One Data Repository, Many Studies: A Reusable Foundation for Digital Medicine Research

Clinical research infrastructure is often built study by study, and the costs of that habit compound over time. A team at Charité university medical center and partner institutions reports an alternative: a single, governed clinical data repository, built on the openEHR standard, that has now been reused across five studies spanning different clinical domains, covering approximately 16,000 patients and 7.9 million data points.

The core idea is to govern data semantics at the persistence layer rather than in each individual project. In the reported environment, an openEHR-based clinical data repository with governed archetypes serves as the canonical store, integrating retrospective electronic health record data, prospective study data, patient-reported outcomes, and wearable sensor streams under one shared semantic model. Archetypes are reusable, machine-readable clinical models; of the 125 archetypes in the deployment, 57 are shared between at least two studies, a concrete measure of reuse across projects.

The authors frame the problem they address as accumulating “interoperability debt”: clinical research infrastructures remain fragmented and project-specific, and semantic inconsistency builds up across studies. Repeated transformations between heterogeneous standards cause semantic drift and information loss. Project-driven data models, they argue, accumulate technical debt that undermines the sustainability and maintainability of research infrastructure across studies and funding cycles.

Duplicate data entry is another burden the architecture targets. Prospective studies traditionally require the same information to be recorded separately in clinical and research systems, increasing workload and introducing inconsistencies. In the new environment, prospective data is captured directly through openEHR-based forms, which removes the separate capture system for study variables. The authors note an important limitation, however: duplicate documentation with a hospital information system that does not run on openEHR remains in place.

Interoperability with the wider ecosystem is handled through reusable transformation pipelines. These support bidirectional FHIR interoperability, connecting the repository to standard healthcare data exchange, and OMOP-based analytics, allowing the same governed data to feed common research analysis formats without bespoke per-project conversions.

The environment was also tested across institutions. Federation nodes at three institutions were trialled with cohort count queries across sites, demonstrating that federated, multi-site queries are technically feasible within the architecture. The authors are explicit that these federation nodes are not yet in routine use, marking this as an early-stage capability rather than an established service.

Deployment at Charité across five studies is the central evidence that one governed repository can be reused across successive projects from different clinical domains within an existing healthcare IT landscape. The authors are equally explicit about what remains unproven: sustainability beyond these five studies and scaling beyond a single institution remain to be shown. The claims are therefore architectural and operational demonstrations at one center, not evidence of long-term, multi-institution sustainability.

Accessibility is part of the design. All tooling is publicly available and provided as a deployable configuration intended for institutional adoption, so other centers could in principle stand up comparable environments rather than building project-specific infrastructure from scratch.

For digital medicine research, the reported result is a working demonstration that semantic governance can live at the database layer and outlast individual projects, at least within one institution and five studies. Whether that foundation holds as studies accumulate and as federation moves from tested cohort counts to routine multi-site operation is the question the authors themselves leave open.

Subject of Research: A governed openEHR-based clinical data repository reused across five studies at Charité to reduce interoperability and technical debt in digital medicine research.

Article Title: An interoperable and reusable research environment for digital medicine

Article References: Kohler, S., Meyer-Eschenbach, F., Schüßler, L., Meixner, M., Kärcher, F., Kling, A., Schubert, V., Meyer zum Büschenfelde, D., Marschollek, M., & Eils, R. (2026). An interoperable and reusable research environment for digital medicine. Frontiers in Digital Health, 8, Article 1943167. https://doi.org/10.3389/fdgth.2026.1943167

Image Credits: AI Generated

DOI: 10.3389/fdgth.2026.1943167

Keywords: openEHR, interoperability, clinical data repository, FHIR, OMOP, archetypes, EHR, digital medicine, federation, Charité, technical debt, research infrastructure