‘Enovation really provides input to improve our ambulance care’

Ambulance Care Netherlands (AZN) is satisfied with products and collaboration

Every day, ambulances in the Netherlands send around 10,000 messages to hospitals. There is a story behind every ambulance dispatch and every message. Each message could be a matter of life and death for the patient in the ambulance. That means the underlying ICT technology must work flawlessly. AZN has been working with Enovation in this area for years.

Evert Zandbergen (Enovation) and Anno van Dijken (AZN) about collaboration on ICT in ambulance care.

In this article, AZN talks about their collaboration with Enovation. How did the collaboration start? How do the parties collaborate, and which issues are solved with what products?

Key role for ICT

Ambulance Care Netherlands (AZN) is the umbrella branch association for all 25 Regional Ambulance Services (RVAs). The association supports the ambulance industry in the Netherlands in various themes such as quality of care, labour market and employership, financing and ICT. The industry employs more than 7,000 people, of which over 6,000 work as ambulance drivers, nurses and dispatchers. In relation to AZN, the RAVs develop and manage a national ICT and information provision, which has played an increasingly larger and more important role in ambulance care in the past 20 years.

Collaboration is imperative

The development of the systems that ambulances, control rooms and hospitals use to contact each other has undergone a turbulent growth. Not only because the technology develops extremely fast, but also because the Netherlands is divided into regions that each have their own ambulance service. An added challenge is that every ambulance in the Netherlands must be deployable and compatible to exchange data with every hospital in the country. That makes collaboration imperative. In addition to mutual collaboration, a robust IT environment also requires collaboration with reliable partners who have expert knowledge.

Growing collaboration

AZN and Enovation have been working closely together for over 10 years. The collaboration began with a simple question: how could ambulance staff, who treated a patient at home, conveniently transfer information to the patient’s GP about the provided care? The solution was ZorgMail from Enovation. Anno van Dijken, ICT and Security Manager at AZN, knows all about it. ‘At that time, we were already working on a small scale with another party on sending messages to emergency care and we wanted to be able to inform GPs when a patient was not taken to the hospital. Our requirement was that it shouldn’t matter which care information system the recipient had, it simply had to work. After contacting Enovation, we soon learned that ZorgMail and mainly the underlying EDI (Electronic Data Interchange) technology was ideal for that purpose.’

Strong point: full-service solution

In the following years, AZN encountered other issues related to ICT, information transfer and communication. And each time, they found a good solution by collaborating with Enovation. When asked about Enovation’s strong points, Anno lists three things he is extremely satisfied with. ‘First, we want a partner that can provide a full-service solution and Enovation has made that happen. System security and privacy are also very important. These elements are also in good hands with Enovation. And finally, the interaction, the collaboration and the consultations work really well. We have regular contact with our account manager and even weekly contact with the Enovation project manager. This means we are kept up to date on what’s going on in terms of ICT in healthcare.’

Expertise proved at crucial step

‘In 2016/2017, we had to take a crucial step at AZN,’ says Anno. ‘The National System of Advance Notifications (LSDV) that AZN uses for communication between ambulances and hospitals had to be migrated to a new platform to accommodate the growing message flow. We were looking for a partner who could collaborate with us on a deep, technical level. We already had good experiences with Enovation. As well as using message traffic through ZorgMail, we were also extremely satisfied with their service desk support. For this major project, we were looking for a partner who could manage and organise the underlying technology and provide us with input about innovations, so we could focus on that. We chose Cloverleaf technology. Six years ago, we were looking for a partner who could provide a full-service solution and Enovation made that happen. At the time, we worked together to migrate the system in six months. It was quite a challenge, but we did it.’

Perfect solution

Evert Zandbergen is account manager at Enovation and has regular contact with AZN. ‘Cloverleaf was perfectly equipped for the AZN’s issue at the time. I instantly knew it was the right solution. With Cloverleaf, you can translate all kinds of messages from one system to the other. We wanted to build something that could be further developed in the future. Even if a hospital uses a different system, you must be able to deliver messages. The Cloverleaf connections make this possible. Don’t forget, it’s in the patients’ best interest to provide effective information provision.’

New requirements, new solutions

Anyone in this world knows that the work ‘under the bonnet’ of ICT technology never stops. We currently live in a time when citizens must always have access to their own file and decide who can see or use their information. Of course this also affects ambulance care.

Access to files

Since 2021, citizens are legally entitled to access their own healthcare file. ‘That meant we also needed a solution for ambulance care,’ states Anno. ‘We saw the development of the PGOs (Personal Health Environment) coming early on. Within AZN the main question was if the individual RAVs wanted to organise this individually or if they would opt for an industry-wide approach. Once they chose an industry-wide approach, it soon became clear that Enovation was the right partner to help us with this. Enovation provided the myhealthConnect solution. Based on the MedMij guidelines, we incorporated that module, and citizens can access it via mijnambulancezorg.nl and PGOs. They can view their file that was created when the ambulance was deployed for most, and very soon all, RAVs.

Current developments and the future

‘lspConnect is the most recent addition we developed together with Enovation. With the module for communicating with and via the LSP, we can exchange certain message via the LSP. This addition gives AZN multiple options for delivering messages.’

LSDVs play an increasingly important role

As the ICT manager at AZN, Anno is working to further implement the Acute Care Data Exchange Guideline. ‘In addition to the message flows from ambulances to hospitals and GPs, other flows are also important. That means the LSDV is becoming increasingly important as an exchange point for messages from the ambulance industry to other healthcare providers and vice versa. The new electronic data sharing healthcare act (Wegiz) may even further accelerate this.’

Healthcare coordination

‘We are currently also working on healthcare coordination,’ says Anno. ‘How do you get the right care (provider) at the right place, at the right time? This involves collaboration between all parties engaged in acute care, to relieve the pressure on healthcare by working more efficiently (together).’ In addition to ambulance care, GP care and emergency care, this also affects acute long-term care and mental health services. In ambulance care we are also dealing with new developments. With Enovation we can rely on a competent and reliable partner in this area.’

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