Think Tank

In 2019, the Carl-Thiem-Klinikum gGmbH (CTK) was invited to join the Medical Informatics Initiative (MI-I). The MI-I brings together German university hospitals and aims to establish data integration centers at each individual site in four consortia with different thematic focuses, whose data pool will be made available to research groups throughout Germany. The CTK chose the HiGHmed consortium and us, the ccc. Center for Connected Health UG, to submit a corresponding application for the CTK. Initially we became networking partners and our application was accepted by the federal ministry of education and research (German: BMBF). Here out the project „R&C.net“ (for: research & care: networked) arose which started on the 01.02.2020.
The cooperation partners are Brandenburg University of Technology (b-tu) and the Brandenburg Medical School (MHB) which are two of the three sponsoring universities of the joint Faculty of Health Sciences (FGW).

• The contribution of the CTK to HiGHmed is the opening up of an interesting and unique region for the consortium in terms of supply and research policy.
• At the same time, the Lausitz region is a prototype for increasingly precarious living conditions: sparse population, aging, and shrinking health care services.
• The investments that have been agreed to mitigate structural change will be channeled to a considerable extent into R&D.
• Although the CTK itself is the largest medical care facility in the state of Brandenburg and is currently an academic teaching hospital of the famous Berlin Charité, it has not yet been called a „research hospital“. However, in order to support this structural change it will be expanded into a „Research Hospital 4.0“ which means that it will function as an innovative digital lead hospital while taking up a substantial part of the prototype health region „Lausitz“.
• Almost simultaneously, it will become a university hospital and will have to ensure teaching and research for the new, first state-supported medical faculty in the federal state.

These requirements and conditions will undoubtedly render medical informatics a constituent part of the CTK’s self-image and its mission from now on. The medical informatics initiative creates important conditions for research and care to move closer together. CTK offers broad experience with the acquisition of mobile-collected data from the outpatient sector to the HiGHmed consortium, and in doing so, a rural, non-urban catchment area. Unlike other catchment areas of HiGHmed, there are no metropolitan areas therein. At the same time, the region is subject to a structural change, as it will always affect other regions in Germany – under varying circumstances – with special conditions for health and disease. In the cardiology use case, new mobile diagnostic technologies for the long-term monitoring of chronically ill patients are being tested in addition to clinical data. They make it possible to collect extensive and sometimes very specific data. These data can be used to detect deterioration episodes in patients with a high-risk potential for cardiovascular diseases at an early stage and thus reduce hospital stays and mortality rates in the long term.

Cottbus and the Lausitz region have been shaped by the mining industry for more than 100 years. Due to a new setup of laws that plan a coal phase-out in Germany until 2040 these specific regions now need to undergo a substantial structural change. Cottbus and the Lausitz will be dominated by the healthcare industry and lead as a role model for digital health.

The medical technology sector is multifaceted. Clinical studies according to the model of cooperation between the pharmaceutical industry and clinics have so far been carried out at best for high-risk products. Cooperation is mostly direct and primarily within the university hospitals. – The majority of medical device manufacturers have only had to deal with the issue of clinical benefits and risk assessment of their products on a massive scale since the announcement of the new EU Medical Device Regulation (MDR). To date, only a few connecting dots have been established for this purpose in the care sector: once again mostly in university-related environments. This shortage is particularly problematic for medical devices used in ambulatory care. Many smaller companies in the healthcare industry have to face crucial problems in order to access clinical users. And this is a major obstacle that many startup companies of innovative healthcare products face: transferring the innovative product to standard care. This also applies to the majority of products from the digital health sector. In both industry sectors a significant need for clinical services is emerging.

To tackle this gap, the industry-in-clinic platform at the CTK, also called TEAM:exchange, is currently being established. TEAM:exchange will support medical technology companies as well as digital health companies by providing them with an infrastructure, equipment, laboratory facilities as well as opening up the access to physician expertise, clinical trial scenarios and data. The offer of delivering complete or partial process solutions for individualized and digitalized applications requires to work across sectors. In the end, this not only accounts for one medical product or one initiative. This process optimization is needed for innovative medical technology and digital health applications (DiGAs) as well as in outpatient and inpatient sectors in everyday care.

