Case Studies

In Upper Austria, the lack of structured collaboration among 14 regional cancer hospitals was seen as an obstacle to assurance of the best quality of care for the cancer patients. The establishment of the Upper Austrian Tumour Centre, a cancer-specific network spanning all regional hospitals, sought to enhance transparency in care processes and cross-hospital medical quality assurance. Central to this initiative was a joint clinical tumour registry, which enabled the hospitals to access critical patient data and tumour documentation for coordinated, high-quality care, especially in the case of patient transfers between the regional hospitals.

The network’s primary goal was to ensure equitable care, with all patients receiving standardized medical and supportive services regardless of treatment location, through the development of defined standards of care and patient pathways. Regional guidelines and a tiered care framework were developed to ensure the high-quality care across the network. Originally launched with two hospital operators and seven hospitals, the network has grown to encompass all 14 hospitals in the region by 2022. 

From 2012 till 2024, the Upper Austria Cancer Centre engaged 350 experts in the development of nearly 60 guidelines, which are updated annually. Originally developed as a bottom-up approach, this strong professional cooperation in guideline development is voluntary and also underlines the high motivation and purpose-driven collaboration between the wide range of stakeholders – health professionals, hospital management and operators, policymakers and the wider community.

The network’s key achievements include the development of regional guidelines, enhanced public transparency through a dedicated website, standardized tracking of disease progression and a cross-hospital digital platform for patient-reported outcomes, all built on the strong foundation of data privacy and cross-hospital collaboration.

Enablers: The project has received strong support from hospital operators, both in terms of funding and the establishment of governance (Governance). Hospital operators and individual hospitals in the network engage in the annual budget planning, which fosters the sustainability of this initiative (Financing). Overall, there was an agreement on issues related to the development and adoption of the digital solutions needed to establish the registry and the interoperable transfer of patients’ data between the participating institutions (Service delivery). Tumour documentation that follows widely recognized international standards is fully implemented in all hospitals in the region and can be further expanded as needed. 

Overall, the action has had a positive impact on overarching health system goals, including improved efficiency through joint investment by the hospital operators and providers, and the resulting shared cost of care improvements, as well as transparency and clarity of structures. Furthermore, the smooth collaboration on governance issues, also based on the clearly defined clinical and administrative leadership (with the establishment of a central office with a full-time medical director), has enabled – among other things – clarification of the legal framework for data sharing across multiple care providers and the legal and technical basis for collecting patient-reported outcomes, enhancing patient involvement in their care and people-centredness as an ultimate health system goal. In addition, the Upper Austrian Cancer Centre has influenced the quality and safety of cancer care through improved cross-hospital collaboration in service delivery and has also enabled long-term analysis of disease progression.

Lessons learned: Establishing a successful cross-hospital network requires a shared long-term vision among all stakeholders. The network management’s focus on creating win-win partnerships helped to ensure that participants continuously recognized the added value of their collaboration. Professional debate and knowledge sharing, rather than rigid structures, were identified as key drivers of effective cross-hospital collaboration, particularly among doctors. In addition, economic benefits, particularly in terms of cost sharing, help hospital operators to reinforce the value of the network and their interest in ensuring the sustainability of such an initiative.