Every patient deserves the healthcare best suited to his or her personal situation. A successful treatment should suit to the personal situation of a patient, which can differ from person to person. The most suitable care is the result of the most suitable treatment and requires patient and healthcare provider to have insight into the outcomes that are relevant for the patient. Patient and doctor should decide together what treatment is best for that particular patient and where the quality of that treatment is guaranteed most. Therefore the Dutch government collaborates with all parties in the healthcare sector in order to make outcome information available and invests €70 million in Outcome-based Healthcare for the years 2018 to 2022.

One of the goals is better access to relevant and up-to-date outcomes information for over 50% of disease burden. Information that is automatically derived from the data that is entered at the point of care in EMR’s. We don’t want doctors and nurses to spend valuable time entering data twice. Time that is better spend delivering care than on administrative tasks.

Automatic generation of outcome data is only possible if the outcome measures are interoperable with the data entered while delivering care throughout Healthcare and exchanged between care providers. Electronic exchange of healthcare information will usecase by usecase become mandatory in Dutch Healthcare. That exchange will be based upon work on semantic interoperability to have unity in language across Dutch healthcare. Standardizing clinical terms such as blood pressure and allergy in “Health and Care Information models (HCIM)”.

We strive to be able to derived outcome measures from that standardized data. Last week we discussed with ICHOM the possibility to harmonize the different outcome sets. And we decided to do a three month long “deep dive” into the current sets and the differences in descriptions of (almost) the same concepts. Not to harmonize per se (but quick wins may be found), but to at least identify harmonization issues to be debated.

I see two obvious goals:

  • Model (and make available) all current ICHOM-measures so to be able to identify different definitions of roughly the same concepts and to identify building blocks used in multiple measures
  • Propose a FHIR-based model for exchanging outcome measures

This will be a joint effort of a number of people. Are you interested to cooperate or review? Please let me know!