Cases
The Cloud Is the Key: How Nuremberg Hospital Is Preparing Its Image Archive for the Future
Radiology is constantly evolving. Innovative technologies play a key role in ensuring patient care and the secure handling of sensitive image data. At the same time, the volume of image data to be managed is growing rapidly, and both physicians and patients expect radiological images to be digitally available at all times. Against this backdrop, the Nuremberg Hospital, one of the largest municipal hospitals in Germany, decided to modernize its image data archive and drive forward its digital transformation. The focus was on migrating from the vendor-neutral tape archive to a modern, scalable cloud solution.
The Customer
Nuremberg Hospital: One of the largest municipal hospitals in Germany
With approximately 8,400 employees, over 2,200 beds, and more than 335,000 inpatients and outpatients annually, Klinikum Nürnberg is one of the largest municipal hospitals in Germany. At its two locations, Klinikum Nürnberg has been treating patients from the entire Nuremberg metropolitan region since 1897. In addition, the Nürnberger Land Hospitals, with two locations, and the Outpatient Treatment Center, with over 20 locations, are part of the Nuremberg Hospital. As a university-affiliated tertiary care hospital, the Nuremberg Hospital offers the full range of medical services, covering all medical disciplines.
As part of its modernization efforts, Nuremberg Hospital is focusing primarily on ongoing structural development as well as a clear digitalization strategy, with the goal of actively shaping the future of medicine. A key component of this digitalization strategy is the modernization of the image data archive, which is to be migrated from a vendor-neutral tape archive to a modern, scalable cloud solution.
“To position ourselves for the future and further digitize our processes, we have now decided to take the next step and have moved our image archive to the cloud.”
Dr. Josefin Ammon, Director of the Institute of Medical Physics at Nuremberg Hospital
The Challenge
Modernization of the Central Image Data Archive
Nuremberg Hospital has been storing its radiological image data digitally since the turn of the millennium. Initially, images from individual modalities were archived, but this soon led to a complex SAN (Storage Area Network) landscape. Consequently, in 2007, as part of a hospital-wide implementation of a new PACS solution, Nuremberg Hospital separated long-term archiving from the Picture Archiving and Communication System.
At the time, the hospital evaluated various long-term archiving options: server-based solutions, hard-drive-based systems, and jukebox solutions. Both purchase options and external services (as-a-service) were compared. Ultimately, the choice fell on Telepaxx’s server-based, vendor-neutral long-term archive, which had been operating successfully for 18 years. “To position ourselves for the future and further digitize our processes, we have now decided to take the next step and have moved our image archive to the cloud,” explains Dr. Josefin Ammon, Director of the Institute for Medical Physics at Nuremberg Hospital.
The transition of the long-term archive to a cloud-based solution is a significant step in the digital transformation of the healthcare sector. While the cloud has been established in many industries for years, many decision-makers in the healthcare sector were still hesitant. Reasons for this included, for example, the lack of a legal framework and stringent security requirements for handling patient data.
Given the advantages of cloud technology for networking and digitization, as well as the changing legal landscape, Nuremberg Hospital has now decided to adopt the cloud. In the fall of 2023, a strategy was developed to gradually migrate image data and workflows to the cloud. In doing so, the hospital adhered to the proven SaaS (Software-as-a-Service) principle and decided against a self-managed cloud archive, partly due to the higher effort involved.
The Solution
Cloud Technology as a Driver of Connectivity
To successfully implement the project, the hospital took a structured approach. First, Dr. Ammon’s team developed a comprehensive cloud strategy that took into account the specific requirements of Klinikum Nürnberg.
As part of this concept, DICOM archiving was identified as the first use case in the area of image data management. To ensure the security of patient data, the legal framework was also carefully analyzed, with particular attention paid to the requirements of the C5 criteria catalog, the ISO 27001 standard, and the GDPR.
Together with its long-standing archiving service provider, the hospital team developed a migration plan for operational implementation that called for a phased transfer of the existing legacy data. “We carried out the migration in several phases to avoid disrupting ongoing operations and to ensure data integrity,” said Jürgen Hertlein, Group Leader of Radiological Informatics at the Institute for Medical Physics at Nuremberg Hospital.
The result
Faster data retrieval, reduced IT workload, and a foundation for further digitalization
Thanks to careful planning, the hospital was able to implement a future-proof, cloud-based archiving solution that boosts efficiency and ensures high security standards.
Image retrieval is now significantly faster, allowing medical staff to immediately notice the improvements. Image data is displayed more quickly in the viewer, and sharing with other facilities has been simplified through the digital transmission of images via QR codes. In addition, storage costs have been reduced by switching from large, physical on-site storage systems to a virtual server. This frees up space and minimizes maintenance requirements. It also lightens the workload for the Radiology Informatics team, giving them more time for other important tasks.
In addition, the cloud-based archiving solution meets all data protection and data security requirements, which are of particular importance to Nuremberg Hospital. In addition to encryption, the data is archived with multiple layers of redundancy in modern, specially secured cloud data centers in Germany. As a KRITIS facility, it was also very important to the hospital that the SaaS solution it uses complies with the C5 standard of the Federal Office for Information Security (BSI) in order to meet the highest security requirements.
Faster Image Retrieval
Significantly faster image display in the viewer by switching to a central cloud archive
Lower storage costs
The switch to a virtual server made it possible to reduce storage costs.
The cloud is the key to the digitization and transformation of image data management in imaging departments and promotes efficiency, flexibility, and safety in patient care. By migrating its DICOM archive, Nuremberg Hospital has taken a well-considered step toward the cloud and has significantly improved its image data management.
“We must ensure our operational readiness even in the event of an internet outage—this is something that must always be taken into account when implementing cloud technologies in a hospital,” says Dr. Ammon. Migrating the long-term archive to the cloud was therefore a logical first step toward leveraging the benefits of modern technologies while ensuring operational reliability.
Building on the new cloud archive, the Nuremberg Hospital now has additional options for digitizing imaging workflows, such as cloud-based viewing, which, among other things, allows access from home and can thus increase the flexibility of medical staff.
(Photos: Nuremberg Hospital | Uwe Niklas, Jasmin Szabo)
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