The Flemish government agency "Kind & Gezin" (Child and Family) has developed the IKAROS concept, which stands for Integrated Child Activity Region sUpport System, ICARUS in English. The project aim is to improve the level of preventive child care through faster home visits and to optimize the vaccination degree of the Flemish population conforming to the recommendations of the World Health Organization (WHO). This is realized by providing mobile nurses with laptop computers, equipped with a personal database and the IKAROS application. In addition, the team developed the iKAROS on-line strategy, in which "i" stands for the Internet. Two services are currently in the pilot phase, which are the Vaccination database for doctors and iKAROS Home, a virtual coaching system to assist parents with young children.
Kind & Gezin is strongly dedicated to ensuring the well-being of young children and their families. With some 650 itinerant nurses on the road in Flanders, the organization successfully addressed the challenge of devising an effective business solution that would meet the mobile nurses' requirements with laptop computers. The system helps the remote nurses exchange information throughout the team, augmenting collaboration with private doctors and improving the health of the children. When Kind & Gezin nurses check in at regional offices before and after home visits, they upload and download record updates via a local area network. The information is replicated to servers on multiple organization levels. One of the system's features consists in enabling the programmatic health care. The nurses are guided through their contacts with children based on a child's age. The application recommends which information and care to provide to family members at different times throughout a child's development.
For the nurses, the on-line iKAROS programme results in more collaboration with doctors and in a new technological paradigm, evolving to thin clients in the office and wireless web-based PDAs on the road. The Vaccination data base contains useful information about all the young Flemish children under the age of 3 and gives external/private doctors access to the vaccination data of their patients. This project is now in pilot phase with about 15 physicians. In turn, iKAROS Home will assist young parents in the initial development of their children, by offering accurate information about events that can occur throughout development. These services will be delivered to Flemish families by way of "web-enabled" televisions. Different scenarios can be imagined. For instance, a mother receiving information about bottle-feeding versus breast-feeding in a multimedia presentation; a baby who doesn't stop crying, urging its parents to join discussion forums with people, who have similar experiences; or parents of a 6-months old baby being reminded that the time for vaccinations has arrived.
IKAROS introduced two major changes in the well-being domain in Flanders. The first and major one relates to collaboration and sharing of data between all parties. Internally, Kind & Gezin information is effectively shared among the district nurses teams and between the different teams in Flanders, 60 in total. Externally, the data is efficiently distributed to doctors and families. The second change constitutes the improved health effect obtained by the global approach and better follow-up, thanks to the unique database and the information system's functionality. Nurses and doctors reach more children and complete first home visits more quickly. In addition, information sharing has helped the health care professionals develop a better understanding and a more profound insight into such issues as child abuse and neglect in the targeted groups.
Given the fact that out-of-the box software and solutions could not be found, iKAROS relies strongly on in-house development, and truly distributed three-tier replication facilities, like master and team servers and laptop computers. These are managed by a central scheduler, introducing a teamware approach in relational database-based applications with thorough exchange as well as collaboration facilities. With the introduction of its new system, Kind & Gezin completely transformed the old-fashioned, paper-based way of working to the innovative and advanced iKAROS solution in only one year. This conversion enables the nurses to leverage technology to reach about 200.000 children. To facilitate the roll-out, Kind & Gezin created an own support & monitoring system. The iKAROS-specific help desk handles about 1000 calls a day.
iKAROS is a solution developed to be used by health care workers, a mostly non-technical and busy population. From the beginning, it has been clear that the success of the project would greatly depend on the usability of the iKAROS application and on the involvement of the user community. A fast and smooth implementation was realized. Only three nurses out of 650, and of which 50% are aged above 40 years and 20% above 50 years, ultimately did not work with the solution every day. In 1999, the roll-out to a greater number of doctors will start, reaching full coverage in the year 2000. The iKAROS project was nominated in the recent Computerworld Smithsonian Award Competition in the category "government and non-profit".