Second-hand licences as a strategic option for modern hospital IT

Cost-effectiveness, licence transparency and security for organisations in the healthcare sector

The German healthcare system remains one of the most efficient, but also one of the most expensive, in Europe. An ageing population, a stagnating economy, systemic disincentives, high levels of inefficiency due to a lack of coordination, a massive backlog of investment in infrastructure and digitalisation, and a growing shortage of skilled workers have been causing steadily increasing economic pressure for years. Small and medium-sized hospitals in particular, but increasingly also larger hospital groups, are struggling with the current challenges and operating conditions – in some cases, for their very survival. To strengthen the quality of care and make the hospital landscape sustainable nationwide, a further major reform of the hospital sector was launched at the end of 2024, featuring targeted structural changes, strengthened cross-sector collaboration and a consistent expansion of digitalisation. Yet it is precisely here that many institutions are reaching their financial limits.

Against this backdrop, in this blog post we explore how hospitals can create targeted financial leeway for digital investments through forward-looking licence management and the use of second-hand software licences. We also use a practical industry example to demonstrate what a second-hand software provider should offer, particularly for companies with high regulatory requirements, and why PREO is the right partner.

Investing in digitalisation: new opportunities for tight budgets

Among other things, the current reform relies on a digitally supported infrastructure to improve management and care provision. This includes electronic patient records (ePA), clinical decision support systems with increased use of AI, and modern communication solutions. These developments are essential for optimising processes, improving the quality of care, and using resources more efficiently. At the same time, IT managers and software asset managers are increasingly asking themselves how these digital requirements can be financed – particularly against a backdrop of tight budgets and the need to meet the healthcare sector’s strict requirements regarding data security, data availability and compliance.

In this context, second-hand software licences for on-premises operations are becoming increasingly important as a strategic procurement option, as many core applications – such as administrative or diagnostic software – continue to run in companies’ own local data centres. Moving to the cloud is not feasible or desirable in the short term in all areas, for example due to security and compliance reasons or a lack of system compatibility.

The purchase of used licences, particularly for widely used standard software such as Microsoft Office applications or server products, offers a tried-and-tested, cost-saving alternative here, helping to ease the strain on investment budgets without compromising on security and compliance.

How hospitals benefit from second-hand licences

A key advantage of pre-owned software is that, depending on the licence version, it costs between 30 and 70 per cent less than buying new. This allows hospital trusts to use their IT budget much more efficiently, whilst freeing up funds for urgently needed investments in infrastructure, equipment or staff. As used software consists of perpetual licences, the recurring rental costs associated with subscription models are also eliminated. Particularly when compared to cloud solutions, on-premises solutions using second-hand licences consistently offer significant long-term cost advantages, whilst providing full control over the system landscape and data management.

One reservation that still arises regarding used software is the issue of legal certainty. However, the trade in used software licences has been legal within the EU for more than 10 years, subject to clear conditions. These include, in particular, that the software must be completely uninstalled by the original licensee and no longer used, so that a valid, perpetual licence can be transferred in a legally secure manner.

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What hospital trusts should bear in mind when selecting providers

Professional suppliers of second-hand software for businesses ensure, through documentation and transparent evidence, that all licences offered are audit-proof. This transparency is essential, particularly in hospitals, which are classified as KRITIS environments and are subject to special scrutiny regarding IT security and compliance. Furthermore, established resellers also offer support with licence management, audits and queries regarding manufacturer contracts, as well as expertise in European licensing law, to minimise risks and reduce internal administrative burden.

The PREO licensing experts have compiled these and other key factors for selecting a reliable provider into a checklist. Click here for a free download.

IT modernisation at Andernach Regional Hospital – licence transparency is key

Andernach Regional Hospital (LKH) modernised its IT infrastructure as support for Microsoft Office 2013 was coming to an end. To save costs and avoid ongoing fees, the LKH decided against Microsoft 365 and opted to purchase second-hand on-premises licences. The tender was conducted as part of an EU-wide procurement procedure, with particular emphasis placed on transparency, traceability and legal certainty.

A key award criterion was the complete proof of the chain of title for each licence back to the original purchaser, meaning that suppliers without full documentation were excluded. “The complete traceability of the chain of title is absolutely essential for us in the context of an audit or a potential resale,” explains Stefan Bach, Head of Information Technology. The result: PREO impressed both in terms of the transparency requirements for the required Microsoft licences and economically, and was awarded the contract in almost every category. 

As a public-law institution with over 5,000 employees, LKH Andernach is the largest hospital operator in Rhineland-Palatinate in the fields of psychiatry, psychotherapy and neurology. The LKH regards the process as a forward-looking tool for legally compliant and economically sustainable IT procurement. “Those who consistently make transparency a key award criterion not only ensure legal certainty but also make award decisions that stand the test of time,” says Stefan Bach, summarising his experience. Click here for the full customer case study.

Audit-compliant second-hand software licences for hospitals and businesses

As one of Europe’s leading B2B resellers of pre-owned software, PREO has been providing hospital groups, healthcare providers, SMEs, large corporations and public sector organisations with legally compliant licences from leading manufacturers such as Microsoft, Adobe, Oracle, VMware, Foxit and ZWSoft for 20 years. Over 5,000 customers benefit from:

• savings of up to 70 per cent compared to new licences
  
  
• a fully legally compliant and audit-proof licence acquisition process with transparent documentation in the PREO licence portal Easy Compliance
  
  
• personalised advice on licence transactions and on integration into traditional IT infrastructures and hybrid cloud models
  
  
• in-depth expertise gained from numerous successfully completed reference projects across various industries

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