In 2019, we – the Carl-Thiem-Klinikum gGmbH – were invited to join the Medical Informatics Initiative (MI-I). The MI-I brings together German university hospitals and, in four consortia with different thematic focuses, aims to establish data integration centers at each location, whose data pool will be made available to research groups throughout Germany. We chose the HiGHmed consortium and ccc. Center for Connected Health UG submitted a corresponding application for the CTK, initially as a networking partner, which was accepted by the BMBF, and the “R&C.net” (for research & care: networked) project launched on February 1, 2020.

The cooperation partners are the b-tu and the MHB as two of the three supporting universities of the joint Faculty of Health Sciences (FGW).

• The CTK’s contribution to HiGHmed lies in the fact that it opens up a unique region for the consortium that is interesting in terms of healthcare and research policy.
• At the same time, Lusatia is a prototype for increasingly precarious living conditions: sparse settlement, aging population and shrinking supply of services.
• A significant portion of the investments agreed to mitigate structural change will go into R&D.
• Although the CTK itself is the largest medical care facility in the state of Brandenburg and currently an academic teaching hospital of the Charité, it is not yet a “research hospital” in the true sense of the word. However, to support this structural change, it is to be expanded into a “Research Hospital 4.0” as part of the “Lusatia Health Model Region” and become a “digital lead hospital.”
• Almost at the same time, it will become a university hospital and will have to ensure teaching and research for the new, first state-supported medical faculty in the state.

These specifications and framework conditions undoubtedly make medical informatics a constitutive part of the CTK’s identity and its mission. The medical informatics initiative creates important prerequisites for closer ties between research and healthcare. The CTK offers the HiGHmed consortium extensive experience in acquiring mobile data from the outpatient sector, coupled with a rural, non-urban catchment area. Unlike other HiGHmed catchment areas, there are no major cities within it. At the same time, the region is undergoing structural change, which – under changing circumstances – will also affect other regions in Germany, each with its own unique conditions for health and illness.

In the cardiology use case, new mobile diagnostic technologies for the long-term monitoring of chronically ill patients are being tested alongside clinical data. They enable the collection of comprehensive and sometimes highly specific data. This data can be used to detect early signs of deterioration in patients at high risk for cardiovascular disease, thus reducing hospital stays and mortality rates in the long term.

The WIR! Alliance
The com(m) 2020 alliance aims to contribute to securing healthcare in Lusatia. com(m) 2020: the acronym stands for the area of need “ Community Care” (health in the local community) and focuses on the corresponding innovation field of community care technologies.
This refers to coordinated structural, process, service, and product innovations that create an efficient and effective continuum of care in rural areas, thus defining and communicating healthcare as a factor that creates quality of life and security.

The goals
The challenge is to bridge the spatial and technical distance between healthcare providers and citizens; the com(m) 2020 alliance is based on three cornerstones:  Digital Care is a first cornerstone of community care technologies, which organize low-threshold access to healthcare, and of com(m) 2020. Innovations in the service sector address this need by increasingly offering outpatient services, delegating them to local staff to a reasonable extent, and enabling citizens to help shape their healthcare. Skilled worker development and mobile care are key words for this second cornerstone of com(m) 2020. Future
trends in mobility offer opportunities to remobilize people with disabilities (the disability can be a walking disability or a small, isolated place of residence) and to keep them mobile. Care Logistics is the third cornerstone of com(m) 2020 .

The Alliance Region:
Rural regions share structural problems in many places and are often focal points of demographic and structural change. Southeastern Brandenburg not only shares many problems with Prignitz and Ruppiner Land, but is also facing massive structural change due to the end of mining by 2038 – the most important regional industry for 100 years. The alliance region of com(m) 2020 is Lusatia: across federal states, in several model regions.

THIEM:COTTBUS5G answers the question of how 5G could improve healthcare. To do so, we examine the “patient journey” into and through a hospital: how do tailored data transmission technologies change this journey, improve patient safety, and transform the patient experience?

5G and its advantages will be demonstrated using the example of the path taken by a patient with an acute heart attack. The technology will then be expanded to other medical conditions and rolled out beyond the campus, into the city and the region.
Treatment pathways will be digitally coordinated in the background and accelerated through the intelligent distribution of process-relevant information . The material and personnel resources required in individual cases will be recorded and consolidated spatially and temporally, thus taking decisive steps toward evidence-based care and improved quality .

Everything becomes a data source: every ultrasound machine, the CT scanner, the laboratory and intensive care unit capacity, the operating room, and every suitable hospital bed.
Thus, a large hospital tends to have an infinite number of “addresses” of a complex Internet of Things (IoT). However, this is not enough: the necessary human resources must be managed (and instructed): medical, support, and nursing staff, to ensure they are in the right place at the right time.

Along the patient journey, the IoT, initially defined only in technical and informational terms, is being further developed into an Internet of Services (IoS) serving the patient.
Data is being provided to the various hospital areas via the most suitable networks and media: 5G is the “data superhighway.”

The patient journey, based on diverse and absolutely up-to-date information, is paved in the background even before admission: The patient arrives and the hospital’s resources are already awaiting them; the path forward is paved.

Smart Hospital  thus means saving time, providing functions, and leveraging resources more effectively—in short, providing better patient care. The  backbone  of this information revolution in hospitals is 5G. Success will depend on 5G being compatible with other old and new data transmission technologies and,  last but not least,  gaining acceptance for 5G in civil society.

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