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Belgium is in a transition from paper-based prescriptions to electronic prescriptions (ePrescriptions). Since patients still receive a paper proof of the ePrescription, this proof is sometimes used as a paper-based prescription. In this study, the frequency of incorrect use of the paper proof was evaluated and possible reasons for incorrect use were hypothesized. In 10,000 prescriptions, 226 ePrescriptions (2.26 %) were handled incorrectly. Possible reasons for this handling are (1) non-compliance of the community pharmacist; (2) errors in software or handling of the community pharmacist; (3) errors at the prescriber side or patient tries to fraud; (4) incorrectly revoking the ePrescription; and (5) errors in prescriber's software. The presence of incentives and penalties might help in preventing this erroneous type of handling.

Diabetes is one of the most challenging problems in the 21st century, whereby research showed that reducing the concentration of blood glucose is thought to prevent or reduce the long-term complications. To do so, a multidisciplinary approach is favourable. In Belgium, a revalidation programme for the diabetic patients concerning self-regulation was introduced followed by the introduction of the Diabetes Pass in March 2003 whereby some goals were stipulated. In IBBT-COPLINTHO, a still ongoing project, an eHomeCare platform is implemented whereby the patient is the central actor. The analysis of the current paper-based Diabetes Pass revealed that the data can be easily extracted from the EHR. An electronic alternative for the Diabetes pass is proposed whereby the added values for the patient are underlined. Before implementing the electronic alternative, some research should still be done, but it is thought that all the actors involved--including the patient, could easily benefit from the electronic alternative.

BACKGROUND: Do-it-yourself technologies such as 3D printing offer interesting opportunities for creating custom-made assistive devices for people with disabilities. Although these opportunities are increasingly acknowledged, it remains unclear how 3D printing technology should be implemented in assistive devices delivery processes. OBJECTIVE: In three separate action research projects carried out in Belgium, Italy and The Netherlands, workflows were designed and evaluated that incorporate 3D printing as a standard option for providing clients with suitable assistive devices. METHODS: In this paper we describe and compare the three workflows that were conceived simultaneously, yet independently from each other. RESULTS: Based on the evaluations of these workflows, and the experiences of the researchers who developed the workflows, we provide recommendations for implementing 3D printing as a common approach in assistive device delivery processes in practice. Most importantly, designing and manufacturing should be done by means of a client-centered co-creation process by interdisciplinary teams of clinicians, clients, and 3D printing experts. We provide several recommendations for facilitating and supporting collaborations within such teams. CONCLUSIONS: The three workflows presented in this paper are strikingly similar and therefore provide a convincing starting point for interdisciplinary design teams who wish to embark on 3D printing custom-made assistive devices. [ABSTRACT FROM AUTHOR]

BACKGROUND: The assessment of work capacity, workable work and the need for a common language is challenging in labour market policy. Being a specific instrument to facilitate Return To Work (RTW), the Integration von Menschen mit Behinderungen in die Arbeitswelt (IMBA) might facilitate the documentation of the individual's work capacity, the job-related workload and the match between these two elements. Since the International Classification of Functioning, Disability and Health (ICF) is worldwide recognized as frame of reference in RTW, this paper presents the linking of IMBA to the ICF, since this is assumed to be beneficial to support RTW. OBJECTIVE: The establishment of the IMBA-ICF linking in order to study 1) the relationship between IMBA and ICF; 2) the content comparison of IMBA with work-related ICF core sets; and 3) the extent to which the linking addresses the challenges in RTW policy. METHODS: A content comparison of IMBA and ICF was conducted, using a 7- step linking methodology in which the Delphi and Nominal Group Technique are integrated in the implementation of the ICF linking rules. An explorative conversion of the scoring systems of IMBA and ICF was established based on expert opinions. RESULTS: In the main 70 IMBA items, 107 concepts have been identified of which 94 were linked to 87 different ICF categories. Body functions and activities and participation are the most presented ICF components in contrast to the environmental factors. IMBA items regarding occupational safety and work organization are respectively 'not covered' and 'not defined' in ICF. CONCLUSIONS: An integration of IMBA and ICF addresses the challenges in RTW policy in the assessment of work capacity, workable work and the need for a common language. In order to do so, extension of ICF terminology regarding 'occupational safety' and 'work organization' is priority. In depth quantitative research is necessary to support the conversion of both scoring systems. [ABSTRACT FROM AUTHOR]

