All Public Health Authorities have recently started working with the iTBC information system thanks to close collaboration between the Public Health Authorities (GGD’s), GGD GHOR Nederland, Topicus.Healthcare and various chain partners. This system is based on the Topicus Synaps platform, which safely and responsibly records data relating to tuberculosis control whilst complying to the necessary standards regarding information security. This means the Public Health Authority has not only brought a new information system into use, but has also adopted an entirely new work process.

National collaboration

An important starting point in this development was the realization of a national information system. A system which could contribute to the efficient organization of TB control throughout each region and support a national collaboration. This was no simple task, as regional demographic differences require different solutions. For example, the different ways in which appointments are processed in various Public Health Authorities. This could be large group screening, vaccinations in the form of a walk-in consultation or individual patient appointments at predetermined times. Despite these difficulties, iTBC has been developed and configured for all Public Health Authorities in the Netherlands to work with the same information system: “Work regionally where necessary, work and organize nationally where possible!”.

iTBC conversion process

Before iTBC was fully functional, all data - originating from different source systems - had to be compared, matched and converted to iTBC. Through an intensive collaboration with the suppliers of these source systems, 3.3 million patient files, 1.3 million documents, 28,000 source and contact examinations, as well as a large number of tasks, lab results and employees have been successfully converted to iTBC.

Modular construction

With iTBC, healthcare providers have low-threshold, but safe access to all patient files (which they should have access to according to current laws and regulations), allowing them to work with it anytime and anywhere. iTBC works with dynamic healthcare programs, which are based on an established set of protocols but are also fully adaptable to the specific needs of each client. The so-called iTBC planning assistant offers the healthcare provider intelligent support of the client’s assigned healthcare program when planning (including combinations of) appointments, which means he/she can focus on caring for the client.

iTBC is integrated with IMS, which is the image system used by all Public Health Authorities in the Netherlands. X-ray orders are automatically prepared for the X-ray modality as soon as the client has registered. The radiographs are available to be assessed in iTBC immediately after being produced.

If a patient is diagnosed with tuberculosis, a source and contact investigation is started as a preventive measure to identify infected contacts as quickly as possible. The source and contact research module within iTBC provides the healthcare provider with a real-time overview of the research results and diagnoses of all contacts examined. An assessment of these results can easily determine if an investigation needs to be up-scaled.

The LabOnline module supports the healthcare provider in processing and viewing the laboratory results of a specific client and provides an electronic link with the laboratories, including lab applications. In addition, the healthcare provider can record and view the provided medication for each client in EVS (electronic prescription system), whereby reduction and increase schemes can be used. The health care provider is made aware of possible contra-indications, allergies and side effects when entering the medication.

In order to decrease time spent on financial settlement, health care providers can use the electronic declaration portal FinControl. FinControl offers financial staff full support to declare the delivered healthcare quickly, easily and correctly.

Continuous collaboration

In the coming years, the Public Health Authority (GGD), the Regional Medical Emergency Preparedness and Planning Association (GGD GHOR Nederland) and Topicus.Healthcare will work together continuously to further develop iTBC to ensure healthcare providers are (even) better supported and patients are fully involved in their healthcare. This further development will focus on linking the healthcare provider with the patient, but also on connecting the healthcare provider with various chain partners, including the Dutch Expert Center for Screening (LRCB), the registration system of National Institute for Public Health and the Environment (OSIRIS-RIVM), the Royal Netherlands Chemical Society TB Foundation(KNCV Tuberculosis Foundation), the Department of Judicial Institutions (DJI) and the Central Agency for the Reception of Asylum Seekers (COA). This means iTBC will continue to safeguard the public health in the Netherlands!