Universitäts-Notfallzentrum

The University Emergency Department Freiburg is funded by the German National Research Network of university medicine (Nationales Forschungsnetzwerk der Universitätsmedizin - NUM) and the Federal Ministry of Education and Research (BMBF) to participate in the AKTIN (Aktionsbündnis für Informations- und Kommunikationstechnologie in Intensiv- und Notfallmedizin) project, a nation-wide registry for emergency medicine in Germany.

The aim of the AKTIN project is to develop a uniform, standardized and interdisciplinary clinical documentation for all emergency department patients in Germany. Electronic health records (EHR) represent the foundation for establishing a national emergency department register. The standardized documentation and the transformation into a semantic interoperable data set enables us to perform cross-clinic evaluations, health-care research and quality improvement by benchmarking. The AKTIN emergency department register is a modern tool for the quality management optimization in emergency departments and for the fundamental improvement of health-care research in the acute medicine in Germany.

The registry data is also used to feed the Emergency Department Surveillance Dashboard by the Robert Koch Institute (RKI).

The AKTIN-project is funded with EUR EUR 111.200,00  by the federal ministry of education and research (BMBF). Please contact Dr. Felix P. Hans or Jan Kleinekort for further information.

Digitalized health data have immense potential to transform health care systems to become more personalized, sustainable and preventive. The game changer for all health care industries in this transformation process will be accessible data in combination with artificial intelligence (AI). Data science and AI provide powerful computing technologies that can extract heterogenous and nonobvious associations and discriminations from complex data sets. AI and data science are predetermined to play a central role in health care due to the advances in computer power, learning algorithms and collection of big data from various sources. Accordingly, longitudinal patient records containing information on patient’s demographics, health, diagnoses, treatments and outcomes, among others, represent a valuable treasure trove of information.

Recent events have proven again that medical mass casualty or mass diseased situations can evolve within days, hours or just seconds. The nature of these events usually is described as an emergence of
patients that exceeds the capacity of the local health care infrastructure. The need of ambulances and EMS (Emergency Medical Services)-personnel at a scene usually is coordinated by local dispatch
centers. But also hospitals are in the need of adjusting the patient flow to prevent ED (Emergency Department)-crowding. First systems in Germany exist and have been stand-up-improved during the recent COVID-19 pandemic. Yet, it has become dramatically obvious that the lack of inter-county, inter-state and international interoperability of those systems can cost human lives in a days’ time. Language barriers as well as synchronization of technical infrastructure and well-known chains of command are crucial parameters of static and dynamic friction between different health care systems. Especially the European continent with high closeness of small states and multiple transnational regional conurbations is in the need of systems that integrate data on cross-border availability of hospital infrastructure as well as clinical parameters for the prediction of patient emergence and clinical deterioration.

The CLINNOVA-project aims to bring together crucial players of the cross-border health care landscape in Baden-Württemberg, Grand Est and Luxembourg. The University Medical Centers in Baden-Württemberg have provided support in the recent COVID-19 pandemic to the health care system in the French neighbor departments by transfers of patients into the respective German hospitals. Unfortunately, it showed that there is no low-threshold access to cross-border transferrals. Only by lengthy negotiations by state officials individual patient transfers could be organized. Given the massive surge of critically ill patients in the area at the beginning of the COVID-19 crisis while German emergency departments and ICU-facilities had been already emptied the enforced idleness was unbearable for all parties.

CLINNOVA’s capacity building creates and consolidates a shared data-enabling dimension between partners in the Grande Région as a central European model region. Cross border data interoperability in a clearly defined region is a key asset and a blueprint for future health care in Europe. CLINNOVA involves translational research institutions and platforms e.g. biobanks, hospitals and other health care providers. It will be designed to integrate cross-border activities, enabling the effective and secure management and analysis of patient data across partner institutions. This mandates the creation of a federated data
environment with remote analysis capabilities.

The CLINNOVA project is funded with  EUR 644.150,00 by the ministry of science, research and art Baden-Württemberg.   Please contact Dr. Felix P. Hans for further information

The COCKPIT aims to identify all relevant process times of the whole patient journey in our ED and helps us understand how to improve both patient and staff satisfaction.

Please contact Dr. Felix P. Hans or Dr. Michael Röttger fur further information

The German medical informatics initiative (MII) aims to promote the use of health data in the development of new bodies of knowledge across the national health care system. To engage patients in the process, explain the risks and benefits and to create the legal foundation for the use of the patient's data, the MII has developed a uniform process of informed consent. This so-called 'broad consent' enables scientists to use the patient's routine data, biomaterials, and metrics of the statutory health system in a retrospective and prospective manner (MII-flyer, PDF download).

As emergency departments often act as the first point of contact in the patient journey, the implementation of a broad consent-system at this point is crucial for recruitment. Therreby we are able to avoid selection biases and to identify eligible patients for the inclusion in studies, surveys, and register studies.

CODEX + helps us to gain first insights in how broad consent can be implemented in the environment of EDs in Germany. We are especially interested in the acquisition of performance indicators such as inclusion rates, required resources and consent-influencing factors. Hence, we will be able to generate valuable procedural knowledge that can act as blueprints for the use of broad consent tools is other elements of the German health care system.

The CODEX-project is funded with EUR 49.500,00 by the Federal Ministry of Education and Research (BMBF). Please contact Dr. Felix P. Hans for further information.

The institutional subscriptions by the Albert-Ludwigs-University in Freiburg enable us to access a variety of professional journals and eBooks.

Beyond these resources, the digital emergency medicine group maintains the  COMPETENCE library equipped with the finest benchmark works associated with health data science, biostatistics and emergency medicine in general. These books can easily be accessed via our facility’s information specialist.

The Digital Emergency Group aims to develop deep system's integrations in our electronic records. We therefore constantly work with our industry partners to connect patient-related data from medical devices with the electronic documentations systems. Thus, we could semi-automatize ventilation data documentation both for business intelligence and for medical usage. In addition, we developed a fluid-management documentation system to achieve a real-time documentation of administered medication to the split second.

Our latest development will be a semi-automatized decision support system for our triage. For the first time we will be computing the urgency of the patient's presentation not only according to the standardized complaints (CEDIS) but also in dependence of age, vital signs and additional risk factors. This Triage-Client will inherit the process times of a preceding patient guidance system we developed. Therefore, we are able to perform a profound process mining to identify possible bottlenecks during the waiting and triage process and guarantee the timeliness as crucial part of the six dimensions of health care quality.