- By Doreen Witt
KHVVG funding: The right Cloud PACS strategy for every hospital size
The KHVVG Transformation Fund promotes innovation and digitalisation in hospitals. As the centrepiece of clinical diagnostics, image management is a strategically important building block. Above all, protected but simple and location-independent image access is becoming increasingly important due to the changing hospital landscape and therefore solutions such as a Cloud PACS. But which digitalisation strategy for DICOM management suits which level of care - and which funding opportunities can be used for this from 2026? Find out how maximum care providers, primary and standard care providers as well as MVZs and specialist clinics can strategically embed a Cloud PACS in their image management transformation planning.
Which funding elements of the Transformation Fund are relevant for Cloud PACS projects
The digitalisation of hospitals is entering the next decisive phase. With the launch of the KHVVG transformation fund IT managers and executive boards are faced with the specific task of defining eligible concepts for 2026 and submitting them to the Federal Office for Information Technology. Social security (BAS) to apply.
Important for IT managers: In contrast to the previous KHZG there are no rigid "must" and "can" criteria for IT measures in the funding programmes of the Transformation Fund. Hospitals have much greater freedom to decide which digital investments are necessary for their organisation - provided that the measure is a functional component of a structural project.
For clinics that want to modernise their image management IT as part of the hospital digitalisation 2026, the list of total Eight subsidised items (FTB), FTB 1, 2, 3 and 5 are particularly relevant, as well as FTB 6.
- FTB 1 - Concentration of acute inpatient care capacities: Promotes, among other things, the harmonisation of the digital infrastructure and measures for interoperability and IT security in the course of cross-location mergers.
- FTB 2 - Restructuring into cross-sectoral care facilities: Promotes the procurement, installation and development of IT systems, insofar as these improve interoperability and IT security - particularly relevant for MVZs and specialist clinics that are part of a structural reorganisation.
- FTB 3 - Formation of telemedical network structures: Promotes the development of interoperable and secure IT systems for telemedical collaboration between hospitals, including teleconsultations and telesurgery.
- FTB 5 - Regional hospital networks: Promotes the harmonisation of digital infrastructures by reducing duplicate structures in regional networks.
- FTB 6 - Integrated emergency structures: Promotes the networking of emergency care structures; IT measures are eligible for funding if they are absolutely necessary for the realisation of the project.
The message is clear: anyone planning a transformation project should consider the digitalisation of image workflows from the outset - because medical image data makes up the largest proportion of a hospital's total data volume, is essential for diagnostics and must be securely shared between departments, locations and increasingly also between facilities.
Cloud PACS by care level: Which scenario suits your clinic?
The transformation fund is aimed at hospitals of all sizes. However, the requirements for a Cloud PACS differ significantly depending on the level of care due to the different deployment scenarios in day-to-day work. In the following, we show which deployment scenarios are suitable for which hospital size - and how the transformation fund can support these projects from 2026.
Overview: Cloud PACS scenarios by care level
← Table scrollable →
| Supply level | Primary application scenarios Cloud PACS | Strategic benefit | Primarily relevant FTBs |
|---|---|---|---|
| Maximum care providers & hospital chains |
|
|
FTB 1
FTB 5
|
| Basic & standard provider |
|
|
FTB 3
FTB 5
|
| MVZ & specialised clinics |
|
|
FTB 2
FTB 5
|
The scenarios outlined are also suitable as a basis for coordinating your digital strategy with the IT service provider in charge. IT system houses and general contractors who support hospitals with KHVVG projects benefit from working with a specialised IT service provider. Best-in-class provider for image data management - with tested security, open interfaces and fast implementation.
1. maximum care providers and hospital chains: Cloud PACS for the implementation of failure concepts and as secondary PACS
Maximum care providers and hospital chains generally have established, local PACS infrastructures. The challenge with image access lies primarily in protecting against possible IT failures, cross-location networking and strategic independence from the PACS provider.
A Cloud PACS supplements the existing on-premises PACS as a second, independent level for image data access as part of a failure concept. During normal operation, the DICOM data is backed up in parallel in the cloud archive. In the event of a crisis, such as during a cyberattack or system failure, the Cloud PACS is ready for use in minutes thanks to its independence.
