Research team

Primary and interdisciplinary care Antwerp (ELIZA)

Expertise

Our research topics of interest are: - triagesystems in primary care - organisation and continuity of care - electronis patient records: use and re-use of data - research databases in primary and acute care settings - GDPR and scientific research - cardiovascular risk management Experience in the use of quantitative and qualitative analysis

Operationalization of a research database with patient data and disclosure for policy and operational purposes. 01/09/2020 - 31/08/2021

Abstract

iCAREdata database processes data in unplannable medical care settings in Flanders. During COVID19, these data are used by the Agentschap Zorg en Gezondheid of Flanders for the monitoring of COVID19 patient contacts at the COVID triage centers and the testcapacity of the Flemish COVID19 test centers.

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Being prepared for COVID-19: more to consider than face masks and social distancing. 17/08/2020 - 16/08/2021

Abstract

This project will support the GPs, who play a crucial role in local flare-ups of COVID-19, in structured referral of vulnerable people and groups to local welfare work. The local network of health workers and welfare workers will in this way play its role more optimally in scientifically detect, monitor and evaluate the psychosocial impact of COVID-19 and the associated measures. This project ensures that local flare-ups of the virus are detected and, in addition to the medical ones, will also detect, monitor and tackle the psychosocial impact of the disease. iCAREdata is already operational with detection and follow-up from COVID-19. This database is easily enriched with the social determinants in order to better deal with the pandemic and its impact traces and combat local flare-ups with a focus on vulnerable groups in the local context. This innovative platform supports GPs in correctly referring psychosocial needs to welfare work. The target audience includes the care actors and care providers in primary care zones (ELZ) who want to coordinate care through partnerships on the needs of the citizen, in accordance with GDPR. Secondary target groups are primary care patients, in particular vulnerable groups as well as the policy bodies that want to gain insight into medical and psychosocial care needs with a targeted and local approach.

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Triaging and Referring In Adjacent General and Emergency departements (the TRIAGE-trial): a cluster randomised controlled trial. 01/10/2018 - 30/09/2021

Abstract

Introduction: Patients who might also go to the general practitioner (GP) frequently consult emergency departments (ED). This leads to additional costs for both government and patient and a high workload for emergency physicians in Flanders. The Belgian government wants to address this problem by improved collaboration between EDs and general practice cooperatives (GPCs). Intervention: Patients presenting at the ED during out-of-hours (OOH) will be triaged and allocated to the most appropriate service. For this purpose the Manchester Triage System (MTS) which is commonly used in Flemish hospitals, will be extended (eMTS). By doing so a trained nurse will be able to diverge suitable patients towards the GPC. Methodology: We will conduct a cluster RCT in which eligible ED patients will be diverged to the GPC using the eMTS. We will collect data using our operational anonymous database for OOH care (iCAREdata). We will study the use of the eMTS, the effectiveness and effects of triage, work load changes, epidemiology at both departments, patient safety, health insurance (HIS) and patient expenditures. Furthermore facilitators and barriers will be studied and an incident analysis of problem cases will be performed. Outcome: The primary outcome is the proportion of patients who enter the ED and are handled by the GP after triage. Secondary outcome measurements are related to safety: referral rate to the ED by the GP, proportion of patients visiting the ED again within two weeks, proportion of patients not following the triage advice and file review for selected patients. Results: We will generate a generic model of triage applicable to all Belgian EDs and GPCs. The model will consist of a validated triage instrument, a manual for setting up triage and scientific support for both effectiveness and safety. In addition we expect to achieve financial savings for the HIS and for the patient.

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Identification of predictive models of COVID-19 severity in a multi-state setting for its use in risk stratification and care management (ID-CoV). 20/10/2020 - 28/02/2021

Abstract

During the course of the COVID-19 outbreak, a wealth of data has been accumulated from the efforts of the health systems to overcome the pandemic. Months of patient encounters with primary to tertiary care systems are leaving an affluence of valuable information reflecting the real impact of the virus in people's health and lives. These real-world data [RWD] offer an unparalleled opportunity to understand COVID-19 but also an important analytical challenge due to the dissimilar and heterogeneous nature of this information. Using complementary data sources from primary health care and hospitals, this project aims to set up a methodological framework for data harmonization, linkage, and analytical development of a novel tool for multi-state risk prediction identifying the role of comorbidities, among other factors, in predicting COVID-19 progression into severity, and subsequent recovery or death. This research will afford a unique instrument for risk stratification and resource allocation in the face of current and future epidemics and will serve as a proof of concept of the usefulness of RWD and the feasibility of the adaptation of novel this methodological framework to other countries/settings based on local data.

