University of Twente will lead the four-year Interreg project CARE-FLOW to improve the cross-border collaboration between the Netherlands and Germany through intelligent decision-support in capacity planning and patient flow optimisation. In both countries, the healthcare systems are under growing pressure due to rising costs, increasing demand and staff shortages. The consortium of software companies, universities and healthcare organisations will use regional data, prognosis and planning algorithms to utilise available resources more efficiently for better health outcomes.
Healthcare spending is at a record high in both Germany and the Netherlands. Rising costs and an ageing population put increasing pressure on hospitals, emergency services, and care facilities. At the same time, a worsening shortage of healthcare professionals limits available treatment capacity. In border regions, this strain is amplified by a lack of coordination between countries, leading to inefficiencies such as duplicate resources, uneven workloads, and delays in care. Cross-border collaboration is already performed by healthcare organisations in the region today and was especially highly effective in past crises, like the transfer of Dutch patients to German hospitals during the COVID-19 pandemic. However, these efforts are still largely manual and fragmented.
Project CARE-FLOW
To streamline cross-border collaboration, the new research project CARE-FLOW develops cutting-edge algorithms to be embedded in software tools to improve healthcare efficiency and accessibility in the German-Dutch border region. The initiative focuses on optimising patient flows and healthcare capacities by enhancing coordination among emergency services, hospitals, and care facilities. By leveraging artificial intelligence, Operations Research, IT, and data analytics, the project aims to enable smart and data-driven decisions for managing resources such as ambulances and intensive care beds. This approach is especially crucial in crises like pandemics, where effective cross-border collaboration becomes vital, but also during capacity bottlenecks occurring in normal operations.
Rather than duplicating services on both sides of the border, the project promotes shared capacity usage, improving patient care while reducing unused capacity. The software solutions will be developed with direct input from healthcare providers to ensure practical implementation and to minimise adoption barriers.
The international consortium, which includes companies, universities, and healthcare organisations from both Germany and the Netherlands, combines diverse yet complementary expertise to address regional needs. The project also introduces a new training model to ease integration of the tools in daily operations, ultimately aiming to boost the quality and efficiency of healthcare across the region.
The core task of UT in CARE-FLOW is to support the complex planning task that requires a substantial amount of coordination in the region. The researchers Derya Demirtas, Daniela Guericke, Sebastian Rachuba and Anne Zander from the cross-faculty Center for Healthcare Operations Improvement & Research (CHOIR), together with a team of researchers, will develop algorithms that make automated suggestions for improving capacity adjustments and directing patients based on regional data and prognoses.
The CARE-FLOW project is carried out as part of the Interreg VI-Program Deutschland-Nederland and has a total budget of 4.6 million euros. CARE-FLOW is co-financed with 2.9 million euros by the European Union, the Dutch Ministry of Economic Affairs (EZK), the MWIKE NRW and the MB Niedersachsen as well as the provinces of Groningen, Fryslân, Drenthe, Flevoland, Overijssel, Gelderland, Noord-Brabant and Limburg.
The consortium consists of the core partners University of Twente, University of Münster, Universitätsklinikum Münster, Stokhos B.V., L2R GmbH and ORTEC B.V. as well as the associate partners Universitair Medisch Centrum Groningen (UMCG), Medisch Spectrum Twente, Radboud universitair medisch centrum / Radboudumc, Kreis Borken, Universitätsklinikum Münster, Klinikum Osnabrück GmbH, Ambulance Oost, Ziekenhuisgroep Twente, Safetyct, De Posten, Zorgschakel, Livio Holding B.V. and GGD Flevoland.
