Scaling multi-clinic digital triage system on Open Telekom Cloud
About the client
Blackpine Medical is a German HealthTech company and a spin-off from Freiburg University Hospital, specializing in digital triage and initial patient assessment for emergency departments and integrated emergency centers (INZ). The company has two core products: TriageClient, a decision-support system for fast, structured patient assessments; And TriageDoc, which streamlines the recording and handover of triage results across care teams.
Challenges
Effective medical triage is critical to ensure patient safety and efficient use of emergency resources. And digitalization is essential in improving this process across Germany. As a result, the development and scaling of healthcare decision-support systems are in growing demand.
Blackpine’s digital clinical decision-support system, TriageClient, has shown its effectiveness in real-world clinical settings, ensuring 4X faster triage time compared to existing documented solutions. With such effectiveness, Blackpine found it reasonable to scale their triage system across clinics and develop a centralized infrastructure management. Such challenges came on the way:
Delivered value
Solution
Tech consulting
First, we focused on defining an infrastructure strategy. At this stage, Blackpine Medical was evaluating Open Telekom Cloud and Microsoft Azure, and required a clear, unbiased expert comparison. Our DevOps engineer assessed both platforms and explained the technical, regulatory, and economic trade-offs of each option for healthcare use. While Azure offered broader familiarity and simpler implementation, Open Telekom Cloud proved to be a stronger fit for the client’s needs due to its data sovereignty guarantees, alignment with German healthcare requirements, and predictable cost structure. So, the client ultimately selected it as the most sustainable long-term option.
Architectural foundation
Our experts jointly defined the solution's architectural foundation, ensuring it aligned with the client’s existing CI/CD system and future scaling plans. For this, we designed and implemented two clearly separated processes:
- Onboarding. Automated creation of a new clinical tenant, including infrastructure provisioning and baseline configuration.
- Delivery. Deployment, updates, and operational management of already onboarded clinics. The delivery model enabled deployment of new functionality and updates to existing clinic environments, and allowed independent management of each clinic without impacting others.
This separation was critical to ensure safe scaling and controlled operations in a healthcare context.
Implementation
Our DevOps expert implemented this architectural solution using the IaC Terraform toolkit. By defining infrastructure as reusable, version-controlled templates, we enabled a standardized approach that could be applied consistently across clinics. A key differentiator was that the same automation used to onboard a new clinic could also be reused to manage and update existing clinics.
The infrastructure was implemented using a Kubernetes cluster integrated with Open Telekom Cloud services and configured to the specifics of its managed environment. Given the differences in OTC’s implementation of networking plugins, IAM mechanisms, and the Kubernetes resource lifecycle, we implemented standard approaches to platform component configuration. These approaches ensure predictable system behavior, enhanced security, and compliance with operational requirements.
With the proposed infrastructure, multiple clinics operate within a shared environment, reducing overhead while remaining logically isolated and operationally independent. As a result, the client got a scalable infrastructure model that supports rapid onboarding and expansion of new clinics.
Deployment
Once the clinic environment was provisioned and configured, we handled deployment and provided the client with the final production URL for the clinic’s portal. By this stage, we ensured the entire lifecycle from environment creation to final release.
Lemberg Solutions is a highly professional partner with strong engineering expertise. For our Software-as-a-Medical-Device product, they supported the selection and setup of our cloud infrastructure and helped us build a solid foundation for our applications. They don’t just execute - they proactively think along, challenge assumptions, and improve the end result. Deadlines were met consistently, they stayed flexible, and the collaboration was genuinely enjoyable.
How it works
