Secure video transmission from the Preemies Station

The Leipziger Klinikum St. Georg has set up a very special service for the parents of sick or preterm infants: Via Internet you can watch your newborn child from home around the clock. This is made possible by webcams in the NICU as well as secure online access solution based on Citrix technologies. The so-called "cuddle View TV" can be made from any location and be retrieved on any device. Even on an iPad or smartphone, parents can always see live images of their new family member.

The Klinikum St. Georg in Leipzig is one of the oldest hospitals in Germany: In 2012 it celebrates its 800th anniversary. Today the St. George Group of companies include the two hospital sites Eutritzsch and Grünau in Leipzig, the specialist hospital Hubertusburg in Wermsdorf and more than 20 specialist clinics and other healthcare facilities. The Group currently has around 1,700 beds and day hospital places in hospitals, in rehabilitation, in forensic as well as in medical and social dormitories. Approximately 43,000 patients are treated annually.

In 2006, the St. George Group created a new organization that bundled together all its IT departments into a separate subsidiary, the St. Georg IT company. The 24 employees of the company have since initiated and implemented a number of new IT projects - from the widespread introduction of the hospital information system i.s.h.med to the virtualization and consolidation of IT systems: "We want to grow our IT infrastructure step by step in a strategic development in order to better support the internal processes in the future, "says Thomas Werchau, CEO of St. Georg IT company.

Standardization and centralization of IT resources with Citrix technology 

An important aspect is the central provision of user desktops. In order to minimize the administrative overhead and to better manage the geographically dispersed group of companies, it will replace the existing client PCs at many IT workstations with thin clients. The default desktop with all core applications will no longer run locally on the device, but will be made available via a central Citrix XenApp infrastructure in the data center. With the IT service provider COMPAREX IT the hospital developed a solution concept, which is now being put into practice. "By the end of 2012, we plan to move about 1,000 of our 1,500 IT jobs on the new model," says Thomas Werchau.

Standardization and centralization are important strategies for optimizing the efficiency of the IT infrastructure. "In the medical field, there are many technical features we definitely need to take into consideration", he adds. Therefore, the IT organization is cooperating with the departments in order to develop solutions that really prove themselves in everyday life.

One of these suggestions came from the Neonatology and Pediatric Intensive Medicine head, Prof. Eva Robel-Tillig. The medical examiner is responsible for the neonatal intensive care unit - the so-called preemies station. It looks after newborns who were born too early into the world or suffer from diseases. For parents, this is a very difficult situation: As they can’t take their newborn child with them and usually only see them for a few hours a day.

The chief physician explained this problem to the IT specialists and reported on an innovative approach, which was first tested in the United States. Several hospitals offer parents the opportunity watch their premature baby around the clock via a webcam. Accompanying studies confirmed that this approach has a very positive effect on the mother-child relationship. Those responsible therefore decided to implement such an offer in the St. Georg Hospital.

Installing live webcams in the Preemie Station 

First, the neonatal intensive care unit of the Children's Hospital had been equipped with cameras for the project called "Cuddle View TV". The webcams were inconspicuously recessed into the ceiling and are directed at each crib and are easy to operate and adjust by the nursing staff. So the nurses can, for example, zoom in on the newborns faces. On a monitor in the ward the nurses can see all the video images at once and thus have an additional way to monitor the little patients in the ward.

"The big challenge for us, however, was how to make the camera images accessible outside of the clinic," says Martin Schmeisser, project manager in the St. Georg IT company. The first idea was to make each video stream as a Web service via a password-protected Internet site. However, this method failed because there were too many ambiguities on what devices the parents would be using. In order to view the video image in the browser, the parents would have to use not only a specific version of Internet Explorer on their computer - it would also have been necessary to enable additional functions and to install plug-ins. "The creation of a multi-page user manual made it clear very quickly that we would technically overwhelm the user," says Martin Schmeisser.

Therefore, the IT organization developed, in cooperation with COMPAREX IT consulting, an alternative access concept for the "Cuddle View TV". Technologically this builds on existing Citrix XenApp infrastructure in the hospital. For each of the six cameras, an adapted Internet Explorer with the required ActiveX settings was installed on a XenApp server. The user can access these centrally deployed application from any device with an internet connection and does not have to configure their system to its own Web browser.

Secure access and flexible use with iPad and Smartphone

To comply with all data protection requirements, the webcam access is hedged several times. Parents of premature babies receive a username, a password and a hardware token for user authentication from the hospital. With their personal login and the randomly generated PIN code they then log on to a specific web address. Only after a successful login, you can see the program icon, which will start the camera connection to their child.

The entire flow of data between the client computer and the webcam application running on an XenApp server, is encrypted by the network component NetScaler VPX Citrix. "This is basically the same technology that we also use to securely connect mobile users and home offices to our network," said Martin Schmeisser. The highlight of the solution: The user can view the video images of their newborn not only on a Windows PC, but also on the Apple notebooks, iPads or even on smartphones. To access with an iPad or smartphone you only need to download the free Citrix Receiver app.

"With Citrix technology, we were able to implement a solution that was not only simple to operate, but can also be exploited from any device. There is no other hospital in Germany that has video transmission on iPad and Smartphone."

Positive feedback from all sides 

Cuddly view TV was very positively received by the parents of preterm infants. The Webcams run around the clock - so parents can have a look at their child at any time day or night. Only during a treatment or avisit is a still image displayed. The Citrix HDX technology provides high quality video stream by optimizing the transmission protocol, the live images of the webcam can be viewed easily even over cellular connections.

Today, not only can the parents watch the newborn, but the whole family. For example, brothers and sisters who are not yet allowed to visit the station have the opportunity to establish a first contact with the newborn. Chief Physician Prof. Dr. Robel-Tillig emphasized the great advantages of the new solution for those concerned: "That means that the newborn can be integrated by the webcam transmission in to the family, although it is spending a lot of time in the hospital. A significant factor in this early binding phase. No-one should fear that parents will no longer come to see their children in the clinic. Our experience shows that especially the mothers still prefer to visit their children in person. But the computer connection is another important contact possibilities," said Robel-Tillig. Thomas Werchau is also proud of the project that the St. Georg IT has provided society with COMPAREX in a relatively short period of time: "The Cuddly view TV shows an example of how we can create real added value for patients and relatives with innovations, It's also nice that we didn’t had to develop a completely new solution for the implementation. Instead, we use as a base the same Citrix technologies that will help us with the optimization of our internal IT infrastructure."

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With Citrix technology, we were able to implement a solution that was not only simple to operate, but can also be exploited from any device. There is no other hospital in Germany that has video transmission on iPad and Smartphone.
- Martin Schmeisser

Project Manager

St. Georg IT

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