Mijn U-center

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The Case
Short introduction
From its Heuvelland location in hilly Limburg, the special U-center clinic provides patients with psychotherapeutic treatments. It is also a leader when it comes to enabling access to the electronic patient record (EPR). U-center was looking for a way to digitize the care process so it would be more user-friendly for its clients. To that end, Betawerk developed 'My U-center': an app that allows each client to exert more control over his or her own treatment by providing personal support during every phase of the care process, even after the clinical stay has concluded.
Launch date
The health-care industry stands on the cusp of changing regulations regarding the digital accessibility of patient information. In the Netherlands, the Ministry of Health is ensuring that Dutch citizens will have access to their medical records by 2020. The mental health care sector (GGZ, Dutch Mental Healthcare Association), of course, is up-to-date on this development. U-center is a pioneer for providing digital access to patients' medical data in the mental health care field. The clinic, in fact, was ready to take the next step: transforming the entire care process into one convenient and user-friendly digital format.
How can we digitize the care process so that clients are even more empowered? And how do we ensure that all existing systems and processes, both digital and physical, are efficiently combined and integrated? These were among the questions put to Betawerk by U-center.

As previously stated, the U-center is a leader in the mental health care sector for providing access to electronic patient records. Never has a mental-health organization been so transparent. The U-center now allows its clients to use their mobile phones or tablets at the clinic. In fact, the devices have become a fundamental part of client treatment.

Via the 'My U-center' app, clients can both find background information about treatment methods and record their activities. Routine Outcome Monitoring (ROM) — the systematic measurement of treatment outcomes — is based on internationally validated and standardized online questionnaires. What’s more, the EPR link helps clients access all of the appointments related to their course of treatment.

Before digitizing the care process, U-center wanted assurances that its clients would be able to find everything in one place while the solution also had to be user-friendly. Therefore, 'My U-center' is easy to access on mobiles and tablets, so every client can log in to the app using their own device. Via 'My U-center', clients can access their EPR at any time to view their medical information. This aligns entirely with the Dutch Ministry of Health's wish to give everyone digital access to his or her medical records by 2020.

To summarize, the objectives included:

> increasing customer loyalty and improving patient satisfaction by giving the patient control over his or her care process via a user-friendly digital solution

> forging a relationship with patients after their treatment has concluded, and translating this relationship into a business model

> promoting cost savings and efficiency by digitizing and automating existing processes

> integrating existing digital systems such as the EPR and U-ROM into a new and user-friendly patient-centred digital environment that provides clients with greater control over their care.
Our proposal to operate on the basis of service-design thinking to enrich the services that U-center provides proved to be a good suggestion. During several productive sessions, we were able to identify the following essential features:

> understanding the individual treatment process
> providing direct access to the online treatment environment and questionnaires
> maintaining a journal
> greater personalization and ease of use
> focusing on privacy and security
> bilingual content to better serve an international client base
> easily accessible courses, coaching, and information for personal development and aftercare.

But what does the 'My U-center' app mean for the mental health care organization itself? Automating and digitizing the care process delivers significant cost and time savings for the therapists because the processes feature intelligent design. An app even represents an environmentally sustainable decision because the care process is no longer documented on paper.

Even after patients are discharged from their clinical stay, 'My U-center' provides a space to maintain contact. That digital space is coupled with face-to-face meetings, because experience has demonstrated that clients cherish contact with their treatment peers. This contributes to a longer-lasting relationship between U-center and its community of ex-clients. In one fell swoop, the 'My U-center' app has introduced a new and highly effective communication and sales channel for discharged clients.

The staff and therapists have reacted positively to the operation and design of 'My U-center'. This also appears from the fact that 'My U-center' has demonstrably contributed to greater customer satisfaction: in the fourth quarter of 2016, this score increased to a record high of 8.3.

To summarize, the results were the following:

> 'My U-center': a mobile app that enables clients to take greater control over their treatment and that is user friendly due to the efficient and transparent integration of existing digital modules such as EPR and U-ROM. ‘My U-center’ is supplemented with new modules, such as the ability to schedule meetings with treatment peers;

> cost savings and efficiency improvements for U-center as the current processes have been digitized, automated, and combined into a single convenient format

> a longer-lasting relationship between U-center and its community of ex-clients, even after the treatment period. The app has become a new, supplementary business model for U-center
> stronger U-center leadership on digitization, in anticipation of the changing regulations.
Technical challenges
The main technical challenge was to embed existing systems in the resultant app, which U-center had already been using. 'My U-center', for example, had to be linked with systems like Medicore, which stores a patient's electronic records, and U-ROM, which measures treatment outcomes. Despite embedding different systems, the app needed an intuitive and simple interface for patients. Ultimately, the objective was for the patients to gain insight quickly and easily into their care process.
Challenges in (combination of) modules
A link with Medicore has been established that is based on HL7 messages. Via an intermediate layer (Mirth Connect), the HL7 messages are converted to REST web-service calls. The Services module is used for the web services. For event payment, Mollie is used together with the corresponding Drupal module. The rest of the functionality largely consists of Drupal's own modules. For instance, a custom calendar module has been developed because appointments are synchronized via the HL7 link and specific functionalities were required that were not available in the standard modules.
Contribution form the project to the Drupal-community
Although a custom Drupal module was developed for this project, its functionality is so specific that the Drupal community has little to gain from its return. Should this functionality prove necessary in the future, we will consider submitting the module.
Name client
What does the client think about the project?
Tom Schiphof, U-center Health & IT project manager, comments, ‘Clients and employees alike appreciate 'My U-center'. It achieves cost and time savings and is a sustainable solution because it replaces paper and brings together existing digital solutions. It's also much easier now for our clients to access their personal and medical information and to keep track of their treatment. We're also very enthusiastic about the development process. Betawerk carefully studied the existing care process and helped us to examine how we could digitally optimize and integrate the existing methods into the new solution. The result has certainly been a resounding success.'