In this paper, we present an original environment, the Distributed Collaborative Design Studio (DCDS) which allows multimodal real-time remote exchanges, and which aims at re-creating remotely the conditions of co-present meetings. This environment associates a videoconference tool (supporting verbal and non-verbal communication) and an original realtime shared digital hand-drawn sketches system (supporting graphical communication). The users can import documents and annotate them in real-time at distance. In this paper, we are interested in studying the use of the graphical modality (digital sketch and document annotations) as a tool for collective design and remote communication. This study takes place in the framework of a collaborative architectural design studio, which has taken place during 3 month, and gathering students from Belgium and France to work together in 3 small groups mainly at distance. The study focuses on the role of graphical modality in the synchronous remote meetings supported by the DCDS. We identify the types of digital annotations made on the imported document, thanks to the electronic pen, and their role in the cognitive processes of designing and in the collaboration and communication processes. We also identify the different practices of digital sketching, according to the group and its collaborative strategies. We discuss the utility of the graphical modality as an efficient support for collaborative synchronous activities and show that the DCDS environment supports different strategies of collaborative design (co-design and distributed design). We conclude on recommendations for improving the system and for designing sketch-based collaborative environments. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous research demonstrated the negative consequences of precarious employment for the health and well-being of employees. However, the broader social consequences of precarious employment are under-examined. OBJECTIVE: This study explores the broader impact of precarious employment on the life course, family and social life of households. A multi-actor perspective is adopted, considering the perspectives of different household members. METHODS: For this aim, in-depth (household) interviews among temporary agency workers in Belgium are conducted. RESULTS: The results reveal that precarious employment influences the life course and family and social life in three ways: (1) by hindering or facilitating life course events and transitions of household members, (2) by influencing the daily life and household planning, and (3) by influencing the mood of household members. CONCLUSION: The consequences of precarious employment reach further than the work environment; they impact the life course, and social and family life of workers. Moreover, precarious employment does not only influence the workers themselves, but also their household members, which is often forgotten in studies. Therefore, policy makers should consider the far-reaching consequences of precarious employment when developing (flexible) labour market policies. [ABSTRACT FROM AUTHOR]

Vision in general and images in particular have always played an important and essential role in human life. Today, image processing is a very active research area with many applications. In order to cope with the wide variety of image processing problems, several techniques have been introduced and developed, quite often with great success. Among the different techniques that are currently in use, we also encounter fuzzy techniques. The use of fuzzy techniques in image processing is one of the main topics of the Fuzziness and Uncertainty Modelling Research Group of Prof. Kerre. In this paper, we briefly summarize some achievements of the past years. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is a growing interest in HR-analytics because of its ability to analyze employee behavior based on HR data. Predicting voluntary turnover of employees is an important topic of study, both in academia and industry. OBJECTIVE: The current study analyzes determinants for turnover, distinguishing between blue and white collar workers. The turnover analyses are based on a dataset from a payroll company, in contrary to previous turnover studies that used survey and interview data. METHODS: The studied dataset contains demographic and work specific factors for more than 380000 employees in 15692 Belgian corporations. Logistic regression is used to estimate individual turnover probabilities, the goodness of the model is tested with the AUC method. RESULTS: The study confirms turnover determinants and differences between blue and white collar workers that were described in previous work based on survey and interview data. Additionally, the study exposes so far unstudied turnover determinants and differences between blue and white collar workers. Confirmed determinants are among others age, seniority, pay and work distance. New determinants are company car, meal vouchers, night work and sickness. Different relationships to turnover are revealed for blue and white collar workers based on gender, number of children, nationality and pay. CONCLUSIONS: The presented dataset-based approach has its merit in analyzing turnover: it enables to study actual turnover instead of turnover intentions, and reveals new turnover determinants and differences between blue and white collar workers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several studies have been performed on the relationship between working conditions and health. Numerous parameters still require further study, including working hours and obesity among different groups, specifically older workers in national, regional, and international levels. OBJECTIVE: Working hours have considerable effects on the socio-cultural, psychological, and economic aspects of people's lives and health. While long working hours increases income level and raises living standards, it increases the risk of certain health problems. This study investigated whether working hours are associated with obesity in upper-middle-aged workers. METHODS: The Survey of Health, Ageing and Retirement in Europe (SHARE) dataset was used for the analyses. Analyses were carried out by means of a Cox regression of the panel dataset created with the data in question, surveyed by European Commission to 12,000 participants. RESULTS: The survey was performed in Austria, Belgium, Switzerland, Germany, Denmark, Spain, France, Greece, Italy, the Netherlands, Sweden, the Czech Republic, Poland, and Ireland. We found that in most countries, especially Sweden and the Netherlands, upper-middle-aged employees working > 59 hours per week are more likely to gain weight than their counterparts working < 59 hours. CONCLUSIONS: Our findings raise awareness of obesity in older workers, and highlight the need to regulate working conditions and hours in the European Union and other countries. [ABSTRACT FROM AUTHOR]

