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Author: Irene Gebuis

INDICATE: what is federated data analysis?!

What is INDICATE?

Healthcare institutions possess vast amounts of untapped data that could drive innovation and improve patient outcomes. As much as 97% of health data world-wide is not re-used. With INDICATE we aim to unlock this potential by building a federated data infrastructure for Intensive Care Units (ICUs) across Europe.

But how can you analyze data without accessing it directly? The answer lies in INDICATE’s design, specifically in its first development phase due for delivery in August 2025. 

What is Federated Data Analysis? 

Federated Data Analysis allows researchers to run analyses across multiple ICU datasets without seeing the raw data. It is a code-to-data scenario to facilitate secure computation.

INDICATE’s federated analysis architecture enables data users, such as researchers, innovators, and policy makers, to derive insights from ICU data across multiple institutions, regions, and European countries.  

How is INDICATE designed to make Federated Data Analysis possible? 

In the beginning of the project, the architecture will consist out of four essential components that work together to enable federated observational studies: 

  1. Metadata catalog 
  2. Study repository 
  3. Secure processing environment 
  4. Aggregated results exchange 

Metadata Catalog 

The metadata catalog is usually the starting point for a researcher who has an idea. It enables researchers to discover what data, standardized and in a common format, is available across participating hospitals without accessing the data itself. Similar to browsing a library catalog that shows book titles and summaries without revealing the books’ contents, researchers can see what types of ICU data exist and where, allowing them to design appropriate studies.  

Study Package and Study Repository 

The study repository manages the lifecycle of Study Packages. A Study Package is a collection of files, such as a research protocol, scripts, and data requirements that are used to answer a research question. Think of it as a library or GitHub repository where researchers can submit their study proposals.  And other researchers and data providers can review the proposals, raise issues, and provide feedback. Once a researcher is happy with their proposal, they obtain ethical approval for the study. Next, the researcher can invite Data Providers to join the study. Data Providers are hospitals that participate in INDICATE and make their data available. The researcher’s institute and the Data Providers will need to enter into a Data Sharing Agreement. This Agreement includes the data processing purposes, the legal basis for processing, and how intellectual property rights are handled. After the Data Sharing Agreements have been signed, the Study Package is locked. It is now ready for download. 

Secure Processing Environment 

The secure processing environment is where the analysis of personal health data occurs. The health data stays within the hospital setting. This means that the hospital downloads the Study Package from the Study Repository and installs it in their Secure Processing Environment. The Study Package is executed against the hospital’s data. Think of the secure processing environment as a clean room where an analysist performs experiments the researcher told them to do without taking anything outside, except the results.  

A data steward at the Data Provider is responsible for downloading the signed Study Package. They verify it is the correct version. Next they install and run the package and check for errors. If the package executed correctly, the data steward verifies the Aggregated Results. It is also their job to verify that there are no personal data remaining in the Aggregated Results. If all checks are passed, the data steward uploads the Aggregated Results to the Aggregated Results Exchange. 

Aggregated Results Exchange  

The aggregated results exchange enables the secure sharing of aggregated outputs from the analysis. Aggregated results include statistical summaries, such means, standard deviations, frequencies and proportions, but not individual patient data. It is like the airlock to the clean room where the results may be placed for pick-up, without the being able to enter the clean room itself.  

After Aggregated Results have been uploaded to the Aggregated Results Exchange, the researcher is notified that new results are available. They can log in and download the Aggregated Results. Next, the researcher can combine all of the Aggregated Results from all participating Data Providers into one pooled result. This pooled result can be used for a scientific paper, for example. 

Data Protection, Privacy and Security in INDICATE 

INDICATE architecture implements privacy by design principles, maintaining data sovereignty as a core requirement. Personal data of patients always remains within the hospital, and only aggregated results leave the hospital’s environment after review. 

This approach aligns perfectly with General Data Protection Regulation (GDPR) requirements and physician-patient confidentiality by ensuring that: 

  • Data providers (hospitals) retain complete control over their data
  • Personal data remains within the hospital’s security boundaries
  • Only non-sensitive, aggregated statistics are shared, such as averages, and counts
  • All processing occurs with appropriate legal bases and safeguards 

Real-world applications 

INDICATE’s first set of deliverables will result in a Minimal Viable Product that supports observational studies across European intensive care units. This way INDICATE provides immediate value through applications such as comparative effectiveness research and quality benchmarking. In comparative effectiveness research treatment approaches across different hospitals can be compared to identify best practices. Quality benchmarking allows hospitals to compare their performance metrics with peers while maintaining data privacy. 

For hospital executives, this means gaining valuable insights without the compliance risks of traditional data sharing. For start-ups developing healthcare solutions, it provides access to a broader evidence base for validating innovations without the hurdles of data transfer agreements. 

Moving forward 

INDICATE’s Minimal Viable Product (MVP) is scheduled for completion in August 2025. This foundation will later expand to include federated machine learning (Plateau 2) and decision support capabilities (Plateau 3). 

By joining INDICATE, partners like healthcare institutions can contribute to and benefit from a European-wide approach to collaborative research while maintaining full sovereignty over their data. The architecture provides the security, privacy, and governance needed to unlock the value of ICU data for better patient outcomes across Europe. 

