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The historical development of the Dutch Sentinel General Practice Network from a paper-based into a digital primary care monitoring system

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Abstract

Aim

The Dutch Sentinel General Practice Network (SGPN) was founded in 1970 for disease surveillance in primary care, based on paper questionnaires. Advances in information technology offered new prospects of data collection from electronic health records (EHRs). This study investigates the resulting challenges for the SGPN and its transition towards electronic data collection.

Methods

A qualitative approach included triangulation of SGPN annual reports, network publications, its computerisation project protocol of 2004, public health policy documents, and expert interviews.

Results

In the 1990s, the design of the SGPN, coordinated by the research institute NIVEL, no longer corresponded to new Dutch government information demands regarding developments in primary care utilisation and quality. The emergence of the EHR-based Netherlands Information Network of General Practice (LINH) could have rendered the SGPN obsolete. However, NIVEL researchers recognised that routine EHR data on health problems could not fully provide required information obtained by questionnaires and samples for laboratory analysis. They developed a plan (1) taking EHR-based routine data collection as a basis, and (2) simultaneously retaining the more detailed supplementary data collection that was the core of the SGPN. The transition towards electronic data collection from 2005 onwards was followed by the integration of both networks into the NIVEL Primary Care Database in 2014.

Conclusion

The Dutch model is an example of a process responding to the challenges and opportunities associated with the emergence of electronic data collection, leading towards the integration of routine and supplementary data collection for both sentinel surveillance and health services research.

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Notes

  1. The name of the Ministry of Health changed over the course of time because the policy areas of public health, social affairs, culture, and sport were grouped in different ways in different periods. See: Rijksoverheid, Ministerie van Volksgezondheid, Welzijn en Sport (n.d.) Geschiedenis: Ministerie van Sociale Zaken en Volksgezondheid (Ministry of Social Affairs and Public Health) 1951-1971, Ministerie van Volksgezondheid en Milieuhygiëne (Ministry of Public Health and Environmental Hygiene) 1971-1982, Ministerie van Welzijn, Volksgezondheid en Cultuur (Ministry of Well-being, Public Health, and Culture) 1982-1994, Ministerie van Volksgezondheid, Welzijn en Sport (Ministry of Public Health, Well-being, and Sport) since 1994.

  2. Here, we have followed the time frame provided in the biannual report for 1989/1990 (Bartelds 1991) and Dekker et al. 1992. Later reports state 1988-1989.

  3. The fluctuation can be observed by comparing the names of participating GPs in the annual reports for 2004 and 2009.

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Acknowledgements

We wish to thank the general practitioners who contributed to the Dutch Sentinel GP Network and LINH as well as the health care providers contributing to the NIVEL Primary Care Database. We also wish to thank Dr Aad Bartelds, Professor Bertien Collette, and Professor François Schellevis for their contributions to this article as interview partners.

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Authors and Affiliations

  1. School of Public Health, Research Centre 2: Epidemiology, Biostatistics and Clinical Research, Research Centre 3: Health Systems and Policies – International Health, Université libre de Bruxelles, Campus Erasme, bâtiment A, CP594, route de Lennik 808, 1070, Brussels, Belgium

    Christoph Schweikardt & Yves Coppieters

  2. Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118–124, 3513 CR, Utrecht, The Netherlands

    Robert A. Verheij & Gé A. Donker

Authors
  1. Christoph Schweikardt
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  2. Robert A. Verheij
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  3. Gé A. Donker
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  4. Yves Coppieters
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Corresponding author

Correspondence to Christoph Schweikardt.

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Conflicts of interests

The first author received a MiniARC grant from the Université libre de Bruxelles (ULB). The other authors declare that they do not have a conflict of interest.

Ethics statement

No patients were involved in this study. Consent was obtained from the three experts to be interviewed and to be named in the acknowledgements. Consent was obtained from expert 2 to be cited in the manuscript.

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Schweikardt, C., Verheij, R.A., Donker, G.A. et al. The historical development of the Dutch Sentinel General Practice Network from a paper-based into a digital primary care monitoring system. J Public Health 24, 545–562 (2016). https://doi.org/10.1007/s10389-016-0753-4

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  • DOI: https://doi.org/10.1007/s10389-016-0753-4

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