-physician in Germany. During her studies, she completed the Master of Business Administration in Health Management at the Ingolstadt University of Technology, which she completed in 2012 with a master's thesis on »Internal budgeting in hospitals - Development of an internal budgeting system based on the InEK calculation and the contribution margin calculation«. After five years in Ingolstadt, she moved to the Darmstadt Hospital as Head of Internal Audit. In 2015, in the context of the purchase of two hospitals by the Darmstadt Hospital, she was given the challenge of assuming an interim hospital management with the main focus on carrying out a protective screening procedure in accordance with section 270 b of the Insolvency Act in St. Rochus Hospital gGmbH Darmstadt-Dieburg. After the successful completion of the procedure, she took over the management of the group management and the legal department at the beginning of 2016 in Darmstadt. In addition, she has been managing director of the Educational Center for Health Professionals Mathildenhöhe Darmstadt since 2016. She is a member of the hospital management of Klinikum Darmstadt GmbH.

Erika Raab received her doctorate in 2016 with her thesis titled »Medizincontrolling – Wert und Nutzenstiftung klinischer Leistungen durch interdisziplinäre Entscheidungsoptimierung« (equiv. Medical Controlling - Value and Benefit Foundation of Clinical Benefits through Interdisciplinary Decision Optimization) at the Faculty of Economic Sciences of the University of Potsdam with Prof. Dr. med. Christoph Rasche.

She has been a member of the Executive Board of the German Society for Medical Controlling (DGfM) since 2013 and headed the risk and project management division until her election as deputy CEO of the DGfM in October 2015. Furthermore, she was the head of the expert committee "Remuneration Systems in Psychiatry and Psychosomatics" DGfM operates from 2010 to 2016. 

Teaching

Erika Raab's has two years teaching experience as a lecturer in the module Medical Controlling at the Ingolstadt University of Technology in the vocational MBA program Health Management and as a lecturer in the MBA program Innovative Health Management of the University of Potsdam, module Medical Controlling with focus on reporting and rehabilitation of hospitals since July , 2015.
As part of the support scheme for emerging researchers, she was involved in additional teaching from March 2015 to December 2016 at the Medical School Hamburg. In January 2017 she accepted the ad interim professorship for Medical Controlling.

Research 

The research interest of Erika Raab applies to three fundamental questions of the young discipline:

1. Academic definition of medical controlling
The discussion of the academic definition of medical controlling, the object of knowledge and the methods to be used to gain insights has so far only been given a broad outline. The current legal and practical developments can also serve as indicators for empirical research, such as the search for theoretical foundations, which are compared with the practiced practice of cognition-building. What is currently missing is a consistent theory and paradigm building for medical controlling, for which many interpretive monopolies are currently being claimed. Due to the specific, interdisciplinary context dependency, which determines the concrete design of the concept of medical controlling, it is possible to differentiate between external and internal influencing factors, which in turn have a concrete effect on the structure, function, instrumentalization and organization of medical controlling.

2. Structural change in the organization hospital and intersectoral networking

Little research has been carried out in Germany as to what extent it is possible to speak of a structural or »archetypal change« in the organization of the hospital. The few studies have in common is that under the premise of the shift in cost-income ratios, the balance of power between management and doctors move by the management moves to the strategic decision-making power. The professionals, on the other hand, experience cuts in their professional autonomy and are subject to a new efficiency and quality-oriented performance regime. In the interdisciplinary research focus, the focus is on investigating the behavioral and organizational effects of these changes in the healthcare system. Due to the expected shortage of skilled workers in medical personnel, there is a need for work organization to substitute and delegate medical services to other occupational groups, which is increasingly accelerated by the increase in performance and complexity in a legally and economically dynamic environment.

3. Key figures and performance indicators
In promoting selective case growth without considering the specific internal and external budgeting factors, the hospital sector faces not only the risk of new liquidity risks but also existential risks, which is why key indicators and performance indicators have been introduced with the introduction of the DRG system and the flat-rate payroll system in psychiatry and psychosomatics increasingly gaining relevance. Optimizations are required along the cost, time, quality, service, and innovation dimensions to translate performance into measurability. The result of the treatment process is always subject to the evaluation of its relation to the resource consumption, which must be used for medical-nursing processes, activities and procedures. Efficiency, effectiveness and quality aspects, measured with instruments of process controlling and process costing prioritize the consideration of the treatment process under economic value added aspects beyond the existing sector boundaries. Accordingly, the research approach of medical controlling in hospitals is based on the support of a focused corporate management, which should enable better results with the same resources. Even specialist disciplines such as psychiatry are faced with the introduction of the PEPP pay system analogous to the DRG system with a performance measurement and number orientation, so that despite obvious arguments against standardization rationing, rationalization and prioritization a radical rethinking to assess clinical processes is required. With the introduction of quality-oriented remuneration for hospital financing, another research focus in the consideration of hospital processes becomes relevant. 

