Successful management of mergers and heterogeneity

The IT team at the University Heart Center Freiburg-Bad Krozingen has shown how two complex IT structures can be merged successfully. It takes skilled professionals, mature products and the requisite finesse from the outside IT staff supporting the project.

When the University Heart Center Freiburg-Bad Krozingen was founded, the cardiovascular medicine departments of the University of Freiburg Medical Center and the Bad Krozingen Heart Center were merged. The challenge for IT: connecting departments that were fully integrated into the University Medical Center’s IT structures with the Bad Krozingen Heart Center’s hospital information system (HIS).

Fusion und Heterogenität erfolgreich meistern
University emergency center II at University Hospital Freiburg


The data from two different hospital information systems was to be merged via interfaces to allow for billing in either of the two systems using a single IK number (institutional identifier used by healthcare facilities in Germany). Both hospitals possessed the expertise needed to develop the interfaces. Considering the resources available, a mature commercial product was to be purchased in order to reconcile and merge the patient data records. A comparison of the products available on the market revealed that ICW’s MPI met the requirements best, so it was chosen.

That decision has held up well so far, with ICW handling maintenance and support of the patient merging algorithm in cooperation with the patient administration departments involved. The project was completed in a record time of just six months. It would have been significantly more expensive to adopt a unified HIS. By linking the two systems via interfaces and the MPI, we were able to save millions in costs. Our collaboration with ICW and deployment of the MPI were the key success factors in this project, known as Agenda 2014.

The first objective was to merge the two systems so that billing could be carried out under a single IK number, and to achieve the unique patient identification process necessary for the task. Additional objectives included mutual access to reports and organizational backup for patient admissions and other processes. There was more to the merger than this, however. An IHE-compliant, interface-based, and modular strategy is indispensable to the consolidation of different IT structures and cultures. From the start we wanted an IT structure that could integrate the best of both worlds. This kind of approach can be superior to a strategy that relies solely on uniformity. For us, this was crucial to success, as well as a cost-reducing factor. It could also be a route to success for other hospitals with strong IT expertise.


In addition to uniform alignment with IHE-compliant architecture, specific agreement on and standardization of interfaces within the HIS architecture are factors that should not be undervalued. The employees of the two IT departments get to know and appreciate each other, and this may also help reduce the anxieties that inevitably come with mergers and consolidations, and often stand in the way of constructive and cooperative collaboration.

The next collective step was not just to use the MPI for the data merge within the Heart Center, but to take it to the next level and “clear” the data both within and across organizations. The University of Freiburg Medical Center and the University Heart Center Freiburg-Bad Krozingen, together with ICW, took that step in 2016. At this stage, too, it was necessary to harmonize the different cultures and processes in the two organizations; this is a major success factor.

This was, and still is, a special challenge for our partner ICW, and we can attest that they have the requisite finesse and clarity. Integration of qualified outside and independent partners in such a major project is also an important corrective in the internal discussions. The contents of these jointly established structures start with the quite complex requirements of data protection, and also encompass issues like defining interfaces, which must be worked out in detail. This task and the contributions of outside partners should not be undervalued.

Two separate, complex and mature IT landscapes in two different hospitals were to be merged into one affinity domain in such a way that the best IT solution from each facility would be carried over. In contrast to the approach commonly taken in mergers, where one partner’s system is simply forced onto the other, our strategy means that investments and special qualities can be preserved, and even made available for the other partner’s use. However, a high level of IT expertise from both partners is crucial to this kind of strategy, as well as the willingness to cooperate and outside partners with appropriate insight and ability—like ICW’s employees. The most important prerequisite for this kind of development, however, is an MPI with appropriate growth potential and scalability across multiple organizations. On the whole, Agenda 2014 provided the blueprint for the architecture that will now be used to build the in-house affinity domain between the University Medical Center and University Heart Center organizations step by step. At the same time, we have created a foundation for integrating additional organizations.

The inner courtyard of the Heart Center Bad Krozingen