The Document Repository: An ID for every situation

For the Sozialstiftung Bamberg (Bamberg Social Foundation), the expansion of the CGM Clinical Archive is a key building block on the path to an interoperability platform. The reason being that it creates the conditions for enriching all important patient information in perspective with metadata in the future.

For persons residing in Upper Franconia, the Bamberg Social Foundation is an essential resource. The association, which was founded just over 20 years ago and has grown steadily since then, describes itself on its website as a “point of contact for almost all situations in life.” For example, the foundation includes medical practice centers and a center for rehabilitation medicine located near the Bruderwald Hospital, which is the region's maximum care provider. It also includes the Senior Citizens' Center, which in turn caters to a wide range of needs, from a neighborhood office to a dementia center. 

The vision of a seamless journey for the approximately 45,000 acute inpatients as well as the 130,000 part-time stationary patients and outpatients each year seems to be within reach here. The major obstacle until now was the lack of data transparency. “We were unable to show that the patient remained under the same roof when being transferred from one facility to another, but had to re-admit them again and again, so to speak,” says Patrick Merdian, KHZG (Hospital Future Act)  Project Manager at the Bamberg Social Foundation.
 
This is now set to change. The CGM Clinical Archive is to play a decisive role here. This is because the expansion of the document archive of the VISUS parent company, among other things, ensures that documents relating to patients and residents of all facilities of the Bamberg Social Foundation are available in a single data pool - a Document Repository. 

The CGM Clinical Archive also ensures that every document is registered in the social welfare foundation's central interoperability platform. If required, and provided that the patient has not objected, attending physicians as well as nursing staff can access and view a person's documents from all facilities via a dedicated user interface in the CGM Clinical Archive. Expansion of the CGM Clinical Archive is part of a large-scale project for an interoperability platform made possible with funding from the Hospital Future Act (KHZG).

Interoperability as a result of IHE compliance

"When we applied for funding during the project initiation phase, we had a clear vision in mind, but to be perfectly honest, we didn't yet know how to get there. Thanks to our collaboration with the CGM team, we learned to understand the necessary mindset," says Patrick Merdian. And this is how the process works on the system side: From the various patients who are created in the respective patient management systems (and who are actually one and the same person), a unique ID is created for each person with the aid of another system, the Master Patient Index (MPI). The i.Pack integration component from CGM serves as the interface between the register and the CGM Clinical Archive as the Central Document Repository. 

The significant added value in addition to absolutely clear patient assignment: Because all the components of this structure are based on the IHE (Integrating Healthcare Enterprises) intiative  standards for interoperability, it is possible to enrich the documents stored in the CGM Clinical Archive with metadata - a prerequisite for medical staff within the network to view all the important information about a patient. 

This involves 194 document types 

But what constitutes “important” information? And how far into the past should this go? “The big challenge in providing historical documents is that I have to be able to rely on the source,” explains Jan de Boer, IT Project Manager at the Bamberg Social Foundation. In practice, this means that the social foundation wants to cover a maximum period of three years.

Even more important was the question of relevance, as there were no clear guidelines on the desired metadata when the project was started in early 2024. The project management team therefore embarked on a selection process together with the hospital management. What remained was still an impressive amount: 194 document types with approximately 24 million documents for the clinics alone, and even more metadata.

If one takes into account that the Document Repository and Master Patient Index are intended to be part of an even more comprehensive platform, it becomes clear just how big a task implementation is. IT expert de Bor is convinced of the strategy. In his view, this is “the smarter way to provide structured data and be able to use it for other applications in the future.”