Filling the Gaps in a Fragmented Health Care System: Development of the Health and Welfare Information Portal (ZWIP)

• Published in: JMIR research protocols Vol. 1; no. 2; p. e10
• Main Authors: Robben, Sarah Hm, Huisjes, Mirjam, van Achterberg, Theo, Zuidema, Sytse U, Olde Rikkert, Marcel Gm, Schers, Henk J, Heinen, Maud M, Melis, René Jf
• Format: Journal Article
• Language: English
• Published: Canada JMIR Publications 19-09-2012; JMIR Publications Inc
• Subjects: Behavior; Caregivers; Carers; Clinical decision making; Collaboration; Decision making; Frail; Frailty; Goal setting; Informal care; Intervention; Long term health care; Meetings; Older people; Organizational change; Original Paper; Patients; Personal health; Planning; Primary care; Segmentation; Selfmanagement; Web portals; Working groups; frail elderly; electronic health records; interdisciplinary communication; Self-care; cooperative behavior
• ISSN: 1929-0748; 1438-8871; 1929-0748
• DOI: 10.2196/resprot.1945

Current health care systems are not optimally designed to meet the needs of our aging populations. First, the fragmentation of care often results in discontinuity of care that can undermine the quality of care provided. Second, patient involvement in care decisions is not sufficiently facilitated.
To describe the development and the content of a program aimed at: (1) facilitating self-management and shared decision making by frail older people and informal caregivers, and (2) reducing fragmentation of care by improving collaboration among professionals involved in the care of frail older people through a combined multidisciplinary electronic health record (EHR) and personal health record (PHR).
We used intervention mapping to systematically develop our program in six consecutive steps. Throughout this development, the target populations (ie, professionals, frail older people, and informal caregivers) were involved extensively through their participation in semi-structured interviews and working groups.
We developed the Health and Welfare Information Portal (ZWIP), a personal, Internet-based conference table for multidisciplinary communication and information exchange for frail older people, their informal caregivers, and professionals. Further, we selected and developed methods for implementation of the program, which included an interdisciplinary educational course for professionals involved in the care of frail older people, and planned the evaluation of the program.
This paper describes the successful development and the content of the ZWIP as well as the strategies developed for its implementation. Throughout the development, representatives of future users were involved extensively. Future studies will establish the effects of the ZWIP on self-management and shared decision making by frail older people as well as on collaboration among the professionals involved.