Conference contributions

Dokumentationsansätze und Kodierassistenz in der Psychiatrie - Modelle, Systeme und Delegation ärztli­cher Aufgaben. 1. Jahrestagung »Entgeltsystem Psychiatrie« der Deutschen Gesellschaft für Medizincon­trolling, Frankfurt/M., 29.9. 2011

Welches Ausbildungsprofil brauchen Kodierfachkräfte in der Psychiatrie?, Jahrestagung der Deutschen Gesellschaft für Psychiatrie, Psychosomatik und Neurologie (DGPPN) Berlin, 23.11.2011

Aktueller Stand der Entwicklung des Entgeltsystems Psychiatrie/Psychosomatik, Fortbildung des Regio­nalverbands der Deutschen Gesellschaft für Medizincontrolling Süddeutschland, Ingolstadt 12.12.2011

MDK in der Psychiatrie, 2. Jahrestagung „Entgeltsystem Psychiatrie“ der Deutschen Gesellschaft für Medizincontrolling, Frankfurt/M. 1.10.2012

Controlling und Codierung vor Ort, Jahrestagung der Gesellschaft für Gefäßchirurgie, Wiesbaden, 3.10.2012

Abrechnungsprüfung unter Berücksichtigung der Rechtsprechung in der Praxis aus Sicht des Kranken­hauses,Fortbildung des Regionalverbandes der Deutschen Gesellschaft für Medizincontrolling Süd­deutschland: Abrechnungsprüfung im Krankenhaus unter Berücksichtigung der Rechtsprechung - Neuester StandIngolstadt, 3.12.2012

Update: Controlling und Codierung vor Ort, 7.Gefäßspezifisches DRG-Praktikum & Ökonomie in der Ge­fäßtherapie, Offenbach 25.1.2013

Forum Entgeltsysteme: „Einführung des PEPP-Entgeltsystems und notwendige IT-Unterstützung“, conHIT, Berlin, 11.4. 2013

Bericht aus einem Optionshaus, 3. Jahrestagung „Entgeltsystem Psychiatrie“ der Deutschen Gesell­schaft für Medizincontrolling, Frankfurt/M. 29.09.2013

Abrechnungspraxis im Krankenhaus – 8. Gefäßspezifisches DRG-Praktikum & Ökonomie in der Ge­fäßtherapie, Offenbach 23.01.2014

Erfahrungen eines Optionshauses – Umstellung auf das neue Entgeltsystem in der Psychiatrie, Bayeri­sches Institut für Krankenhausorganisation und Betriebsführung, München 17.3.2014 und Nürnberg 28.3.2014

Mit PEPP – Erfahrungen eines Optionshauses und aus dem Fachausschuss Entgeltsysteme Psychiatrie und Psychosomatik, Jahrestagung „Entgeltsystem Psychiatrie“ der Deutschen Gesellschaft für Medizincon­trolling, Frankfurt/M.  27.10.2014

Abrechnungspraxis im Krankenhaus – 9. Gefäßspezifisches DRG-Praktikum & Ökonomie in der Ge­fäßtherapie, Offenbach 23.01.2015

360° Berichtswesen. 14. Nationales DRG-Form, Berlin, 20. März 2015

Ist der Datenschutz Makulatur? - 14. Herbstsymposium der Deutschen Gesellschaft für Medizincontrolling Frankfurt/M., 01.10.2015

Die neue PrüfvV – Vorstellungen und Erwartungen der Krankenhäuser, I.O.E. Fachkonferenz Rechnungs­prüfung und kein Ende! Prüfverfahrensvereinbarung 2016 – was ist zu erwarten und was zu befürchten? Düsseldorf, 13.10.2015

Die neue Rechtsprechung des Bundessozialgerichtes – Auswirkungen auf die Krankenhäuser, 10. Rhein-Main-Zukunftskongress, Offenbach 25.02.2016

Ambulante Notfallversorgung im Krankenhaus - aktuelle Entwicklungen, 16. Herbstsymposium der Deutschen Gesellschaft für Medizincontrolling Frank­furt/M., 24.10.2017

Strafrechtliche Risiken an der Sektorengrenze zwischen ambulanter und stationärer Versorgung, 11. Rhein-Main-Zukunftskongress, Offenbach 28.02.2018