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Development of a valid methodology to facilitate caregivers in the process of qualitatively export and update of SUMEHR reports. 07/05/2019 - 06/05/2020

Abstract

In a first sub-project we map the current use of Sumehrs by the doctors at the general practice cooperative (GPC). This is done on the basis of an evaluation of the available information in the Sumehrs at the GPC and their use. The registered quantitative parameters are: percentage of actually available Sumehrs in the files of the patients who consult the doctor on duty at theGPC, and percentage of use of these Sumehrs by the doctor on duty. With the permission of the GPC, this information is generated automatically from their software package with the help of the software distributors. In a second sub-project we will study perceived quality of the Sumehrs at GPCs. This subproject is running simultaneously with subproject 1. For this we are planning a descriptive qualitative study with telephone interviews with 35 doctors from different Flemish regions during 4 weekends. On the basis of semi-structured telephone interviews, we estimate how high the perceived availability of Sumehrs is, what the doctors experience as added value to the use of Sumehrs, in particular what data from the Sumehr is used by them at the GPC and for what reason, what are deficiencies and what facilitates or complicates their use. This information will also provide input for the development of quality indicators and training on the preparation and consultation of Sumehrs.

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A study of the feasibility and risks of the integration of triage and regulation of acue medical care. general practitioners, emergency departments and the 112 help centre. 01/04/2016 - 31/03/2018

Abstract

In Belgium, emergency departments and GPs take care of urgent medical care during office and out-of-hours (OOH). Patients have access to the care provider of their choice. Over the last years protocols for triage of unplanned care have been developed by working groups in Belgium. The central aim of the present project is to establish if telephonic triage (using the phone number "1733") with professional call takers using these protocols is feasible, reliable and effective. A pilot project is established in the region Leuven-Tienen, in close collaboration with the emergency departments, the general practice OOH services and the regional emergency call centre which operate in that region. The overall research questions are 1. What is the safety and efficiency of newly developed protocols when used by call takers? 2. What is the epidemiology of unplanned medical care both during office and out-of-hours? 3. What is the influence of telephone triage on the workload and cost of care for unplanned medical problems? Other activities during the project will help to inform the public and the health professionals in the Leuven region. The two year project started May 1, 2016. Results of this study will inform stakeholders about future organisation of OOH care in Belgium. The OOH care research group is part of the General Practice group of the Department of Primary and Interdisciplinary Care Principal investigator: Hilde Philips Co-supervisor Veronique Verhoeven Junior researcher: Hanne Claessen Junior researcher: Annelies Colliers Team member: Roy Remmen

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Scientific leadership for the Unit of Guideline Development of Domus Medica 04/06/2015 - 31/12/2015

Abstract

Hilde Philips MD PhD chairs the Guideline Development Unit of Domus Medica, the professional organization of general Practitioners in Belgium (Flanders). The Unit develops guidelines and shares expertise as methodologic experts with other organisations and education in guideline development. Both groups cooperate in GIN (Guidelines International Network).

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Prospective Intervention Study on the implementation of the GP sentry in Merksem, ZNA Palfijn. 31/12/2010 - 31/07/2011

Abstract

This research focusses on the implematation of an ouit of hours service in the fysical neighborhoud of a general hospital in Northern Antwerp. Data will be collected before its implementation to study future change of patient fluxes.

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Writing and disseminating recommendations for good Practice Policy. 01/04/2009 - 31/03/2011

Abstract

This project includes: - Wrting the recommendations for Good Practice 'Policy on pandemic influenz', carried out on the basis of the methodology of the Steering group Flemish project guidelines - Collaborating in the development of a scenario for the organisation of primary care in case of pandemic influenza.

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Writing and distribution of recommendations for good practical experience. 15/02/2007 - 31/03/2011

Abstract

The general aim is to develop guidelines for general practice. Guidelines are followed by general practitioners unless they have practie relevant reasons not to do so. Guidelines are developed step by step: starting up authorgroups, developing clinical questions, draft version of the guideline, assessment by the commission, external experts and local quality groups of GPs. Each year one guideline is started up and one other is finalised. All guidelines are regularly updated and reviewed.

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