Reducing fragmentation in the care of frail older people: the successful development and implementation of the Health and Welfare Information Portal
Our fragmented health care systems are insufficiently equipped to provide frail older people with high quality of care. Therefore, we developed the Health and Welfare Information Portal (ZWIP), an e-health intervention which aims (1) to facilitate self-management by frail older people and informal caregivers and (2) to improve collaboration among professionals. The ZWIP is a personal conference table, accessible through a secure internet connection, for multidisciplinary communication and information exchange for frail older people, their informal caregivers and professionals. After development, the ZWIP was implemented in seven general practices, and this process was evaluated by means of a mixed-methods study. Eventually, 290 frail older people and 169 professionals participated in the ZWIP. Most professionals were positive about its implementation. Facilitators for the implementation were the experienced need for improvement of interprofessional collaboration and the user-friendliness of the ZWIP. Barriers were the low computer-literacy of frail older people, start-up problems, preferring personal contact, and limited use of the ZWIP by other professionals. In sum, this article describes the successful development and implementation of the ZWIP, an e-health intervention which can reduce fragmentation in the care of frail older people.
Samenvatting
Ons gefragmenteerde zorgstelsel is onvoldoende in staat om goede zorg te bieden aan kwetsbare ouderen. Daarom ontwikkelden we het Zorg en WelzijnsInfoPortaal (ZWIP), een e-health interventie die beoogt om (1) zelfmanagement door kwetsbare ouderen en mantelzorgers te ondersteunen en (2) de samenwerking tussen hulpverleners te verbeteren. Dit ZWIP kan gezien worden als een persoonlijke, via internet toegankelijke overlegtafel voor multidisciplinaire communicatie en informatie-uitwisseling voor kwetsbare ouderen, hun mantelzorgers en hulpverleners. Het ZWIP werd geïmplementeerd in zeven verschillende huisartsenpraktijken en dit proces werd geëvalueerd met een mixed-methods onderzoek. In totaal namen 290 kwetsbare ouderen en 169 hulpverleners deel aan het ZWIP. De meeste hulpverleners waren positief over de implementatie. Bevorderende factoren voor de implementatie waren de ervaren noodzaak tot verbetering van de samenwerking tussen hulpverleners en het gebruiksgemak van het ZWIP. Belemmerende factoren waren beperkte computervaardigheden van kwetsbare ouderen, opstartproblemen, een voorkeur voor persoonlijk contact, en beperkt gebruik van het ZWIP door andere hulpverleners. Concluderend beschrijft dit artikel de succesvolle ontwikkeling en implementatie van het ZWIP, een interventie die de fragmentatie in de zorg kan verminderen. Dit wordt nog eens ondersteund door het feit dat een zorgverzekeraar het ZWIP als een declareerbare inspanning heeft erkend.
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Dankbetuiging
Dit onderzoek werd mogelijk gemaakt door een subsidie van het Nationaal Programma Ouderenzorg. Onze dank gaat uit naar Wilma Derksen-Driessen, Emile ter Horst, Mark Kuster, Charlotte Neger, Jean Nielen, Leontien van Nieuwenhuijzen en Joep Scheltinga voor hun hulp bij de ontwikkeling en implementatie van het ZWIP.
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Robben, S.H.M., Heinen, M.M., Makai, P. et al. Het verminderen van fragmentatie in de zorg voor kwetsbare ouderen: de succesvolle ontwikkeling en implementatie van het Zorg en WelzijnsInfoPortaal. Tijdschr Gerontol Geriatr 44, 59–71 (2013). https://doi.org/10.1007/s12439-013-0014-8
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DOI: https://doi.org/10.1007/s12439-013-0014-8