This article investigates which public values are prioritized in e-government policies, what the connection is to governance approaches and how the public value prioritization can be explained. Strategic horizontal e-government policy documents are analysed from 2000 to 2018 in Belgium, the United Kingdom and the European Union. A public value typology is developed which connects three-ideal type governance approaches: (1) hierarchy, (2) market and (3) network. The results show that market related public values often play a dominant role in e-government policy documents, but so do – to a lesser degree – network related public values. Hierarchy related public values are seldom dominant. At the national level, four factors explain the prioritization: The attention for a specific governance approach at a given time, the influence of politics, the specific topic of the e-government policy document and the role of authors. Power distribution at the EU level plays a key role in defining the public values balance. This articles contributes to the knowledge on public values in e-government policies, the wider discussion on governance approaches in public administration and the need to understand the relation between public values and public value creation. [ABSTRACT FROM AUTHOR]

Focuses on the Elizabeth Haub Prizes for exceptional services to international environmental law in Brussels, Belgium. Areas of activity in the field; Professional degrees of the award winners; Speech of Wolfgang E. Burhenne, Executive Governor of the International Council of Environmental Law.

OBJECTIVE: Ankle rigidity is a common musculoskeletal disorder affecting the talocrural joint, which can impair weight-bearing ankle dorsiflexion (WBADF) and daily-life in people with or without history of ankle injuries. Our objective was to compare the immediate effects of efficacy of Mulligan Mobilization with Movement (MWM) and Osteopathic Mobilization (OM) for improving ankle dorsiflexion range of motion (ROM) and musculoarticular stiffness (MAS) in people with chronic ankle dorsiflexion rigidity. DESIGN: A randomized clinical trial with two arms. METHODS: Patients were recruited by word of mouth and via social network as well as posters, and analyzed in the neuro musculoskeletal laboratory of the “Université Catholique de Louvain-la-Neuve”, Brussels, Belgium. PARTICIPANTS: 67 men (aged 18–40 years) presenting with potential chronic non-specific and unilateral ankle mobility deficit during WBDF were assessed for eligibility and finally 40 men were included and randomly allocated to single session of either MWM or OM. INTERVENTIONS: Two modalities of manual therapy indicated for hypothetic immediate effects in chronic ankle dorsiflexion stiffness, i.e. MWM and OM, were applied during a single session on included patients. MAIN OUTCOME MEASURES: Comprised blinding measures of MAS with a specific electromechanical device (namely: Lehmann’s device) producing passive oscillatory ankle joint dorsiflexion and with clinical measures of WBADF-ROM as well. RESULTS: A two-way ANOVA revealed a non-significant interaction between both techniques and time for all outcome measures. For measures of MAS: elastic-stiffness ( p = 0.37), viscous-stiffness ( p = 0.83), total-stiffness ( p = 0.58). For WBADF-ROM: toe-wall distance ( p = 0.58) and angular ROM ( p = 0.68). Small effect sizes between groups were determined with Cohen’s d ranging from 0.05 to 0.29. One-way ANOVA demonstrated non-significant difference and small to moderate effects sizes ( d = 0.003–0.58) on all outcome measures before and after interventions within both groups. A second two-way ANOVA analyzed the effect of each intervention on the sample categorized according to injury history status, and demonstrated a significant interaction between groups and time only for viscous stiffness ( p = 0.04, d = - 0.55). CONCLUSION: A single session of MWM and OM targeting the talocrural joint failed to immediately improve all measures in [ABSTRACT FROM AUTHOR]

