Digitalisation strategy

The foreseeable future will be characterized by a phase of disruptive change as a result of the second industrial revolution (“Industry 4.0”). This global trend also affects medical universities, because digital technologies are significantly changing the healthcare system. The drivers of this development are “-omics” technologies as a result of the “Human Genome Project” and technologies for processing large amounts of digital data (“Big Data”, e.g. “Human Brain Project”, “Humans as Datasets”). In medicine, this will have a significant impact on teaching (virtualization, virtual reality, simulation), research (precision medicine, renaming of diseases, synthetic biology, gene editing, neurocognitive research) and routine care (robotics, bionics, machine learning, telemedicine). The healthcare sector is also an important area of application for artificial intelligence, for example in medical imaging and diagnostics or drug development.

Research

Digital Medicine

Over the next few decades, digital technologies will fundamentally change the healthcare system and medicine. This will affect all areas, from biomedical basic research and the development of drugs to topics such as healthy aging. Machine learning and big data will create evidence for new diagnostic and therapeutic procedures based on large amounts of data, e.g. predictive modeling of disease progression or identification of new biomarkers. Digital medicine strengthens all three of MedUni Vienna's strategic objectives: precision medicine, translational research and prevention. A key to success will be the close and networked collaboration of different disciplines – medicine, genetics, molecular biology, bioinformatics, data science, machine learning – with the help of interdisciplinary teams.

MedUni Vienna already covers a wide range of digital medicine topics, from the micro to the macro level. New professorships will complement these competencies and help to build a critical, central mass of experts at the university:

• Digital Medicine
• Personalized Medicine
• Molecular Medicine
• Computing and Machine Learning
• Cognitive Imaging
• Computational Medicine

It will be essential for success that different disciplines – medicine, genetics, molecular biology, bioinformatics, data science, machine learning – work together closely and in a networked manner with the help of interdisciplinary teams. However, structural measures such as the development of corresponding core facilities, bioinformatics services, and the expansion of IT4Science must also be further developed at the same time. One of the basic requirements is access to data, i.e. the expansion of interfaces for data from the university patient care at the AKH, access to legal registry data and to data for outcome research (cause of death statistics, central civil registry), to health data and much more. In addition to the IT infrastructure, the spatial conditions must also be created.

As part of one of the largest investment projects of the City of Vienna, three centers are being built on the MedUni Campus AKH, covering around 60,000 m², where 21st-century medicine will be shaped: the Eric Kandel Institute - Center for Precision Medicine, the Center for Translational Medicine and Therapies, and the Center for Technology Transfer. The focus is on precision medicine, biomedical research, genome technology, bioinformatics and data technologies. This will create the spatial infrastructure for the expansion of digital medicine.

Digitization of the research process

Digital technologies affect every single step in the research cycle and also create new possibilities for generating data and for analyzing and interpreting results. Even a core activity of researchers, publishing or generally disseminating results, is strongly influenced by new digital possibilities. Open Access, Open Data, Open Science, Citizen Science, Open Notebook Science, Open Review or Alternative Metrics are just a few keywords in this context.

The sustainable handling of research data in the sense of systematic archiving and controlled access options for reuse is increasingly being demanded by research funders and publishers for reasons of validation and reproducibility. The reuse of research data and numerous initiatives under the buzzword “Open Science” have been launched to avoid duplicating costly research, to improve scientific discourse and to accelerate scientific progress. In this context, the European Commission, the European Research Council and numerous research funding organizations have launched the so-called “Plan S”, which aims to make all publicly funded scientific output publicly and freely accessible. A prerequisite for funding is compliance with the open science criteria, which specify the description, documentation, storage and sharing of data. However, open access, i.e. the transformation from “read-only” to “publish-only” contracts with publishers, also has far-reaching financial implications.

In view of the need for sustainable handling of research data, but also the conflicting considerations arising from the need for open science and the necessity of data protection, the rectorate of MedUni Vienna adopted a research data policy in January 2018.

As part of the “e-Infrastructures Austria Plus” project, researchers at MedUni Vienna were interviewed using guided interviews about their practical experience and ideas regarding research data management.

The following further developments in research data management were derived from the researchers' responses:

• Creating awareness of the need for central storage and structured filing of research data
• Establishing minimum standards for describing stored research data
• Training in data management and the use of data management plans
• Opportunities for researchers to deepen their knowledge of the rights, obligations and options for data sharing
• Information measures to disseminate the FAIR principles for handling research data
• Development of an infrastructure for the centralized and structured storage of research data to enable efficient reuse

In light of the above, and in the face of ever-increasing amounts of data and the necessary computing power, increased investment in computers, databases, networks and IT tools will be necessary in the future. In doing so, national initiatives (e.g. AT2OA, Platform for Bioinformatics in Austria, e-Infrastructures, RDA Austria, Vienna Scientific Computing, etc.) and European networks and infrastructures (e.g. BBMRI, Euro Bioimaging, ELEXIR, European Science Cloud, etc.) should be used to the best possible advantage.

Teaching

Digital Medicine

Digitization is one of the most important topics for the future because it has a lasting impact on the way individuals perceive and use their environment by enabling the flexibilization and individualization of workflows. Particularly in the life sciences, digitization in medical practice (digital healthcare) is advancing inexorably. Not only is an increasing amount of health data being stored in digital form, but the relationship between doctors and patients is also increasingly dominated by IT platforms (keyword: digital waiting room). In addition, recent successes in artificial intelligence and machine learning will bring about revolutionary changes in diagnostic practice.

These new requirements will also be reflected in the content to be taught. In order to meet these requirements, the teaching staff needs to be thoroughly informed about which digital tools or new media are available in the respective field, how they are used in practice, how much they can support medical staff and what needs to be considered when using them.

