Digital care solutions
Care that can be provided at home, we’ll provide at home. This gives patients more control over the care that they receive, and enables health professionals even better to provide care that matches the patient’s needs. To be able to provide the right care in the right place, we are working on an innovative digital care offer using data, artificial intelligence, and digital technology.
In 2021, together with health professionals, our (chain) partners and the Zilveren Kruis health insurer, we continued to develop the foundation to organize and deliver remote care. Based on this, more agreements were signed to finance remote care. We also continued to train our health professionals to provide good remote care and to help patients make optimal use of it. We further continued to expand our Medical Control Center and to equip it structurally for remote care, seeing that more and more patients are making use of this facility.
Smart COVID care
When the COVID crisis broke out in 2020, we at UMC Utrecht started looking for smart ways to provide the best possible care to COVID patients. We implemented for example a Smart Patch to monitor COVID-19 patients from a distance. We used it again in 2021 in our cohort departments. We also developed a smart e-Health application called Early@home , which enabled recovering COVID patients to go home earlier while being monitored effectively with extra checkups and support from our Medical Control Center . In addition, in 2021, we and our partners started with CovidTherapy@home . This intervention ensures that COVID patients who need extra oxygen can be treated and monitored directly at home, thereby lessening the chances that they will be hospitalized.
Home monitoring for pregnant women
In 2021 studies showed the success and safety of our home-monitoring tool SAFE@Home for pregnant women with a high risk of complications during pregnancy due to high blood pressure. About 10% of all pregnant women develop a form of high blood pressure during pregnancy, which can lead to pre-eclampsia. Until now, pregnant patients with a high risk of complications due to blood pressure regularly had to go to the hospital for checkups, sometimes up to three times a week.
SAFE@Home has reduced the number of visits to the outpatient clinic by 20 to 25%, and has led to three times fewer hospitalizations.This means less inconvenience for pregnant women, and cost-savings of about 20%. In total, over 100 pregnant women have taken part in the home-monitoring study via SAFE@Home, from the third month of their pregnancy. Women who participated were positive about the use of the app, the blood-pressure monitor, and the accompanying instructions. In 2021, we expanded SAFE@home in a countrywide upscaling study. In the meanwhile, 10 more academic and peripheral hospitals besides UMC Utrecht have become involved, and over 500 pregnant women have used SAFE@home. We also set up SAFE@home_corona, whereby some 80 pregnant women with COVID could be monitored at home from our Medical Control Center during the COVID crisis. The app was highly rated by pregnant women.
Home monitoring for patients with ALS
In 2021 we introduced our e-Health concept ALS home-monitoring and coaching , with a subsidy from ZonMW , via our care network in 10 rehabilitation institutions. This gives us insight into barriers and conducive factors and successful strategies for importing the e-Health care concept for people with ALS. Based on this, we can continue to develop the concept and bring it even more in line with the needs and desires of ALS patients, their caregivers, and rehabilitation institutions. We can therefore offer a good care continuum and make ALS Home Monitoring and Coaching available to all patients with ALS in the Netherlands.
ALS Home Monitoring & Coaching (ALS T&C) is a care concept that is based on home monitoring where patients with ALS answer questions about their health at fixed hours using an app, and maintain contact with healthcare professionals. A care coach gives feedback on the information that they have filled in, answers questions, and schedules appointments with the ALS treatment team if necessary. 7 out of the 10 institutions that participated, decided to continue using ALS Home Monitoring and Coaching.
AI for patient care
In 2021 we also made good progress in applying artificial intelligence (AI) in our health care. This enables us to provide bespoke care and thereby ensure better quality of care for patients, often at a lower cost.
We have for instance started to use artificial intelligence in treatment for patients with rheumatic fever . Patients with rheumatic fever would often like to scale down medication if the disease process has been under control for some time. But with scaling down, there is always the risk that rheumatic symptoms will increase again. To reduce the risk of such a flare, UMC Utrecht used data science technologies to develop a predictive computer model . It makes use of regularly available information on the patient, such as blood-test results, use of medication, and disease activity. The model can then be used to decide at each subsequent step of scaling down medication, whether it is indeed safe.
In 2021 we also made good progress in applying artificial intelligence (AI) in our health care.
Since the end of 2021 we have also been using the AI app Sleep Well Baby in our neonatology department. Sleep Well Baby analyses aspects like heartbeat and breathing in real time to give insight into the sleep patterns of vulnerable premature babies. In the near future, it will enable us to administer care at times when the baby is awake. We will therefore need to disturb the babies less or not at all during their sleep. Babies sleep significantly less in incubators than in the womb, even though sleep is very important for premature babies’ optimal growth and brain development.
The impact of both AI applications on patients’ health is now being studied in practice.
Patient portal mijnumcutrecht.nl
Via the online patient portal mijnumcutrecht.nl patients can check their medical information fast and securely, and have the possibility to control the care that they receive. Via an e-consultation on the portal, a patient can for example ask their doctor a (non-urgent) question or ask for a repeat prescription. Due to COVID-19 we delivered more remote care, which means that the number of patients who logged in to the patient portal rose considerably in the past two years. In 2021, 355,000 patients logged into the portal (unique logins). In 2020 there were 282,697. The portal scores a good average satisfaction rating of 8.4.
Based on the patient’s ‘journey’ at UMC Utrecht and on the online patient portal, we have looked at how we can support patients even better. As a result, we have improved information supply in several ways. Patients now receive improved notifications (emails) in which the information helps the patient to prepare for a visit to UMC Utrecht. All appointment letters now also have a QR code that links to the most up-to-date and relevant information for the patient. This gives patients an idea of the journey that they can expect. Caregivers and friends and relatives of the patient can also receive authorization from the patient. This means they can look at the patient portal as well and take some of the burden of the patient.
Due to the COVID pandemic we delivered more remote care. An important way to ensure that we can keep providing good care is video consultations. As a result, the number of video consultations rose tremendously in 2020 and 2021.
The number of e-consultations; an email from a patient to a practitioner via mijnumcutrecht.nl, also continued to rise in 2021.