Perhaps, if it was up to perinatologist Dick Oepkes of the Leiden University Medical Centre (LUMC). In the past few years he has felt the lack of a reliable and structured monitoring system in the Dutch prenatal screening process. Which is strange, because in his view it’s already available on the market: the QSPS by BMA.
Maybe Dick Oepkes is not entirely objective. After all, the ties between the LUMC and BMA are close. Also, the QSPS is really ‘his’ thing: ‘You can really call this hospital an experimental garden. My role mainly concentrates on the QSPS. On January 1st, 2007 national prenatal screening took off in the Netherlands. The corresponding quality level has to be maintained and ensured at the regional level. We are responsible for the region called Northern South-Holland. Everybody knew of course that for good quality you need good IT support, but this has been lacking for some time, because other aspects of the screening process received more priority.’ However, in 2006 Dick Oepkes went to Sweden: ‘In Sweden they showed me a multi-functional web-based database that was also used for prenatal screening. To me, this looked very useful for the Netherlands as well. During the International Fetal Medicine and Surgery Society Conference in 2007 on the Dutch island of Aruba the Swedes came into contact with BMA, and BMA later approached me to help them develop the QSPS.’
QSPS: wait or just go ahead?
The real problem is that this issue involves various conflicting developments and interests. The authorities naturally have to stick to a set course, whereas perinatology has its own priorities and the industry has already produced a quality system, the QSPS. This is a web application that is available on a 24/7 basis, which is essential in chain care. Oepkes: ‘The QSPS is ready for use on a national scale. I would even go further: is there any reason not to use it? The National Institute for Public Health and the Environment (RIVM) and the Ministry of Health, Welfare and Sport have to go through a European tender procedure, but both BMA and the LUMC thought that this would take far too long. The situation is that at this moment we do have a good solution that is readily available and offers the perfect quality check for prenatal screening. We have been screening for two years now, and we think a system like the QSPS is needed right now. That is why we purchased it from our own budget. The QSPS complies with all the requirements future users could have. Second, this is a university hospital and we believe that the QSPS will provide a basis for future research.’ Awaiting further national developments Dick Oepkes has already progressed much further: ‘At this moment we are collaborating with the most enthusiastic centres in the region to implement the QSPS, and also to optimise the processes involved. Within three or four months the QSPS could be used in this region on a large scale, allowing people to see for themselves what the advantages really are: less paper, always an overview of your own statistics and an instant check on the quality of all partners in the chain. The QSPS has become what I wanted it to be, a huge step forward from the original Swedish system.’
QSPS fully on course in Leiden
As of January 1st, 2007 the Regional Centre Northern South-Holland is also responsible for the quality of the prenatal screening process in Northern South-Holland. According to Ine de Rijk of BMA, who had a large share in the development of the QSPS, developments in Leiden and surroundings can only be described as highly satisfactory: ‘We see that an increasing number of centres in the chain are starting to enter data in a standardised manner by using the QSPS. At this moment already 2,500 registrations have been entered. One may say that developments are now accelerating.’ This statement is corroborated by Annemieke van Rooden, the prenatal screening coordinator of the region Northern South-Holland: ‘One of my tasks is to visit as many practices as possible and to show them what the QSPS can do. These visits will go on for some time, but it is clear that people become highly enthusiastic once they see what the system can do.’
The power of the QSPS: statistics and data analysis
Apart from the many statistics already available in the QSPS that are based on the requirements for a minimal data set prescribed by the RIVM (National Institute for Public Health and the Environment), BMA is also working on a separate analysis module. This will enable users to make extremely detailed analyses throughout the entire database, extending much further than the current requirements for a minimal data set. Ine de Rijk: ‘This add-on module allows the user to do much more with his or her statistics. For example, the Netherlands Health Care Inspectorate requires an insight into these statistics to see how much time goes by between all the separate steps in the screening process. The QSPS supplies them. The present statistics already render data so much clearer that the participating centres can use them to improve their own working processes.’ Late September 2009 all contracting parties will convene for a regional meeting. At that moment the new add-on analysis module will most certainly be available. Annemieke van Rooden witnessed the first demonstration of this new functionality: ‘It looked very promising. BMA has shown us what the system is capable of. I myself work both on the implementation of the QSPS in the region and as an ultrasound operator in two hospitals in Leiden. The system offers many possibilities. The QSPS allows us to do our work properly and to collect all the data we need to ensure the best possible quality.’ Supported by BMA.