Research Hilde Philips

Abstract

In this project we want to tackle the problem of cervical cancer (CC) and its inequitable burden of disease in Ecuador, by designing and implementing a feasible strategy for screening and follow up in remote communities. The project combines 1) research aimed at improving and implementing screening facilities with 2) strategies to promote uptake of screening services and 3) a highly innovative component in the construction of a VIA-telemedicine and AI based tool for automatization of diagnosis of cervical abnormalities. Embedding the activities in existing local services and training female local health workers will lead to a sustainable strategy in which women are not only the main beneficiaries but, by their protagonist role in the project, drivers of change. The project builds on the good results we obtained in our SI project ending in August 2022.

Researcher(s)

• Promoter: Verhoeven Veronique
• Co-promoter: Bogers John-Paul
• Co-promoter: Condori Sandra
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

Abstract

iCAREdata is a state-of-the-art research database processing routine clinical data of out-of-hours (OOH) patient contacts at general practice cooperatives (GPCs) (huisartsenwachtposten), pharmacies and emergency departments (EDs). The database contains data starting from 2015 until to date. Dataflows are secured by encryption of the social security numbers of the patients by eHealth as a trusted third party (TTP), as well as the RIZIV numbers of the physicians. At no point in the flow, personal data can be matched to clinical data. In de final database, pseudonymised personal data enable the linkage of different patient contacts to the same person, offering the opportunity to describe patient trajectories in the OOH care services; e. g. Person X consults a general practitioner at the GPC on Saturday morning, goes to the pharmacie to collect the prescribed medicines in the afternoon of the same day and finally shows up during the night on Sunday morning at 2am at the emergency department. To realise this data flow and linkage, thorough knowledge about the use and implementation of eHealth services is crucial, besides an up-to-date experience in standardisation and classification systems currently used in medical research datasets. A large network of health care services and health care workers is being part of and has to be fully involved with this project. This is only realised by implementing full transparency about the content of the dataset, how the flow is set up, and for what kind of research the data are used and by who. Researchers as well as data-supplying stakeholders stress the importance of upscaling the datasets by expanding with all GPCs in Flanders (at this moment 38 out of 44 GPCs deliver data on a daily basis) as well as adding extra EDs and pharmacies. Researchers suggest to add routine data of daytime general practices. This is necessary in the long term to be able to follow the entire flow of patients. Also the link with patient contacts in telephone- or selftriage, callcentres for urgent medical care (HC112), and follow-up contacts in general practice or hospitals complete the patient trajectories at different sites. iCAREdata has strong links with newly developed tools in referral to and cooperation with welfare services. This is a unique link between medical care and wellbeing which is in scope to be developed during the upcoming years. Besides research opportunities, iCAREdata also offers the opportunity to add up to a data driven policy on the micro, meso and macro level of health care and welfare services organisation, which was a crucial issue during Covid-19 pandemic. In addition several scientific research topics make the database worthwhile to maintain: evaluation of drug prescriptions by physicians in several contexts (antibiotics, opioids, …), use of health care services, epidemiologic topics like surveillance of infectious diseases, gaps in the offer of health and welfare services, waiting lists…iCAREdata has an experienced team of computer scientists developing modular software based on Normalized Systems Theory (NST). These modular software structures enable the introduction of additional data providers in a fast and reliable way. Thanks to financial resources, iCAREdata will further develop, validate and finalize the link with the emergency services and pharmacies. This enables us to set up valuable use cases to acquire users and (paying) customers. The funding will also be used to further develop the public dashboard and the user dashboards.

Researcher(s)

• Promoter: De Loof Hans
• Promoter: Philips Hilde
• Co-promoter: De Loof Hans
• Co-promoter: Mannaert Herwig
• Co-promoter: Philips Hilde
• Co-promoter: Verelst Jan
• Co-promoter: Verhoeven Veronique

Research team(s)

• Physiopharmacology (PHYSPHAR)
• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

Abstract

In this project, the population managers of the primary care zones are guided and supported during the COVID-19 vaccination campaign between 23/02/21 and 30/09/21. On the one hand, training sessions are elaborated that are given during the online exchange sessions with the population managers, organized by VIVEL. On the other hand, the development of a manual for using the population management dashboard is supervised.

Researcher(s)

• Promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: van Olmen Josefien
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Philips Hilde
• Co-promoter: Bastiaens Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Verhoeven Veronique
• Co-promoter: De Graeve Diana
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Coenen Samuel
• Co-promoter: Philips Hilde
• Co-promoter: Verhoeven Veronique

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

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).

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project website

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Remmen Roy
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project

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.

Researcher(s)

• Promoter: Van Royen Paul
• Co-promoter: Peremans Lieve
• Co-promoter: Philips Hilde

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)

Project type(s)

• Research Project