Vitaly Reference Case: Maastricht UMC+: Referral management cancer care

Vitaly Reference Case: Maastricht UMC+: Referral management cancer care

Due to the increasing complexity of cancer care and sub-specializations in this therapy area and more drive for personalized care tailored to individuals, cooperation between different institutions and experts is needed to guarantee the best quality of care.

In the multidisciplinary consultation (MDT meeting), all possible treatment options are discussed, and a treatment plan is drawn up for the patient. Vitaly solution supports the digital process for automated and seamless referral for surgical procedures of these patients, involving all relevant documentation and other health-related data to perform the referral procedure in the shortest time possible.


Challenge

The demand for cross-institution referrals has risen significantly over time. Historically, patients primarily received care within a single hospital. However, an increasing number of patients now require treatment spanning multiple hospitals, creating a pressing need for seamless referral processes.

Today, efficient communication and seamless information transfer are paramount for healthcare collaboration, ensuring quality, promptness, and patient safety. Referral processes (for assessment, treatment, or procedure) are often paper-based, time-consuming, error-prone, and lack real-time information sharing.

Among the primary challenges medical professionals face in this collaborative healthcare landscape is the lack of provider integration and the inconsistent transfer of critical patient information. The incompatibility of electronic health record (EHR) systems between different healthcare providers can impede the seamless exchange of patient information. Non-compliance can affect the effectiveness of the referral process. Besides, incomplete or inaccurate information in referral documentation can impact the receiving provider’s ability to fully understand the patient’s medical history and needs.

 

Solution 

After the multidisciplinary team meeting recommendations have been made, Vitaly supports the digital process for automated and seamless patient referral for the procedure, involving all relevant documentation and other health-related data to perform the referral procedure promptly and comprehensively.

The Vitaly platform introduces a streamlined, transparent, and trackable workflow, considerably reducing administrative burdens. Embracing a patient-centric approach, it furnishes comprehensive data for heightened clinical accuracy and expedited decision-making and referral performance.

Vitaly Referral management: case review and referral workflow that streamlines the administration of patientstransitioning to the next step in their care.

Referral Process Flow:

  • Referral Request via context launch from local Electronic Medical Record

Referral doctors view patient data in their local electronic patient record (SAP) through context launch. They can request a referral to the procedure from their local EMR. The patient data is seamlessly displayed in Vitaly.

Upload and share Documents:
The referring doctor can easily search for documents in MUMC+’s FHIR Repository upload based on the patient’s BSN number and document classification. They can also share patient documents using Vitaly.

All uploaded documents are stored in MUMC+’s FHIR Repository.

 View Patient’s BgZ:
As part of the referral form, users can see a section where structured patient summary data are enclosed. The referring clinician can view the patient’s summary (Dutch: BgZ) in the MUMC+ FHIR Repository and select relevant referral information.

Submit Referral:
Referral doctors can securely select partner organizations that accept the referral. A referral doctor can securely submit a referral to the organization that arranges robotic surgery. The referral doctor sees a list of all outgoing referrals with or without patient context.

  • Receiving/performing the referral

Notification of Incoming Referral:
Vitaly users are securely notified via email and in-app notification of an incoming patient referral.

View Pending Incoming Referrals:
Vitaly user sees a list of pending incoming referrals that haven’t been accepted yet. Referrals are organized in groups according to status. The list displays all ‘submitted’ referrals of respected organizations.

Accept Incoming Referral:
Vitaly user accepts an incoming referral. He/she can view data (BgZ) in the MUMC+ FHIR repository, the third-party institution, and the system. The user chooses data to accept and store in MUMC’s FHIR repository.

  • Finalising referral (viewing, accepting, and transferring data)

View Completed Incoming Referrals:
After the completed procedure, the patient is referred back to the referring hospital. Vitaly user sees a list of completed incoming referrals. Vitaly displays full data obtained from third-party institutions and systems and the selected imported data. No updating of processed referrals is needed; the flow ends after acceptance.

Update Referral:
Vitaly users can update a referral within a specified time frame (initially 2 days). She/he can un-select or select additional ZiBs and documents. Vitaly user can select an action to compare enclosed patient summary structure data and view which sections were changed/updated (according to the one sent when the patient was referred to the procedure).

Patient Search in Standalone Mode:
New referrals are triggered only when launched from SAP; patient search goes to Vitaly’s internal registry.

Standards and Integrations

SAP context launch to Vitaly

  • Starting Vitaly and the referral flow from the local EMR 

FHIR (integration with Firely)

  • Storing all documents sent or received
  • Possibility to view only own data within the FHIR server from the EMR
  • View old data and new data next to each other to copy data to your own systems (FHIR server)
  • Possibility to open the referral app from the EMR
  • Possibility to select/unselect preselected documents
  • Possibility to add documents
  • Support flow for documents not within the FHIR server (necessary for the use case)

NUTS exchange mechanism with third-party hospitals and systems  

BgZ/ZiB: FHIR-based structured clinical data

  • NUTS is a Dutch-oriented decentralized network that is committed to secure data exchange. Built on the W3C Verifiable Credentials Data Model, it ensures data access is secure, verifiable, audited, and under patient control. With the help of the NUTS protocol, this is achieved by implementing robust encryption and identity verification processes, which ensures that patient data is not only protected from unauthorized access but also made readily available to authorized healthcare professionals only.
  • Caregivers of Vitaly now can select the Patient summary (in Dutch Basisgegevenset Zorg / BgZ) and also choose which documents are important to share with the referring institution. This is all based on the NUTS bolt “Zorginzage” for the secure exchange of data. NUTS is tightly coupled with the whole flow of the referral, meaning a user can view all potential receiving hospitals for a specific use case, select one, issue credentials for the clinical data and inform them of a referral being available (notified pull). NUTS ensures the actual data exchange is done securely and viewed only by those with the right to see it.

VIPP 5 Module 3 compliance: VIPP 5 is the Acceleration Program for Information Exchange between Patient and Professional Medical Specialist Care and audiology centers. The program stimulates the secure digital exchange of information between professionals and patients’ personal health records.

Key benefits for patients and/or care professionals

The use of the Vitaly brings many beneficial outcomes for the patients, professionals, and the healthcare system, with some of the most significant being elaborated below.

  • Improved Patient Care: Digital referrals reduce delays in diagnosis and treatment, leading to better patient outcomes. Specialists can access patient records instantly, enabling them to make informed decisions quickly.
  • Enhanced Efficiency: The system streamlines the referral process, reducing administrative overhead, paperwork, and manual data entry. The automated referral process is mainly completed and accessed via the Vitaly application and less via emails, posts, and printed documents. Optimized manual activities and better user experience lead to cost savings and allow staff to focus on patient care.
  • Increased Collaboration and greater transparency: Different healthcare institutions can collaborate seamlessly. For example, referring physicians can easily refer patients to specialists for procedures, fostering a more integrated and personalized healthcare approach. Faster time to referral due to easy-to-use application, having all data available via regional FHIR repository.
  • Data Security: Robust encryption and authentication mechanisms ensure patient data privacy and compliance with healthcare regulations. Structured patient summary data (BgZ) enables better and more comprehensive oversight of the data processed and viewed.
  • Data Analytics: A digitally supported referral system generates valuable data that can be analyzed to identify trends, optimize resource allocation, and improve healthcare delivery.
  • Competitive Advantage: Connected healthcare institutions that embrace digital referral systems can position themselves as leaders in providing modern, patient-centered care.

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