Our offer: We individually accompany the product cycle from the development of an idea to market maturity. We are able to fall back on patients of the largest hospital of the federal state and the medical-clinical expertise of this institution. Moreover, we are able to provide competencies and the network of the neighboring Technical University in Brandenburg. The commercialization needs to be prepared in order to achieve an easier market access and to ensure a sustainable market penetration in the end. On this platform – the industry-in-clinic platform TEAM:exchange – modular, professionalized offers across the entire value chain can made.
At the end of the conception phase and thus at the start of the testing phase, TEAM:exchange UG is established as an umbrella organization for applied research and transfer services (Applied Research & Transfer Services): problem-oriented diverse expertise and highly equipped test fields for medical devices (and DiGAs) in preparation for market entry, certification and recertification. This economically independent umbrella organization complements THIEM Research GmbH, which, as a wholly owned subsidiary of CTK, organizes „classical“ clinical-scientific research projects (clinical trials, RCTs) together with the study center. TEAM:exchange UG offers and distributes individual modules or the complete package.

THIEM:COTTBUS5G answers the question of how 5G could improve healthcare. To do this, we look at the „patient journey“ into and through a hospital: how can tailored data transmission technologies change this journey, improve patient safety, and transform patient experience?
5G and its benefits will be demonstrated using the journey taken by a patient with an acute heart attack as an example (and then extended to other conditions) and rolled out spatially beyond the campus into the metropolitan area and region.

The treatment routes are digitally coordinated in the background and accelerated by intelligent distribution of process-relevant information. The material and personnel resources required in individual cases will be recorded and combined in terms of space and time and thus decisive steps will be taken toward evidence-based treatment and higher quality.
Everything becomes a data source: every ultrasound machine, the CT, the laboratory as well as the intensive care unit capacity, the operating room and every suitable hospital bed.
While following this principle an infinite number of dots need to be connected: a complex Internet of Things (IoT) in a large hospital. However, this is not enough: the required human resources must be directed and guided: medical, assistant and nursing staff are supposed to be in the right place at the right time.
Along the patient journey, the IoT which was initially defined only in terms of technical information will be further developed into an Internet of Services (IoS) for the benefit of the individual patient.

For the various hospital areas data is provided via the most suitable networks and media in each case: 5G is the „data highway“ here.
The patient journey which is based on a wide range of absolutely up-to-date information is initiated in the background even before admission: the patient arrives and the hospital’s resources are already waiting for him; the way ahead has been paved.

Smart Hospital means that time is being saved, functionality is made available and resources are made more effective – in short: the patient will receive better care. The backbone of this information revolution in the hospital is 5G. Success will depend on 5G being compatible with other old and new data transmission technologies and last but not least on gaining the acceptance of civil society for 5G.

The WE! alliance
The com(m) 2020 alliance wants to contribute to securing health care in the Lausitz region. com(m) 2020: the acronym stands for the area of need Community Care (health in the communal community) and focuses on the corresponding area of innovation Community Care Technologies.

This means coordinated structural, process, service and product innovations that create an efficient and effective continuum of care in rural areas, thus defining and communicating health care as a factor that creates quality of life and security.

The goals
The challenge is to bridge the spatial and technical distance between care services and citizens; the com(m) 2020 alliance is based on three key pillars: Digital Care is the first pillar of community care technologies, which organize access to health in a low-threshold way, and of com(m) 2020. Innovations in the service sector address the area of need by increasingly offering outpatient services, delegating them to local forces to a reasonable extent, and allowing citizens to help shape their health care. The key concepts of this second pillar of com(m) 2020 are the development of skilled workers and mobile care.

Future trends in mobility offer opportunities to remobilize people with handicaps (the handicap can be a walking disability but also a „disconnected“ small place of residence) and keep them mobile. The third pillar of com(m) 2020 is Care Logistics.

The alliance region

Rural regions share structural problems in many places and are often hotspots of demographic and structural change. However, southeastern Brandenburg not only shares many problems with Prignitz and Ruppiner Land, but also faces 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 the Lausitz: across the federal states in several model regions.

The partners
Partners of the Carl-Thiem-Klinikum (CTK), Cottbus, and the Brandenburg University of Technology (b-tu) Cottbus-Senftenberg are the model municipalities as well as a total of more than two dozen strategic partners, actors and multipliers of the regional economy, regional supply and regional science.