Abstract
Introduction: Due to the covid pandemic, healthcare resources for chronic primary care are scarce. Care should be delivered to people with the highest risk of deterioration. Therefore, general practitioners (GPs) and nurse practitioners (NPs) are faced with a high workload and, thus, an urgent need to identify people’s vulnerability .
Although many digital tools giving insight into aspects of vulnerability are available, their use by healthcare providers in general practice is limited. Insight in needs and preferences of healthcare professionals concerning the design and use of a tool that helps identification of people’s vulnerability is lacking, including the impact on people’s health.
Aims, Objectives, Theory or Methods: This mixed-methods prospective study is based on the ‘Technology Readiness Level’ model (1). Following the TRL model, with a qualitative approach, the objectives are: 1) to provide insight in healthcare professionals’ wishes concerning the design of a ‘vulnerability tool’ (level 1); 2) to develop a tool that is rooted in current evidence on vulnerability and expert opinions (level 2); 3) to get insight into key conditions for successful implementation in GP practice (level 3). 4) understanding the effect on people’s health outcomes, which will be explored with quantitative methods.
Highlights or Results or Key Findings: Level 1: vulnerability of people should be identified for COPD, cardiometabolic diseases and elderly . Recommendations concerning follow-up such as advance care planning should be provided.
Level 2: an interdisciplinary key team (two experienced GPs and NPs, one ict expert), led by a behavioural scientist, defined a first use case targeting COPD. Four determinants associated with risk of rapid deterioration were defined. Based on patient registry data, a digital ‘traffic light’ dashboard was construed depicting people with high, elevated and medium vulnerability, including a roadmap for tailored proactive follow-up.
Level 3: in 2022, the dashboard will be tested as an experimental proof of concept in 5 Dutch GP practices. The implementation process will be monitored with focus groups among practice staff. Furthermore, people’s satisfaction will be measured with interviews and health outcomes will be evaluated based on routine data registry. Based on these results Level 4 will be determined. At the conference first results of this testing will be shared.
Conclusions: The dashboard ‘View on vulnerability’ meets the preferences of primary healthcare professionals in daily practice. Considering the easy-accessible insight into the vulnerability of people and the enthusiasm of practices for study participation, it might support primary healthcare professionals in times of limited resources with proactive population health management.
Implications for applicability/transferability, sustainability, and limitations: The dashboard might help to tailor care to people’s vulnerability, resulting in slower deterioration of chronic conditions and a decreased workload of GPs and NPs. For a better understanding of the dashboard’s impact on people’s experiences and health outcomes, professionals’ workload and cost effectiveness, a broader exploration is warranted.
References
1.European Association of Research and Technology Organisations. The TRL Scale as a Research & Innovation Policy Tool, EARTO Recommendations. Brussels, Belgium; 2014.