Cloud as a digitalization tool for university hospitals

The University Medical Center Freiburg is one of the top hospitals in Germany. With 15,000 employees, almost one million patients, and around 2,050 beds, Freiburg is one of the largest hospitals in Germany. Anyone who is treated here is in good hands. The University Hospital is dedicated to providing “quality-centered university medicine”. For the patients, this means: top quality in healthcare. The current FOCUS Clinic List from October 2023 confirms the claim: here, the best hospital in Baden-Württemberg comes in the fourth place nationwide. The facility is best known for its treatment of leukemia, strokes, and lung tumors.

In addition to providing medical care, university hospitals have a second important mission that extends beyond the boundaries of their own facilities: for research purposes, findings from treatments are shared and thus serve to improve medical care in the long term.

“This resulted in a very diverse IT landscape in which some systems can be described as ‘legacy’ with a clear conscience – they have been in operation for 10 or even 20 years,” says the CDO, summarizing the situation. “In the next few years, we will have to replace some of them – if they no longer meet the requirements. The biggest challenge here is to ensure that we do not lose the experience and best practices gained in the systems when switching to state-of-the-art solutions.”

The CDO sees this transfer as one of the biggest challenges in modernizing the application landscape in hospitals. But that's no reason for him not to look ahead: “We have had a good experience with modernization of IT and digitalization, and we are keeping an eye on developments – our aim here is to stay ahead. This does not mean that we are pursuing digitalization for the sake of digitalization. Digital tools must provide us with new opportunities and added value, e.g. to relieve medical professionals of administrative tasks so that they have more time for their core work: the care of patients. Or to open up new options for diagnostics and therapy,” says Jahnke. Ultimately, of course, patients benefit from the resulting increase in the quality of medical care.

But what projects are on the CDO's agenda? “We are currently working on the topic of quality assurance in real time,” says Dr. Jahnke. The traditional model of experience sharing in medical research is time-consuming. Patients are treated, the findings are documented in scientific papers, and then shared with the community. It takes a long time before the experience gained is incorporated into regular operations. Modern IT is set to change that: “Medical knowledge should be available more quickly for the treatment of patients, for example, directly in the operating theater.”

How is that supposed to work? “With a combination of sensor technology and Artificial Intelligence (AI), for example. The vision is to create a kind of digital surgical assistant, similar to a lane departure warning system in a car. The medical staff have control over the procedure, but they are supported in manual and administrative activities.” With the help of cameras and microphones, the AI listens, watches, and gives tips at various stages of the procedure, such as “Remove clamp now”. AI gives specialist staff access to the accumulated experience of entire generations of doctors – a living library directly in the operating theater, so to speak. AI can also document the treatment, even with videos, which in turn can be used in research and teaching and provide much better insights than pure text.

Jahnke cites a second example that illustrates the added value of digital tools: “Shock rooms and operating theaters are a scarce resource in hospitals, and are therefore used to capacity. However, they are not only needed for treatments, but also for training. These bottlenecks in training can be eliminated with realistic virtual images of the rooms. Immersive metaverse technologies are suitable for this purpose.”

However, innovation topics also arise outside the hospital. A current topic of cutting-edge research is the model project in accordance with Section 64e SGB V on genomic medicine. Over the next few years, the pilot project will test how genome sequencing can be integrated into healthcare. Experts are in favor of its use, particularly in oncology and in the diagnosis and treatment of rare diseases. The Freiburg University Medical Center is part of the pilot project. The project creates its very own requirements for the hospital’s IT.

“In this project, we expect around 500 TB of raw data from genome sequencing over the next five years,” explains Jahnke, “this data must be stored and, if necessary, quickly analyzed – whereby further data is generated.” From an IT perspective, this is a typical high-performance computing (HPC) scenario that temporarily requires top specialized computing resources such as GPUs. “This is where we reach our limits,” says Jahnke. Why? “Space for IT resources in hospitals is limited, and moreover, the capacities for power supply and waste heat management are limited and not dimensioned for HPC.” The university hospital must also ask itself whether it wants to become an HPC provider as part of the pilot project.

Using the cloud could be an elegant alternative. “With the cloud, we would be able to scale quickly and easily, i.e. we have access to capacities for data processing and storage without having to manage them ourselves or build up the corresponding expertise.”

This means that the university hospital can quickly get started with the model project without being slowed down by investment processes. When using the cloud, however, it is important for the CDO that the external resources are integrated in such a way that they act as an “invisible” extension of the in-house capacities – and that the user experience is right. The specialist staff must not notice the additional resources “under the hood” and only consume them as part of the sequencing service – if they are necessary. “In addition, it is of course important that the cloud also meets the specific data protection and data security requirements for this use in a highly regulated environment. Otherwise, their use is difficult to imagine.”

Under these conditions, the pilot project will be a project par excellence for the use of a Sovereign Cloud. With its built-in data sovereignty, it can easily combine digitalization and compliance requirements. This will significantly speed up the implementation of this pioneering project.

Want to find out more about using the cloud for the pilot project? Further information on genome sequencing in the clinical environment and the use of the T-Systems Sovereign Cloud powered by Google Cloud can be found in the webinar recording “The future of personalized medicine from the cloud” with Dr. Lennart Jahnke and other experts, and in the expert paper: “Genome sequencing from the cloud.”

Learn more about genome sequencing in the clinical environment and the use of the T-Systems Sovereign Cloud powered by Google Cloud in the webinar recording "The future of personalized medicine from the cloud" with Dr. Lennart Jahnke, among others.