BACKGROUND: From an employee-perspective, temporary agency employment can be considered in twoways. According to the first perspective, agency jobs are associated with job characteristics that adversely affect mental well-being: job insecurity, low wages, a lack of benefits, little training, poorer prospects for the future, high working time flexibility, minimal trade union representation and problematic triadic employment relations. The other perspective underlines that flexibility, learning opportunities and freedom in agency employment enable workers to build the career of their choice, which may positively affect mental well-being. OBJECTIVE: This article aims at interpreting and explaining these conflicting perspectives. In particular, we discuss the role of coping resources (control, support, trust and equity) in the stress pathway between characteristics of temporary agency employment and mental well-being. METHODS: Semi-structured interviews with 12 Belgian temporary agency workers were conducted and analysed from a phenomenological perspective. RESULTS: The results reveal mainly how a lack of coping resources plays a key role in how (precarious) characteristics of temporary agency employment affect employees' mental well-being. CONCLUSIONS: This study illustrates the earlier assumed stress pathway between precarious employment and mental well-being, in which coping resources play an intermediary as well as a moderating role. [ABSTRACT FROM AUTHOR]

BACKGROUND: Employees working for office-cleaning companies are directly affected by the growing competition in this sector. They face a heavier workload and heightened psychological pressure. A majority of these workers are less qualified women working part-time, with flexible and inconvenient schedules. OBJECTIVE: The objective of the study is to highlight the workers' strategies to deal with fast work, schedule requirements and the consequent difficulties to reconcile their professional and private life commitments. METHODS: This study is based on in-depth interviews.PARTICIPANTS: One hundred and twenty-five male and female workers responsible for cleaning offices. RESULTS: The themes generated from the results highlight a continued deterioration in working conditions in this sector. They also show that even approximate respect of the theoretical workload as calculated by the sub-contractor and the client company mainly depends on the workers' subjective strategies to accommodate increasingly fragmented work hours with their private lives. CONCLUSIONS: In conclusion, since these individual strategies are not enough to make up for the deterioration in work conditions, improving them requires sub-contractors and client companies to agree on organisational arrangements that take into account the reality of the employees' lives. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to identify atherosclerotic risk using pulse wave velocity (PWV) in steel workers employed in different shift-work rotations, and to elucidate its relationship to social jetlag and shift schedule details. PARTICIPANTS: Male workers in a steel factory (n=77, 32 fast clockwise (CW), 30 slow counterclockwise (CC), 15 day workers (DW); mean age 42 ± SD 7.6 yrs) with at least 5 years of experience in their current work schedule participated. METHODS: All workers completed questionnaires on demographics, health, psychotropic agents, sleep, social and work life, social jetlag (difference between mid-sleep time on workdays and days off used as a marker of circadian disruption) and chronotype (mid-sleep time on free days corrected for sleep deficit on workdays). In 63 workers we measured PWV, blood pressure (BP), heart rate (HR) between 08:00 and 12:30 h in controlled posture conditions (no caffeine/smoking/exercise). RESULTS: There was no significant difference in PWV (covariates: age, BP) between the different shift-rotations (CW, CC and DW). In all workers combined, HR and social jetlag were significantly positively correlated. Demographic variables did not differ between shift-workers and day workers; shift-workers (CW, CC) reported significantly more stomach upsets, digestion problems, weight fluctuations, and social jetlag. The CW and CC workers did not differ in ratings of how shift-work affected sleep, social and work life. CONCLUSIONS: PWV was not different between the two shift-rotations. This pilot study shows first evidence that HR is related to social jetlag, and therefore warrants more studies in different shift schedules. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the inter-rater reliability of the Merkmalprofile zur Eingliederung Leistungsgewandelter und Behinderter in Arbeit (MELBA). PARTICIPANTS: Twenty-five young adults with psychosocial limitations. METHODS: The MELBA measures work ability in five themes: cognitive, social, work performance, psychomotor characteristics and cultural/technical communication, divided into 29 work-related items, which are assessed by work-related tasks and by observations during work performance. Two raters independently evaluated one participant during the same time/test and independently assigned scores on 19~items out of 29. For this observational study the inter-rater reliability, expressed as the Intraclass Correlation Coefficient (ICC), was calculated for every item. An ICC of at least 0.75 was considered as showing good reliability, below 0.75 was considered poor to moderate reliability. RESULTS: The ICC for six items was good: comprehension (0.81), attentiveness (0.84), problem solving (0.79), imagination (0.88), independence (0.79) and speed of reaction (1.0) showed good reliability. CONCLUSION: Especially the items of cognitive characteristics of the MELBA showed a good inter-rater reliability and can be used to measure work ability in people with psychosocial limitations. [ABSTRACT FROM AUTHOR]

