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Introduction: Digitalization and Artificial Intelligence (AI) are transforming healthcare on a global scale. At the University Medicine Halle (UMH) – comprising the University Hospital Halle (UKH) and the Medical Faculty of Martin-Luther-University Halle-Wittenberg (MF) – this transformation faces structural challenges due to distinct legal and organizational frameworks. In order to leverage the potential of AI and digital tools while maintaining regulatory compliance and operational coherence, a strategic transformation process was initiated.

Methods: Since 2018, UKH and MF have jointly invested in digital infrastructure and organizational reform. Key initiatives include the establishment of two junior research groups, the founding of a Digital Transformation Unit at UKH, and participation in national initiatives such as the Medical Informatics Initiative. Permanent structures such as a Data Integration Center (DIZ) and cross-organizational committees have been established to support the implementation and governance of AI.

Results: At present, the responsibility for digitalization and AI activities is shared by six institutional entities, comprising four divisions and two inter-organizational committees. While each of these entities plays an important role within its respective domain, the absence of overarching coordination has resulted in siloed strategies, redundant efforts, and delays in implementation. The coexistence of multiple stakeholders with partially overlapping mandates has made consistent decision-making and unified infrastructure development increasingly difficult.

This fragmentation has underscored the pressing need for a higher-level coordination unit. In response, UMH initiated the development of a comprehensive strategic framework structured along four pillars:

1. AI Usage Guidelines – Practical protocols for secure and responsible AI deployment.
2. Governance Structure – Compliance mechanisms aligned with the EU AI Act, including risk management and certification requirements.
3. Use Case Catalogue – Over 100 potential applications, structured to guide targeted development.
4. Layered Infrastructure Plan – A tiered technical model integrating local, commercial, and web-based AI tools.

Pilot projects based on these principles have already been launched: In administration, automation scripts reduce redundant tasks; in clinical settings, AI-based triage and documentation tools are under development; and in research, large language models (LLMs) are locally deployed for document understanding and information extraction. However, these developments often evolved in parallel without mutual reference, further underlining the necessity for centralized oversight.

Discussion: The current organizational structure, though rich in expertise, lacks the integration required for efficient and strategically aligned digital transformation. A central coordination office is therefore under discussion. Such an entity could consolidate expertise, avoid duplication, ensure interoperability, and act as a steering body for future AI and digitalization projects. Absent this structural transformation, the transformative potential of AI at UMH might be constrained by inherent discord and disparate execution.

Conclusion: UMH’s experience illustrates the pivotal role of organizational alignment in the context of digital health transformation. Establishing a dedicated coordination unit is not merely an administrative improvement – it is a prerequisite for scalable, secure, and ethically sound AI implementation. This case may serve as a blueprint for similar institutions navigating complex transformation processes under legal and structural constraints.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.

References

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