Three major teaching hospitals in The Netherlands have set up a joint venture with Polydoc, a British-Dutch software provider, specialized in knowledge management. The Pro-Gram consortium aims to develop a system based on language technology, to unequivocally record some 15.000 medical protocols and directives. If the plan succeeds, Pro-Gram is bound to realize a turnover amounting to tens of millions of guilders within three years. In due time, the four partners hope to design a universal system for knowledge management and document control, to be applied in all Dutch hospitals, and at medical facilities, situated in Flanders, Surinam and the Dutch Antilles, as stated by the Automatisering Gids.
The Polydoc company and the academic hospitals of Groningen, Amsterdam and Maastricht, united in Pro-Gram, each own a quarter of the shares. In the next three years, the four participants will invest about fl. 6 million in all sorts of product design. The basic software programme has to be ready by the year 2000. The system will consist of nine different modules. The modules for medical care, nursing, and laboratory activities already will be delivered in 1999. The remaining modules involve items like paramedical care, logistics, instrumentation and management documents. Nearly all the work is performed by the hospitals, so the Pro-Gram organization itself only has to engage three full-time employees.
Hospital protocols and directives have a very specific nature, like for example the introduction of a gastric catheter or the gradual performance of a cardiac surgery. Pro-Gram wants to create a golden standard for all these protocols, in order to provide a systematic distribution and a methodology for updating. The greatest effort lies in the standardization of the protocol language. The Polydoc company has licensed its proprietary QualiFlow software technology to the three Pro-Gram hospitals. QualiFlow offers an integrated solution for the creation, management, dissemination and archival of medical protocols. Large quantities of text can be structured and coded by means of XML tools.
The Pro-Gram consortium will actively co-operate with the Central Office for Inter-Fellowship's Assessment (CBO) in Utrecht, and with scientific societies of medical experts to evaluate the contents of the protocols and directives. There is no risk however that use of the same protocols across the country will amount to a dull medical uniformity. Certain medical protocols remain specifically valid for only one hospital or region. In addition, the health care professional is always entitled to depart from a protocol provided that he has solid reasons to do so. It is the protocol user who has the final responsibility for interpreting the directive. Pro-Gram only records the state-of-the-art.
The QualiFlow software operates as a linguistic expert system. The moment the protocols are introduced, the system screens the consistency of the used terminology through consequent application of synonymy. The combination of linguistic technology with document management is truly unique for Pro-Gram. QualiFlow equally allows to present protocol variants for the various medical user groups. The treatment protocol for a surgeon is different from that for a nurse, since they have other responsibilities. In addition, an HTML format has been added to QualiFlow, as to directly include protocols into an intranet.
The complete set of nine modules will cost a hospital over fl. 1 million. The Pro-Gram software has to be integrated into the hospital information system. Currently, the Pro-Gram consortium is already talking with the Dutch HIS market leader Baan/Hiscom. Other providers will be approached likewise. For the year to come, Pro-Gram cherishes the ambition of extending its focus to the five remaining academic hospitals as well as to the 25 major general hospitals in The Netherlands. The arrival of more players in the field indeed may improve the overall distribution of the substantial workload. Question remains whether an average hospital will be prepared to largely invest in the Pro-Gram software.
For the past two years, the Polydoc company, listed on the Amsterdam Stock Exchanges' New Market, has been active as a software provider in the Dutch hospital sector. The company provides medical facilities with innovative and cutting-edge systems for knowledge and quality management. At the end of last year, Polydoc gained access to over half of the Dutch hospital market via the strategic acquisition of Lessenger Associates. The Lessenger software has been installed in seven academic hospitals and seventy regional facilities, in order to distribute both the physical and electronic stream of documents. It is obvious that a good hospital management starts by providing an excellent document management.