The sleep system (i.e. the combination of mattress and bed base) is an important factor of the sleep environment since it allows physical recuperation during sleep by providing proper body support. However, various factors influence the interaction between the human body and the sleep system. Contributing factors include body dimensions, distribution of body weight and stiffness of the sleep system across the mattress surface. During the past decade, the rise of several new bedding technologies has made it increasingly difficult for the consumer to select a proper sleep system. Therefore, this study presents a method to model human-bed interaction in order to objectively predict the ideal sleep system for a particular individual. The proposed method combines a personalized anthropometric model with standardized load-deflection characteristics of mattress and bed base. Results for lateral sleep positions show a root mean square deviation of 11.9 ± 6.1 mm between modeled spine shapes and validation shapes, derived from 3D surface scans of the back surface. The method showed to be a reliable tool to individually identify the sleep system providing superior support from a variety of possible mattress-bed base combinations. [ABSTRACT FROM AUTHOR]

The aim of this study is to establish whether the Assessment of Motor and Process Skills (AMPS) is an appropriate tool to evaluate the quality of work performance by comparing clients' results on the AMPS with the quality of the skills that they demonstrate on the shop floor. A convenience sample of chronically unemployed (vocationally disabled) participants (N=139) with no formal training who were seeking unskilled work through Jobcentrum West-Vlaanderen (West Flanders Job Centre, Belgium) was used. Results demonstrated that in 75.2% of cases the prediction of employment outcome was correct; it is suggested that an AMPS motor score < 2.5 and a process score < 1.2 is insufficient for regular employment, while a motor score > 3.1 and process score > 1.5 indicates that regular employment is a realistic goal. The quality of the motor skills measured by the AMPS and measured on the shop floor are comparable, but little similarity was found in the measurement of process skills. [ABSTRACT FROM AUTHOR]

Abstract: Two dominant species of Willow (Salix triandra) and Reed (Phragmites australis) along the Schelde Estuary (in Belgium) were selected in this research. The pigments of higher plant was used as biomarkers, the decomposition process of the two species were studied after they fall into the Schelde Estuary. After statistical analysis (Spearman rank order correlation, P < 0.05), the results has shown the decomposition dynamics pattern of the pigments, and the willow showed different pattern in comparing with the reed, e.g. Chlorophyll-a decomposition dynamics for willow is: γ[sub 1] = 12196χ² - 175895χ + 1E + 06 + k, R² = 0.5706 while for reed is: γ[sub 2] = - 37878χ² + 229782χ + 734282 + k, R² = 0.9065. The precise time of the leaf litter spent in the water was also calculated as were less than 24 days, 24 - 37 days, longer than 37 days (willow) and less than 24 days, longer than 24 clays (reed), the leaf litter fate of the two dominant species in the Schelde Estuary was also compared. [ABSTRACT FROM AUTHOR]

Highlights the First International Workshop on Ant Colony Optimization (ACO) in Brussels, Belgium from October 14 to 16, 1998. Aim of the workshop; Presentation of the ACO meta-heuristic; Improvements of the performing ant algorithms for telecommunication applications.

The article highlights the bi-annual conference Informatie2005 held in Brussels, Belgium on September 22-23, 2005. Almost one third of the 900 delegates had attended both days of the event. A list of library supplier exhibitors in the event was presented, including 3m, Ex Liris company, the Vlaamse Centrum voor Openbare Bibliotheken or the Flemish Center for Public Libraries, LIBIS-Net and ADLIB Information System. The presenters on the event include Dspace on the use of digital library application, combination of integrated processing and management by electronic resource management, and application of the depot server for digitized video records by E-depot of the Municipal Archives of Rotterdam and Library and Documentation Centre.