Irrespective of the establishment of such an emergency structure for image access, a Cloud PACS can also be used as a flexible supplement to a primary PACS to create a modern working environment for doctors making findings.
The strategic benefits at a glance:
- Business Continuity Management (BCM): A cloud-based secondary PACS ensures that doctors can access treatment-critical image data even during a complete failure of the local IT infrastructure. This is a key requirement of the NIS-2 Directive, which has been in force in Germany since December 2025 and now affects facilities with 50 or more employees in the context of hospital IT security.
- Location-independent consideration: In hospital networks with multiple sites, a Cloud PACS enables web-based viewing from any internet-enabled device - for example, in the background or when on call from home. This relieves the burden on service operations and improves the availability of radiological expertise.
Whether as part of the introduction of a Cloud PACS or a project to create interoperable IT structures, the strategic decoupling of PACS and archive can also be part of a subsidised transformation project. By archiving the image data in a vendor-neutral cloud archive (VNA) maximum care providers free themselves from dependence on individual PACS providers and thus generally also increase the interoperability of their image archive with various software systems.
KHVVG funding for maximum care providers and hospital networks
This scenario can be assigned in particular to funding category 1 (cross-site concentration) if it is implemented as part of a structural merger of sites. If the maximum care provider is part of a regional hospital network, FTB 5 can also be considered. Investment in IT security and interoperability is explicitly eligible for funding in both cases.
2. primary and standard care providers: Cloud PACS for image networks, emergency concepts and secondary diagnosis
For primary and standard care providers, the focus is often on integration into Regional supply networks in the foreground. Whether teleradiology, stroke networks or cooperation with specialist centres - the fast and secure exchange of image data across institutional boundaries is becoming a success factor.
A Cloud PACS supports image distribution in medical networks: Image data is archived centrally and securely in the cloud and is available to all authorised doctors in the network - without VPN complexity and without the costly operation of separate exchange servers.
Like maximum care providers, primary and standard care providers can of course also use a Cloud PACS to access image data independently of internal systems during threatening situations (system failure, cyberattack) or for flexible image access for secondary diagnosis in the background.
The strategic benefits at a glance:
- Protected image distribution across locations: Doctors in network clinics can call up image data and findings directly via a web portal - regardless of location and without complex VPN connections. This speeds up time-critical decisions in particular, such as teleconsultations in stroke networks.
- Avoidance of duplicate structures: Thanks to the cloud archive behind the Cloud PACS, DICOM data does not have to be stored twice in different departments or facilities, but is available centrally to all treating facilities thanks to rights-based image access. Additional data storage in individual facilities is therefore no longer absolutely necessary.
- Emergency concept for image data: Primary and standard care providers are also increasingly affected by cyber attacks. A Cloud PACS as a secondary system ensures that access to critical image data is guaranteed even during an IT outage - a requirement that is being met by NIS-2 is also becoming increasingly important for organisations with 50 or more employees.
KHVVG funding for primary and standard care providers
Funding elements 3 (telemedical network structures) and 5 (regional hospital networks) are particularly relevant. The establishment of interoperable IT systems for the secure exchange of data between hospitals is explicitly named as eligible for funding in both FTBs. Funding item 1 could also be applied if, for example, several smaller hospitals merge in a region.
3rd MVZ at hospitals and specialist clinics: Primary PACS from the cloud
Medical care centres (MVZ) that are affiliated to clinics, as well as specialist clinics - for example in the fields of orthopaedics or surgery - are faced with a different situation: they often lack a powerful PACS or the existing system is outdated. The need for a lean, quickly deployable solution for image archiving and viewing is paramount.
Recommended transformation fund project: Primary PACS from the cloud
In this scenario, a cloud PACS completely replaces the local system or is the first PACS to be introduced. Operation as Software-as-a-Service (SaaS) ensures a lean IT infrastructure right from the start - without large-scale servers and lengthy IT projects.
The strategic benefits at a glance:
- Fast operational readiness: A Cloud PACS like the one from Telepaxx can be put into operation within a few weeks - without a lengthy IT project and without extensive hardware. This is a decisive advantage for MVZs and specialised clinics with limited IT resources, as the majority of IT tasks are performed by the SaaS provider.
