Population-oriented ICT-supported preventive care: Coping with local circumstances

Prevention is usually positioned as a separate, disease-specific activity (prevention of diabetes mellitus, prevention of cardiac diseases, etc.). In daily practice, workers in the health care system and often even the target groups themselves have to integrate (or select between) these separate preventive activities and merge them with other activities (e.g., curative care). Information and Communication Technology (ICT) is increasingly used to support preventive tasks. The intervention strategies developed for this purpose, however, are also characterized by a fragmented, disease oriented approach (one software module for cardiovascular screening, another module for diabetes, etc) -- even though the risk factors for individual diseases may overlap. Ideally, ICT aids an individual practitioner to deliver an effective, integrated set of preventive activities tailored to the special characteristics of the population served by that individual practitioner. As illustrated by the separate disease-specific modules, current intervention strategies that use ICT to support preventive tasks are based on the prevention in the setting of an individual disease; these interventions do not address the issue of providing, in an environment characterized by limited resources, the optimal set of preventive activities for an individual population over all diseases. In this study we will investigate the impact of an ICT-based intervention that allows the practitioner to tailor preventive activities to a local population and to local procedures. The intervention takes as starting point the generic activity prevention rather than prevention based on an individual disease. Rather than support preventive care in the context of an individual disease, we propose an intervention that supports selecting and tailoring prevention over multiple diseases to the characteristics of the local population in the light of the local circumstances. In this study we will a) prepare an inventory of the preventive activities documented in the guidelines of the Dutch College of General Practitioners, b) develop an ICT-supported intervention that analyses the local population and procedures, allows the practitioner to define a set of preventive activities and supports the execution of those activities, and c) conduct a randomized trial to study the feasibility of the intervention.