Provides information on Benelearn, a series of annual workshops on machine leaning in Belgium. Issues facing Benelearn; Participants of the workshops; Highlights of the workshops.

We assessed the impact of a nation-wide ambulatory care complex intervention (the "care trajectory program") on quality of care in Belgium. We used the three-step public health triangulation method described in this paper and data from four different data sources: a national reimbursement database, an electronic patient record-based general practitioner network, the Belgian general practitioner sentinel network, and a new national registry for care trajectory patients. By applying our method and using the available evidence, we identified key findings that have been accepted by experts and stakeholders. We also produced timely recommendations for the decision-making process, four years after the start of the care trajectory program.

Starting in 2009, the first ever Belgian nationwide data collection network using routine data extracted from primary care EPR (upload method) has been built from scratch. The network also uses a manual web-based data collection method. This paper compares these two methods by analysing missing and most recent values for certain parameters. We collected data from 4954 practices, pertaining to 29,180 patients. Mean values for the most recent parameters were similar regardless of which data collection method was used. Many missing recent values (&gt;46%) were found for all of the parameters when using the upload method. It seems that, in Belgium, uploading routine data from primary care EPR on a large scale is suitable and allows the collection of chronological retrospective data. However, the method still requires major, carefully controlled improvements.

Efficiency and privacy protection are essential when setting up nationwide research networks. This paper investigates the extent to which basic services developed to support the provision of care can be re-used, whilst preserving an acceptable privacy protection level, within a large Belgian primary care research network. The generic sustainable confidentiality management model used to assess the privacy protection level of the selected network architecture is described. A short analysis of the current architecture is provided. Our generic model could also be used in other countries.

There are many secondary benefits to collecting routine primary care data, but we first need to understand some of the properties of this data. In this paper we describe the method used to assess the PPV and sensitivity of data extracted from Belgian GPs' EPR (diagnoses, drug prescriptions, referrals, and certain parameters), using data collected through an electronic questionnaire as a gold standard. We describe the results of the ResoPrim phase 2 project, which involved 4 software systems and 43 practices (10,307 patients). This method of assessment could also be applied to other research networks.

Personalized medicine may be considered an extension of traditional approaches to understanding and treating diseases, but with greater precision. A profile of a patient's genetic variation can guide the selection of drugs or treatment protocols that minimize harmful side effects or ensure a more successful outcome. In this paper we describe a decision support system designed to assist physicians for personalized care, and methodology for integration in the clinical workflow. A reasoning method for interacting heterogeneous knowledge and data is a necessity in the context of personalized medicine. Development of clinical decision support based semantic web for personalized patient care is to achieve its potential and improve the quality, safety and efficiency of healthcare.

Dedicated primary care research networks aim to gather and analyse data collected from general practioners' (GPs) electronic health records (EHRs). ResoPrim (2003-2008) was a Belgian multidisciplinary research project which was set up to provide recommendations for facilitating the organisation and management of these primary care research networks, assessing and improving opportunities for researchers working with available data from EHRs, and stimulating the involvement of GPs in such networks. This paper provides a short description of Resoprim's global methodology (which included 2 pilot phases involving 64 GPs and 6 different software systems), followed by the project's final recommendations.

This paper describes the results of the KINELECTRICS project. Since more and more clinical documents are stored and transmitted in an electronic way, the aim of this project was to design an electronic version of the registry that contains all acts of physiotherapists. The solution we present here, not only meets all legal constraints, but also enables to verify the traceability and inalterability of the generated documents, by means of SHA-256 codes. The proposed structure, using XML technology can also form a basis for the development of tools that can be used by the controlling authorities. By means of a certification procedure for software systems, we succeeded in developing a user friendly system that enables end-users that use a quality labeled software package, to automatically produce all the legally necessary documents concerning the registry. Moreover, we hope that this development will be an incentive for non-users to start working in an electronic way.