The future of healthcare research lies not in centralizing data, but in federating insights—allowing knowledge to flow while keeping sensitive information secure. 

We would love to hear your thoughts on INDICATE’s design, so feel free to reach out to us via email or our LinkedIn page!

Introducing the Principal Architect for INDICATE

We’re excited to welcome Arie as the Principal Architect for our European data infrastructure project, INDICATE!

His experience as Cloud Architect & Lead Architect with complex, large-scale data environments is a tremendous asset to INDICATE.

In this role, Arie supports the Technical Lead in the development of the Enterprise Architecture of INDICATE. He designs and reviews the business, data and application, technology, and security architecture of INDICATE. In addition he helps planning and governance of the deployment of the federated data infrastructure.

With Arie on board, we’re taking another strong step toward building a future-proof European data infrastructure. Welcome, Arie!

Julie Benbenishty

European Federation of Critical Care Nursing Association
Position: Work Package 5

I am Julie Benbenishty I work as a nurse with a PhD degree in an ICU in Jerusalem Israel. I am an educator, clinician and researcher. In addition, I am the deputy chair of the European Federation of Critical Care Nurses. 

With all of the above experience, I am working in WP5 Dissemination, Exploitation, and Communication with my colleagues to promote the INDICATE project and develop educational modules for clinicians and researchers to be able to learn about and utilize INDICATE data to it’s best advantage. In every aspect of the development of the INDICATE project, I try to include nurses, nursing data and research so the nurses’ voice can be heard. My goal is to achieve as much nursing exposure to INDICATE as possible.

Alicia San José

European Federation of Critical Care Nursing Association
Position: Work Package 5

Alicia San José, RN, PhD, is a distinguished nursing professional with a global perspective shaped by years of clinical experience in the United Kingdom, France, Spain, and Sweden. Certified sworn translator (English/French), Dr. San José is an effective communicator and advocate for high-quality healthcare within an international environment. 

A passionate educator and researcher, Dr. San José is committed to advancing nursing practice through innovative curricula, simulation-based learning, and impactful international collaborations. Dr. San José is a board member of the European Federation of Critical Care Nurses (EfCCNa).

As a participant in the INDICATE project, a pan-European initiative to create a federated infrastructure for ICU data, Dr. San José contributes to Work Package 5 (Dissemination, Exploitation, and Communication), focusing on data user on-boarding, provision of digital skills training, and educational resources.

Her expertise in nursing education, research, and international collaboration is essential to realizing INDICATE’s vision of a data-driven healthcare ecosystem.

Establishment of the Ethics Advisory Board

The Ethics Advisory Board members will advise us on ethical issues to ensure that our project complies with ethical standards and regulations.

Ethics Advisory Board members

Atia Cortés, Recognized researcher at the High Performance in AI group of the Barcelona Supercomputing Center (BSC-CNS). Atia specializes in the ethical, legal, socio-economic, and cultural aspects of AI, contributing to various EU-funded projects and initiatives.


Stefan Buijsman, Associate Professor Responsible AI at TU Delft, The Netherlands. Stefan’s research focuses on transparency and explainability of AI, and he leads the WHO Collaborating Centre on AI Governance and the TU Delft Digital Ethics Centre.


Ania Henley, is a Citizens and Patients Involvement Expert Advisor with over 25 years of experience in finance, clinical audits, and research data systems. She advises the NIHR Imperial Biomedical Research Centre for Multiple Long-Term Conditions at Imperial College London, supporting patient-derived quality of care initiatives. She has served as Deputy Chair of the EIT Health Board on Ethical, Legal, and Social Issues, contributing to the Data Saves Lives initiative and the European Patient Forum. At Imperial, she co-chaired the HEALTHYSTATS committee, helping develop a new way to communicate clinical trial results, published in BMJ Open Access, and supported the REACT COVID-19 studies.

Establishment of the External Expert Advisory Board

Our INDICATE External Expert Advisory Board is in place! These four experts bring a wealth of knowledge and experience to our project.

Michael Beil from NHS Highland, UK is Visiting Professor, School of Computer Science and Engineering, The Hebrew University of Jerusalem, Israel. His role within the External Expert Advisory Board is ICU domain expertise. Michael specializes in predictive modeling and AI in clinical practice, focusing on reinforcement learning and human-machine interfaces.


Marc Pont is Data Architect for the Zuyderland hospital in The Netherlands. His role within the External Expert Advisory Board is Data architecture expertise. Marc is passionate about improving healthcare data landscapes with open solutions, focusing on data architecture, AI, analytics, and research.


David Van Laere is CEO of Innocens BV and former Neonatal Intensive Care Specialist. His role within the External Expert Advisory Board is Start-up representative. David leads a team developing AI technology to detect early signs of infections in neonates, leveraging his extensive experience in neonatal care and machine learning.


Filip Haegdorens, is Assistant Professor in Nursing and Healthcare at the Universiteit Antwerpen, Belgium. His role within the External Expert Advisory Board is Nurse representatives. Filip is a nurse researcher dedicated to improving patient outcomes through innovative technologies, clinical decision support systems, and healthcare workforce modeling.