- Workstation-independent viewing with certified web viewer: A Cloud PACS offers a web interface via which doctors can view the DICOM data directly in the browser from any workstation with Internet access and a medical viewer - Telepaxx uses the powerful and certified viewer MedDream in its cloud PACS for this purpose. Alternatively, a Cloud PACS can of course also be used in combination with existing, local systems.
- Referrer portal for simple image transmission: Depending on the provider, image data can also be transmitted securely via a Cloud PACS to downstream facilities or referring GPs, who can access, view and download the image data assigned to them via a web platform - a concrete added value for medical centres and specialist clinics that work closely with referring physicians.
KHVVG funding for MVZs and specialist clinics
A primary PACS from the cloud may be eligible for funding as part of funding item 2 (restructuring into cross-sector care facilities) - especially if the MVZ or specialist clinic is part of a structural reorganisation of a hospital site. Initial equipment with an interoperable PACS is also a sensible component in the context of FTB 5 (regional alliances).
The TMD Cloud: A Cloud PACS for hospital digitalisation in 2026
The TMD Cloud from Telepaxx is designed precisely for these aforementioned scenarios. As a German SaaS provider with decades of experience in managing medical image data, Telepaxx offers a flexible Cloud PACS that can be adapted to the requirements of every level of care.
The basis is formed by two service components that can be used individually or in combination: the TMD Cloud Archive as a vendor-neutral long-term archive (VNA) and TMD Cloud View as a multifunctional Cloud PACS. Both can be integrated with all common PACS, RIS and HIS via standard interfaces (DICOM, HL7, FHIR).
The user-friendly TMD Cloud View web portal enables image management, image retrieval and image import for doctors, patients and co-operating facilities. Depending on the application scenario, various functionalities can be added and enabled. The image portal comes with a simple web viewer as standard, but can also be used for diagnostic viewing directly in the browser by activating a certified medical viewer - without software installation and from any internet-enabled end device.
In this version, the TMD Cloud also offers a Business continuity concept for demand-based access to image data: automatic data backup in normal operation, fast access to the cloud archive in the event of an attack and the option of archiving new image data even in emergency mode.
The TMD Cloud was one of the first SaaS solutions for the healthcare sector to receive the C5 certificate from the BSI received. As the operator, Telepaxx also holds a ISO 27001 certification.
Visit Telepaxx at the DMEA 2026 from 21 to 23 April in Berlin
Experience live how the TMD Cloud digitises image workflows from archiving to viewing - securely, modularly and quickly ready for use.
KHVVG funding: Setting the course now for the image IT of the future
From 2026, the transformation fund will offer hospitals a historic opportunity to strategically modernise their infrastructure. As the centrepiece of image archiving and communication, the PACS plays a central role in efficient image workflows and should therefore be set up in such a way that it supports the digital transformation and networking of hospitals. A Cloud PACS addresses several funding objectives at once: Interoperability, IT security, networked care and the decoupling of vendor-bound systems.
It is crucial that hospitals do not view the digitalisation of their image IT as a downstream measure, but rather embed it in their transformation strategy from the outset. This is because a Cloud PACS enables cross-location access to image data and simplifies integration into existing hospital networks.
Frequently asked questions about the transformation fund and cloud PACS
Yes, provided the Cloud PACS is implemented as a functional component of a structural project. The KHTFV requires that digitisation measures promote interoperability and IT security. A Cloud PACS with vendor-neutral archiving (VNA) and open interfaces (DICOM, FHIR) fulfils these requirements.
In particular, FTB 1 (concentration of acute inpatient care capacities), FTB 2 (cross-sector care), FTB 3 (telemedicine networks), FTB 5 (regional networks) and FTB 6 (integrated emergency structures). In all five, investment in interoperable and secure IT systems is eligible for funding.
The KHZG subsidised individual IT measures with fixed must/can criteria. The transformation fund promotes holistic structural projects in which digitalisation is embedded - with greater leeway for IT managers. For the foundations of the KHVVG we recommend our article The KHVVG: Roadmap for the digital clinic of the future.
The TMD Cloud from Telepaxx can be put into operation within a month - without a complex IT project. Existing Telepaxx customers who already use the long-term archive can even upgrade to the business continuity concept in just a few days.
Do you still have questions about how a Cloud PACS can benefit your organisation?
Please contact us and we will be happy to provide you with more information in a personal meeting.