As widely discussed in the literature, there are many potential scientific usages of data extracted from the primary care Electronic Health Records (EHR), such as quality of care, epidemiological or socio-economical studies. Yet, can we use the current available data in the EHR for such purposes? In this paper, our objective is to report on the preliminary findings of the Belgian ResoPrim project (2003-2005) to answer the question. We set up a semi-anonymous network involving 26 current practices (28 volunteer GPs), 3 different EHR software systems and two Trusted Third Parties. Based on a literature overview we identified 27 research questions to be answered using 50 indicators. The study design includes retrospective (2002-2004) and prospective (6 weeks) data collection processes around the theme of "Hypertension and cardiovascular risk factors". For some data sets, the data extraction was a full automatic procedure, for some others, the data extraction was related to an input from the GPs allowing some comparisons between both procedures. At this stage, we performed an extended descriptive analysis of our data. Retrospectively we collected data related to 42,217 patients and 203,128 contacts. Prospectively we collected data for 9,236 patients and 15,234 contacts. Our main findings are briefly presented and discussed in this paper. The most promising fields seem to be the Health Research Information Systems assessment and the quality of care studies. It is quite too soon to reach the expected theoretical benefits for epidemiologic and socio-economic studies, yet some progresses could be made in relation with the denominator issue. Based on our preliminary findings and hypotheses, further analyses are foreseen during the second phase of the project (2006-2007).

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liège to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study started in 2000 and will end with the implementation of the revised B-NMDS in January 2007. The study entailed four major phases. The first phase involved the development of a conceptual framework based on a literature review and secondary data analysis. The second phase focused on language development and development of a data collection tool. The third phase focused on data collection and validation of the new tool. In the fourth phase the validity and reliability of the dataset was tested. The new dataset is without avail if it is not leading to new information. Four applications of the dataset has been defined from the beginning: evaluation of the appropriateness of stay (AEP) in the hospital, nurse staffing, hospital financing and quality management. The aim of this paper is to describe how the B-NMDS can contribute to each of these applications.

The paper tackles the topic of collecting data from home visits using the electronic patient record (EPR) of general practitioners (GPs), in a context with a high proportion of home visits in primary care. Since data from home visits, representing about 40% of GPs' consultations in Belgium, are rather scarcely recorded in the EPR, we wanted to study the impact of not taking into account home visits for quality assessment in primary care. Five quality indicators, which measured the accordance of the delivered care with guidelines on the management of osteoarthritis, were compared between a pooled database (consultations and home visits) and a restricted database (after removal of home visits). Our findings suggest that removing home visits from a database collected from primary care may provide a slight modification of the estimate of the quality of care, whereas conclusions on quality improvement remain relatively stable. Quality of care assessment with the EPR of GPs seems not to be dramatically hampered by the poor recording rate of home visits in the EPR.

This paper describes the process of revising the Belgian Nursing Minimum Data Set (NMDS). The study started in 2000. Implementation is planned from 2006. The project is divided in 4 major phases. The first phase (June-October 2002) implied the development of the conceptual framework based on literature review and secondary data-analysis. The Nursing Interventions Classification (NIC) was selected as framework for the revision of the NMDS. The second phase focused on the language development (November 2002 - September 2003) with panels of clinical experts (N=75) for six care programs. They indicated hospital financing, nurse staffing allocation and assessment of the appropriateness of hospitalization as priorities of a revised B-NMDS. A draft instrument with 84 variables, using NIC, was developed during this period. This leads to an alpha version of a revised NMDS. The third phase (October 2003 - December 2004) focused on the data collection and validation of the new tool. The new NMDS was tested on 158 nursing wards in 66 Belgian hospitals from December 2003 until March 2004. This test generated data for some 95.000 inpatient days. The interrater-reliability of the revised NMDS is tested. The criterion-related validity of the revised NMDS is compared with the actual NMDS. The discriminative power of the revised NMDS is tested to select the most relevant items for data collection. This will result in a beta version of revised NMDS in December 2004. The records of the revised NMDS are linked with the hospital discharge dataset and other mandatory datasets to integrate the revised NMDS in the broader health care management. The fourth phase (January-December 2005) will focus on information management.