It is proposed that a basic module on medically relevant informatics content be included in the curriculum. International recommendations and guidelines can be used as a reference point for the content to be taught (IMIA, GMDS, etc.). This module should be exam-based if possible and should convey technical and formal content in a lively way to introduce students to the subject rather than put them off.

In addition, a block-specific integration of teaching on the topic of digitization is proposed. In the scope, two hours could be spent in each block teaching the associated digital tools, their practical use and their potential in clinical use.

In addition to these points, the ethically acceptable use of IT technology in medicine must also be taught.

The content taught in the classroom on digital components in medicine must be continuously evaluated and updated. In particular, the handling of instruments (e.g. analog vs. digital microscopy) must be continuously adapted to the expected future clinical practice.

On the basis of the expertise gained from the existing Master's curriculum in Medical Informatics – the parallel implementation of which with the Medicine curriculum is a unique feature of the Medical University of Vienna – these findings can also be applied to the postgraduate sector, following an international model in the sense of a University Course in Medical Informatics for medical practitioners, in order to meet the increasing demand for IT-oriented doctors.

pro futuro also needs to take account of developments in digitalization in the field of examinations. As with the digitalization of teaching, the digitalization of the examination process should not be an end in itself, but must offer added value, taking into account all aspects. Although this must be viewed critically at the present time, considering the current technology, it seems quite possible that technological advances within a 10-year period could significantly shift the status quo in favor of digitalization.

Conclusion: Medical teaching must take account of the rapidly advancing changes towards digital medicine. MedUni Vienna is in an excellent position to do this thanks to the “Medical Informatics” master's program that exists alongside the medical curriculum. International examples provide additional support for the increased incorporation of informatics content into medical education.

Hybrid Education

Hybrid Education in the sense of this document is understood as the interweaving of personal knowledge transfer with the help of digital media and platforms. Hybrid Education in the sense of the definition given here thus includes elements of e-learning, but is always understood in the form of blended learning, i.e. the interaction of face-to-face teaching and e-learning units in teaching.

The following key points must be considered for the implementation of Hybrid Education:

Hybrid learning environments can support the personal transfer of knowledge, which is an immovable cornerstone of university education. They are also suitable for simulating applications or handling practical examples.

There must be a balanced and defined interweaving of face-to-face hours and e-learning at a meaningful time interval or ratio; there must be an alternating supplementation of knowledge transfer. In this respect, hybrid education should not replace any aspect of in-person teaching. It should be ensured that e-learning elements and the teaching materials provided for them are assigned a corresponding number of hours and reflected in ECTS – as the basis for staffing and financial compensation in all semesters in which these elements are used. The implementation must be based on defined teaching content and objectives, and evaluations for this special form of teaching must be developed from scratch.

Due to the large amount of work involved in developing and implementing high-quality hybrid learning environments, targeted resource allocation for project development and for the teachers responsible for the project seems to be conducive to achieving objectives.

Hybrid learning environments can be used in all degree programs at MedUni Vienna, whereby the extent and weighting are to be adapted to the respective objectives. The decision on the usefulness and form (e.g. teaching content, course type and group size of the attendance portion) of a use of hybrid learning environments should be left to the teachers and made in consultation with the curriculum coordinators.

As long as the intended didactic goals can be achieved, the use of e-testing is also an option, although its use should be based on the learning objectives and cannot replace high-quality and personalized examination events with appropriate feedback to students.

A clear strategy for the implementation of hybrid education is considered necessary: i) identification of suitable curriculum elements and teaching concepts (e.g. through calls among teachers), ii) definition of the resources to be provided, iii) provision of structured, service-oriented support for technical assistance in a subject-specific implementation.

Further didactic training in connection with hybrid education is recommended; this could be included in the seminar program of 'Medizinische Lehre Wien'.

Conclusion: Hybrid education in the form of blended learning can support personal knowledge transfer, but cannot replace it. Hybrid learning environments can be used in all courses of study at MedUni Vienna. The motivation for implementation should be primarily didactic, or secondary to a strategy to increase time flexibility (specifically to support students with care responsibilities or employment). The implementation must be based on defined teaching content and objectives, whereby the decision on the usefulness and form of the use of hybrid learning environments should be left to the teachers.

The identification of suitable curriculum elements as well as contact and implementation partners for the teachers are considered necessary framework conditions, as is the provision of structured support for the digital implementation of the projects.

Administration

The university administration touches on all core service areas of the Medical University of Vienna. Accordingly, the processes involved in digitization should be designed according to their benefits for the areas of research, teaching and patient care, and transparency should be improved as a result.

The main areas of focus of the digitization project in administration include:

• Computer Aided Facility Management to optimize space management (including research space at the MedUni Campus AKH) and technical operations (monitoring, maintenance, repair)
• Digitization of processes in personnel administration and development
• Digitization and standardization of the investment application and approval process in the global budget and third-party funding area
• Centralization of the IT infrastructure (virtualization) and expansion of “Infrastructure as a Service” to ensure the efficient use of infrastructural IT resources
• Introduction of a digital signature

In addition to the digital mapping of the processes mentioned, the organization of the individual departments/organizational units is to be continuously developed in parallel to better support the core service areas, thus contributing to better mapping and faster adaptation to changing external requirements in the university's core service areas.

Digitization in all core service areas and in the university administration itself poses a challenge for the central IT infrastructure.

To ensure that the increasing demand for storage capacity and computing power is met and that new teaching and learning platforms are made available while maintaining data protection, data security and operational reliability, a basis for decision-making and guidelines for in-house solutions vs. outsourcing models are necessary and, if necessary, coordinated between universities (e.g. private cloud vs. community cloud vs. public cloud) and reflected in the relevant guidelines of MedUni Vienna