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Article History

Received: 18 March 2024

Accepted: 1 July 2025

First Online: 24 July 2025

Competing interests

: Financial competing interests: The authors acknowledge research support and institutional funding received by the German Federal Ministry of Health in line with a resolution passed by the German Bundestag (Grant no: 2516FSB415, Grant holder: K.B.) in the period 2016–2020. Funds were received for salaries and equipment to develop, validate and implement the surveillance methodology, technology, and infrastructure. We acknowledge further funding received by the State Ministry of Justice and Migration (Baden-Württemberg) and Regional Authorities in Bavaria as well as care provider organisations (Klinikum Würzburg, St. Joseph Klinik, MKT) for operational running costs of the use and implementation of the electronic medical records software Ref.Care in the scope of the surveillance network within a non-for-profit licensing model (Grant holder: K.B.). The funders had no role in design, analysis, or interpretation of data or in the decision to publish. Personal financial interests: K.B. and R.J. are registered at University Hospital Heidelberg as co-inventors of the electronic medical records software Ref.Care in line with the Employee Invention Act (ArbnErfG). The invention is related to the underlying software and concept for surveillance, without receiving any individual financial benefits from licenses or use and implementation of the software. The authors declare no other competing interests.