Kooperationen mit der Industrie - Notwendigkeit, positive Aspekte und rechtliche Unsicherheiten, 11. Rhein-Main-Zukunftskongress, Offenbach 28.02.2018

Zu viele Struktur- und Prozessindikatoren? 17. Nationales DRG-Forum Berlin 2018 – Workshop (10): Das neue qualitätsorientierte Prüfregime: Welche Taktiken erwarten wir? 16.03.2018 

Publications

Raab, E., MDK-Management in der Psychiatrie. Das alte System stößt an seine Grenzen! KU-Gesundheitsmanagement 6/2012, S.33-37

Raab, E., Sichtweisen zu MDK-Prüfungen differenziert.  KU-Gesundheitsmanagement 2/2013, S. 64-65

Raab, E. & Rasche, C., Die Logik der Gesundheitsmanufaktur hat ausgedient. Ansätze für ein Berichtswesen in der Frühphase des PEPP, KU-Gesundheitsmanagement 3/2013, S. 49-53

Raab, E., Medizincontrolling aktuell – Tendenziell führen MDK-Prüfungen zu einem massiven Problem in der Weiterbildung unserer Ärzte! KU-Gesundheitsmanagement 3/2013, S. 78

Raab, E. & Rasche, C., Medizincontrolling in der Praxis – ein erster Blick in die Empirie. KU Spezial Controlling und Medizincontrolling 4/2013

Raab, E., Unschärfen in der Abgrenzung. Der Grenzbereich zur ambulanten Versorgung stellt für Krankenhäuser ein wirtschaftliches Risiko dar. KU-Gesundheitsmanagement 5/2013, S. 25-27

Raab, E., PKMS: Klassenziel verfehlt? Dokumentationsbürokratie: Hochaufwendige Pflege von Patienten in der MDK-Praxis, KU-Spezial Medizincontrolling August 2013, S. 21-22

Raab, E., Abrechnungsprüfung in der Praxis. KU-Gesundheitsmanagement 2/2014, S. 76-77

Raab, E., Praxisbericht MDK-Management aus Krankenhaussicht,in: Maier/Heitmann/Rutz/Wolf-Menzler (Hrsg.) Psych-Entgeltsystem. Entwicklungen, Erfahrungen und Best Practice, Heidelberg 2015, S. 197-208

Raab, E., Detailtiefe der OPS – Aktuelle Entwicklungen und Fragestellungen, KU Gesundheitsmanagement 1/2015, S. 33 – 36

Raab, E. In Details verloren. führen & wirtschaften 2/2015, S. 26-28

Raab, E. & Clemens, S., Die Abrechnungsprüfung – aktuelle Entwicklungen. Grundsätze des BSG und ihre Auswirkungen in der Praxis. KU Gesundheitsmanagement, 5/2016, S. 72-75

Raab, E. Die Akademisierung des Medizincontrollings - Ankunft in der Wissenschaft als eigener Vollzeitstudiengang. KU Gesundheitsmanagement / Spezial September 2016, S. 13-15

Raab, E. Medizincontrolling. Theorie, Entwicklung, Praktische Umsetzung, Springer Verlag 2017

Clemens, S. & Raab, E., Notfall für den Notfall – Ambulante Krankenhausversorgung im Spannungsfeld strikter Sektoren-trennung, KU-Spezial Medizincontrolling September 2017, S. 8-11

Conference moderation

Kongressmoderation: PEPP-Jahrestagungen der Deutschen Gesellschaft für Medizincontrolling, Frankfurt (jährlich; 2012-2015)

15. Nationales DRG-Forum Berlin 2016 - Workshop (5) Wirtschaftlichkeit: Mit welchen Zahlen sollen wir uns messen? DGfM- und DVKC-Workshop: Was messen wir wie? Welche Zahlen sind wirklich relevant? Welche Maßstäbe gelten? Benchmarking – mehr als ein Zahlenvergleich? 17. März 2016

16. Nationales DRG-Forum Berlin 2017 – Workshop (9): MDK auf neuen Wegen – Wer legt jetzt fest, von wem und nach welchen Kriterien Strukturprüfungen durchgeführt werden? 24. März 2017

17. Nationales DRG-Forum Berlin 2018 – Workshop (10): Das neue qualitätsorientierte Prüfregime, 16.03.2017

Others

Interview in der Zeitschrift klinik markt [inside], 14. Jahrgang (2016) Ausgabe 20: „Strukturprüfungen auf Augenhöhe könnten Verfahren beschleunigen“, S. 9