Operating Room (OR) information systems should manage the OR time, assigned to every surgeon, thereby minimizing the sum of costs of unused OR time and minimizing the costs of elective cases performed outside normal allocated OR time (excess OR-time). The aim of this paper is to illustrate how the introduction of an OR information system influenced daily OR activity performance. Since January 2001, we introduced an OR information system with a visual, airport-like, screen as central part, displaying all scheduled OR activity linked in real-time activity with all OR theatres. For the aim of this paper, we compared all data of OR activity for elective abdominal surgery (EAS) for the first half of 2000 compared to the first half of 2001, after the introduction of our information system. In 2000, 764 elective cases were performed, compared to 815 cases in 2001. For both periods, the total OR time allocated to EAS for this 6 months period was 805 h. For 2000, the total duration of OR activity for EAS was 1044 h 50 min (implicating 239 h 50 min over-time), compared to 1127 h 35 min (implicating 322 h 35 min overtime) for 2001. For 2000, we recorded 147 h 20 min excess time (=exceeding the time limits of OR activity and inducing extra costs) and 46h45min unused OR time. For 2001, we recorded 123 h 04 min excess time and 35 h 21 min unused time. In conclusion, in 2001 we recorded an increase in total OR activity for elective abdominal surgery by 7% in number of procedures and by 8% in total duration. However, in 2001 we recorded a decrease in excess time by 16% (123 h 04 min vs 147 h 20 min), which was for a large part due to a 23% decrease in unused OR time in 2001 compared to 2000 (35 h 21min vs 46 h 45 min). Therefore, the introduction of an OR information system, with a real-time visual display of ongoing OR activity, resulted in a increased performance of OR activity, with more OR procedures performed despite less excess time and less extra costs.

This paper aims to propose an action plan for the deployment of the use of digital signatures in Belgian healthcare. This action plan is the result of a number of technical, legal and organisational requirements. It starts by establishing the functional components that are needed to set up a framework for the deployment of digital signatures. The main components should implement an infrastructure for: --the creation of digital signatures; --the verification of digital signatures; --the certification of signature keys; --the certification of attributes; --the handling of revocation. The tasks in the action plan are the logical consequence of all the functions that need to be addressed. The objective of this report is to list what has to be done and how it can be done in the context of healthcare, rather to state who will perform the functions required.

This paper will demonstrate the added value of a Process Oriented Hospital Information System based on the current trends and changes in the organisation of patient care in hospitals. To support the integrated patient care with IT, basic functionalities will be described.

A methodology to construct specific messages with clear objectives inside clinical processes, while simultaneously including contextual information, remains a problem today. This paper addresses the issue of combining specific message context (process driven) with the context of a patient record (patient centered). In Belgium, simplified conceptual models for Electronic Patient Record (EPR) architecture and for message architecture, based on previous comprehensive and international work, have been produced, validated and mapped into an integrated message format. The resulting model described in this paper highlights the main conceptual links between both basic models: at the action level and at the Transaction level. Using XML, some parts of the model have already been implemented in various national projects. Key lessons learned may be imported at the international level.

Semantic distance and semantic similarity are two important information retrieval measures used in word sense disambiguation as well as for the assessment of how relevant concepts are with respect to the documents in which they are found. A variety of calculation methods have been proposed in the literature, whereby methods taking into account the information content of an individual concept outperform those that don't. In this paper, we present a novel recursive approach to calculate a concept's information content based on the information content of the concepts to which it relates. The method is applicable to extremely large ontologies containing several million concepts and relationships amongst them. It is shown that a concept's information content as calculated by this method provides additional information with respect to an ontology that cannot be approximated by hierarchical edge-counting or human insight. In addition, it is suggested that the method can be used for quality control within large ontologies.

The paper describes the experiences with a Belgian Primary Care data Network from 1999 till 2002. Three cycles of data collection have been performed. The network involves about 300 general practitioners (GPs) and up to 8 different software packages. This network is semi-anonymous, semi-automatic and mixed (paper and electronic with various software's). For the coming next years, efforts should be focused on solving some frequently occurring problems with the data collection through the EPR, such as a considerable number of data lacking and the fact that GPs do not always use the problem oriented structure of the EPR (Electronic Patient Record). Afterwards, more promising usage could be considered and developed such as repeated data collection using a same GPs' sample, long-term recording studies, usage of larger GPs' samples, etc.