Medi:cus: A New Cloud Platform for Health Data Emerges from Baden-Württemberg

Baden-Württemberg is taking significant steps towards digital transformation in healthcare with the introduction of the Medi:cus project, a cloud platform aimed at addressing the extensive backlog in digitalization faced by hospitals across Germany.

The initiative, backed by substantial initial funding from the state, is set to launch mid-year with basic IT services, while specialized functions are expected to roll out by the end of 2026. Project leader Alexander Becker from the state's interior ministry highlighted the platform as a gateway for clinical services, promoting a marketplace model that supports a multi-cloud environment without vendor lock-in. The overarching goal is to facilitate hospitals' transition into the digital era.

Becker emphasized the importance of acting as an intermediary, envisioning a secure and sustainable health data ecosystem underpinned by standardized and interoperable IT infrastructure. The approach advocates for thinking in terms of 'stores' that offer both specialized services and fundamental offerings. The initiative aims to acknowledge the varying technological capabilities of hospitals, with some lacking basic connectivity while others, like university hospitals, are more advanced.

Ammar Alkassar, a board member of the GovTech Campus, provided insights into the progress of the initiative. As one of the implementation partners alongside Deloitte, he described the proposed 'Medi:core' basic services as a hub for core patient data. This includes identity management for platform access, a messaging solution, and a teleconsultation application that allows healthcare professionals to collaborate digitally on patient diagnoses and treatments. Additionally, Medi:cus aims to address the existing challenges within the market for hospital information systems.

Alkassar acknowledged the complexities of integrating advanced diagnostic tools, such as MRI machines, into the cloud but noted the feasibility of creating secure connections for hospitals to facilitate easier access to cloud services. Furthermore, a uniform data protection strategy is being developed to accelerate the deployment of applications for hospitals while simplifying procurement processes. In critical areas, data processing will remain within local data centers secured via physical VPNs.

Simultaneously, the Gematik organization is working on a comprehensive telematics infrastructure at the federal level, which aligns well with the Medi:cus project's objectives. Alkassar indicated a strategy of 'Embrace and Extend,' whereby they plan to incorporate existing standardization efforts, like the TI-Messenger based on the Matrix protocol.

He confirmed plans to replicate the system closely, working in coordination with the Federal Ministry of Health to ensure timely implementation, even if certain standards have yet to be finalized. For instance, the current size limitation for attachments on the TI-Messenger will be increased to accommodate the sending of radiological images. The project also aims to leverage components from European initiatives related to the European Health Data Space (EHDS) and remains open to innovative applications from startups, particularly in artificial intelligence.

The core philosophy is to create a marketplace for health solutions rather than selecting specific applications. Becker noted that interest from three other federal states indicates a growing momentum, as Medi:cus already has the backing of 200 hospitals, establishing a broad stakeholder network. The initiative is gaining traction and aims to assert its influence within the political landscape to drive the necessary changes in the healthcare sector. Meanwhile, competitors like AWS are actively advancing their cloud solutions for private hospitals, indicating a competitive environment.