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EBM practice Net - Belgium

EBM practice Net - Belgium. Stijn Van de Velde Robert Vander Stichele Siegfried Geens. EBM practice NET : a collaborative effort. Non profit organisation Open to Belgian organisations that produce EBM Funding :

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EBM practice Net - Belgium

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  1. EBMpracticeNet - Belgium Stijn Van de Velde Robert Vander Stichele Siegfried Geens

  2. EBMpracticeNET: a collaborativeeffort • Non profit organisation • Open to Belgian organisations thatproduceEBM • Funding: • Reimbursement organisation (National Institute for Health and Disability Insurance, INAMI-RIZIV) • Started in 2011 • 4 Member groups: • Government • Producers • Disseminators • Users • Foundingmembers BCFI FARMAKA SSMG CEBAM FOD DG 1,2 VIRTUAL LIBRARY DOMUS MEDICA KCE WVVK E-Health MINERVA WVVV EBMpracticeNet

  3. AIM of the EBMpracticeNet • To optimisequality of care and efficiency byproviding all Belgianhealthcareprofessionals free access to: 1) Anup to date database of selectedBelgian and international guidelines(GL) 2) Belgian EBM information (otherthan GL) 3) Anelectronicclinicaldecision support system • Primary focus: GP’s • Alsomuldisciplinaryfocus foralliedhealthpersonnel and specialists EBMpracticeNet

  4. Database of guidelines • Workingprinciple: To beuser-friendly the database should provide GL in 80-90% of diagnosis • Number of Belgian GL toolimited  needforlargeamount of foreignGL  foreign GL needto beadapted  searchingforeverymissing topic the best foreign GL = notfeasible • Topics without BelgianGL:  purchase 1 foreignGL database (withintention to adapt) EBMpracticeNet

  5. Search for a comprehensive database of guidelines • Maincandidates: CKS (UK) en EBM Guidelines (Finland Duodecim). • StudyItalianCochraneCentre: BanziR, Liberati A, Moschetti I, Tagliabue L, Moja L. A review of online evidence-based practice point-of-care information summary providers. J Med Internet Res. 2010; 12(3):e26. • Internal evaluation: • 1) EB methodology / Editorial quality • 2) Coverage • 3) Possibility to link with EPR • 4) Adaptability • 5) Cost • EBM Guidelines (Finland Duodecim) EBMpracticeNet

  6. Infostructure User authorisation Access rights management EBMpracticeNet BelgianGL summaries Belgian EBM information Finnish GL Summaries FinnishEBM-Scripts Search engine (ICPC, ICD, MeSH) User query analysis and routing Specific/generaluser query Computerisedorder withdecision support system Digital Library External EBM websites EBMpracticeNet

  7. EBM-scripts • Principle: • structured patient data from EPRs  EBMeDS system • ESystemreturns reminders, therapeutic suggestions and diagnosis-specific links to guidelines. EBMpracticeNet

  8. EBM-scripts • Evaluation of sample of scripts (by Domus Medica, CAMG, UCL) • Keyquestion: Canexisting scripts bedirectlyapplied to Belgian setting? • Methods: • Identification + analysis of scripts (www.ebmeds.org) forwhichGL Domus Medica was available • In depthanalysis of sample of 10 scripts EBMpracticeNet

  9. EBM-scripts • Results: EBMpracticeNet

  10. EBM-scripts • In depthanalysis of 10 scripts withdisagreements • Samemainreferences different recommendationbecause of contextual factors (eg. Obesity) • Samereferences different interpretation (eg. Hypertension, Diabetes type 2) • Different referencesbecause of lack in updating  different recommendation(eg. Hypertension, Antibioticprophylaxisfor bites, Obesity) EBMpracticeNet

  11. EBM Scripts - conclusions • Workflowrequiredforevaluation/adaptation/validation of scripts ( and GL) • Substantialamount of work • Risk of alert fatigue • Carefulselection of most important scripts EBMpracticeNet

  12. Organigram Redaction Technicalstaff EBMpracticeNet

  13. Next steps • Phase 1: • Selection of prioritytopics • Definition of workprocesses • RestructuringBelgian GL to standardtemplate • Linking to Belgian EBM information • Access to GL Duodecimwithwarningthatinformation is notadapted • Translation of GL Duodecim (seepresentationbytechnical partner IVS) • PhaseII: • Adaption of priority GL forwichnoBelgian GL are available • Adaptation of selected EBM scripts • Continuous • Update of information EBMpracticeNet

  14. Impact evaluation • Collection of data and qualityindicators by Ambulatory Care Health Information Lab – ACHIL • Development of researchprotocol to evaluate impact on the quality of care EBMpracticeNet

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