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Digitization project IT infrastructure to the cloud

Digitization project IT infrastructure to the cloud

from Jan-Hendrik Träger
, Rolf Grube

The Mainschleife Specialist Hospital has successfully migrated its entire IT infrastructure and the centrally operated HIS, consisting of IS-H and i.s.h. med, to cloud operation in the AWS cloud and the web-based hospital information system (HIS) CLINIXX®, respectively.

Oberender - References - Mainschleife Specialist Hospital

Collaboration with partners MARIS Healthcare and VISUS played a critical role in implementing the communications server, PACS, and archive system to improve interoperability and access to medical data.

The project has led to a secure IT infrastructure, more efficient workflows and optimized patient care, which is why a corresponding approach can be considered a recommendation for similar digitization projects in the hospital sector.

Initial situation

Fachklinikum Mainschleife is a leading hospital for orthopedics, trauma surgery and minimally invasive general surgery in Germany. Due to a change of sponsor, the hospital had the opportunity to reorganize its entire IT infrastructure.

With the goal of reacting more agilely and dynamically to changing conditions, the specialist hospital decided to move to cloud operation in the AWS environment and prioritize web-based applications.


The main motivations for moving to the cloud and web-enabled products were cost effectiveness, security and practicality. Within only seven months, the switch from the previous IS-H and systems to the CLINIXX® HIS of AMC Holding GmbH took place.

This presented a challenge to staff who had to manage both the HIS change and the carrier change. In addition to this central system, a total of 29 applications had to be either migrated or relaunched.

In addition, the IT department, which was highly centralized at the previous executing agency, was eliminated. As a result, there was no permanent IT staff at the start of live operations, and many centrally hosted applications were also eliminated. So in addition to the carve-out and migration activities, the complete operational IT was also taken over and a handover concept was developed for long-term support of the company.

The operation of a hospital IT from the cloud was a novelty, best practices and existing data protection concepts did not exist – these had to be developed in the ongoing project, after a positive, initial feasibility study.

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Implementation and solutions

A total of 29 applications were newly acquired or migrated as part of the digitization project. Data migration played a crucial role, especially with regard to legacy data. Here, a dedicated FHIR datalake has been established on AWS to act as a low-cost alternative to the Patient Master Index. This enabled efficient and reliable transfer of patient data into the new system.

Important and particularly constructive partners in this project were MARIS Healthcare, which provided the communication server, and VISUS, which was responsible for the Picture Archiving and Communication System (PACS) (JiveX) and the archive system (HCM). Collaboration with these partners was highly significant, as they were instrumental in successfully implementing the cloud solution and ensuring interoperability by contributing their expertise in the respective areas.

The MARIS Healthcare solution for the communication server (Mirth) enabled effective and secure communication between the different applications, providing “true interoperability” between applications. This meant that even technically less modern software could be seamlessly integrated into the application landscape.

VISUS provided the PACS (JiveX) that enabled the storage, management and access to medical image data. This was an important step towards digitizing the image archive and made it easier for physicians to access relevant medical images and findings.

In addition, the archive system (HCM) of VISUS was implemented, which enabled efficient management and long-term archiving of medical documents and data. This contributed to the fact that the Mainschleife Specialist Hospital can have a complete and well-organized digital patient file.

The constructive cooperation with these partners helped the Mainschleife Specialist Hospital to optimally integrate the digital solutions into everyday work and to ensure a smooth transition. The expertise and experience of AMC, MARIS Healthcare and VISUS were critical to the success of the digitization project in the hospital context. By implementing these solutions, Fachklinikum Mainschleife and its employees have benefited from improved data security, more efficient information sharing and better access to medical information.

The partnership with MARIS Healthcare and VISUS has proven to be extremely valuable and should be considered best practice for similar digitization projects in the hospital context.

Fachklinikum Mainschleife has been running its CLINIXX® HIS in the AWS Cloud since the beginning of the year. To ensure maximum information security, the data was distributed across three data centers in the Frankfurt European region. Compliance with the strict Bavarian data protection guidelines was given top priority in the selection of the infrastructure provider, the creation of the data protection concept and the network architecture.

Results and effects

The introduction of the web-based HIS in the cloud enabled the Mainschleife Specialist Hospital to have a secure and future-oriented IT infrastructure. Employees are already confident in the system and see improvement in the change in working conditions. By leveraging modern technologies such as the cloud and web-based solutions, the hospital can operate more efficiently and improve its responsiveness.

The existing hardware (server) from the previous sponsorship can be dismantled and sold.

In the design of the software infrastructure and the corresponding communication links, pending legal requirements, such as the transmission of KDL classes to documents, and the latest findings from IT security were taken into account and will thus not generate any additional IT expenditure in the long term.

Lessons and recommendations

The case of Fachklinikum Mainschleife shows that a HIS change and the relocation of network and software operations to the cloud can be successfully implemented in a short time.
The technical and content expertise of Oberender AG in the context of healthcare, the innovative strength and technical skills of Kite Consult, as well as the specialized experience and willingness for further development at the software providers were key factors.

It is important to consider the needs of employees and ensure that the software actually benefits people. In this context, “SPOCs” (Single Point of Contact) can perform a core function by standing as interpreters between clinical users and technical experts. In addition, careful selection of partners who have experience in implementing similar projects and/or a high willingness to learn from each other is beneficial.


The Mainschleife Specialist Hospital has taken an important step towards digitization by switching to a web-based HIS in the cloud. The efficient use of modern technologies has enabled the hospital to improve its workflows and optimize patient care.

In the long term, the hospital’s IT will remain competitive and meet regulatory requirements without incurring high and unplanned costs. The successful implementation of this digitization project serves as an example and recommendation for other hospitals seeking similar changes.

The project was reviewed in the trade press

– HCM Magazine: Mainschleife Specialist Hospital – HIS in the Cloud
– kma-online: Specialist hospital operates HIS completely in the cloud

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Within this framework, we provide vendor-independent support together with your team in the development and implementation of needs-based digitization strategies, KHZG or cloud projects.

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Jan-Hendrik Träger


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