• 14 October 2020 -

    HiX supports scientific research with new feature

    Familial Hypercholesterolaemia (FH) is one of the most frequently occurring genetic metabolic disorders in the Netherlands. Approximately 1 out of 175 people in the country suffer from this disorder. In order to detect FH in its early stages, ChipSoft cooperated with Northwest Clinics (Noordwest Ziekenhuisgroep) and added a decision support system to HiX's pre-configured content. This system will alert physicians of the possible presence of FH based on the patient's lab data, medication dosages, and their medical history.


    Supporting research

    This new HiX feature has been developed in cooperation with internist Willem Bax and cardiologist Jan Hein Cornel's research team at the Northwest Clinics during their FH research. This feature allows HiX to support healthcare providers with decisions concerning encrypted data, such as the patient's lab findings, medication dosages, and their medical history. The tool retrieves the data every night and will calculate each patient's FH risk. If their FH risk has increased, the system places them on a list which will be monitored by multiple physicians.


    The research took 26 weeks, during which the LDL-C of 41,937 patients was measured. Out of all cholesterol measurements, 351 of these tests resulted in a value that could indicate FH. 42 of these patients had already been diagnosed with FH at an earlier stage. 127 of the other 309 patients were found to have a higher DLCN-score after including their medical and family history. 'DLCN-score' stands for Dutch Lipid Clinical Network-score which is used to diagnose FH.

    Preventing cardiovascular problems

    Internist Willem Bax has been closely involved with the research. A scientific article describing the research, written by Shari Pipplinkhuizen, will be published in the Atherosclerosis journal. Bax views the new tool as a valuable tool for physicians. "In cooperation with ChipSoft, we have developed an algorithm that investigates a frequently occurring cholesterol build-up disorder. FH is a genetic disorder that leads to arteriosclerosis at a very young age. If it is known that a patient is suffering from this disorder, it's possible to treat it with cholesterol-lowering medication. The information can also be used to track down additional cases of FH within their family. Detecting and treating FH at an early stage helps to prevent severe cardiovascular problems. This is very useful, because this disorder is severely underdiagnosed all around the world."

    A better way of interpreting

    How does this work in practice? Bax states: "A lot of physicians, such as cardiologists and internists, request cholesterol measurements at the laboratory. All values will be ran through an algorithm and the new tool will combine these values with the patient's medical history and medication use. The system will then notify the requesting physician if the outcome is notable. Those values will be interpreted by the physician and they can decide whether it's necessary to talk to the patient about, for example, genetic testing. I think a lot of physicians will appreciate being notified by this type of system of the implications of certain numbers. Not just in the linear sense – a high or low value – but in relation to the most relevant properties of the patient."

    Preventing heart attacks and strokes

    Bax states that the tool is not only a great addition for physicians, but also for patients. "This specific disorder often concerns families in which cardiovascular disorders and strokes frequently occur at a young age. If we discover the disorder at an earlier stage, we can start treating young people earlier. We have frequently worked with the Amsterdam University Medical Centre in this field. Recent Amsterdam UMC research shows that heart attacks and strokes at a young age can be completely avoided by treating children in their teenage years."

    Immediately triggered

    Software consultants Bas Groot and Rutger Vink are closely involved with the CMIO user group which deals with artificial intelligence and decision support. They supported Shari Pepplinkhuizen as co-authors when she was writing her article and figured out how this innovation can be included in HiX's pre-configured content. Bas Groot tells us: "Alexander Lopes Cardozo, CMIO Northwest and participant of the user group, often brings new ideas to the table and connected us with internist Willem Bax. We started this amazing development with his help. I was immediately triggered to start this project because someone in my family is suffering from FH."

    Opportunities for more developments

    Rutger Vink, part of the ChipSoft EHR team and responsible for expansive innovations, immediately saw the potential. "This FH tool shows HiX's power in decision support systems. In the meantime, we have improved the FH tool even more and we see a lot of opportunities for further developments. Opportunities to support physicians based on the available data in the EHR and alerting them of such health problems at an early stage."

    Helping each other out

    Both software consultants have had frequent correspondence with Northwest Clinics' research team recently. "We created several overviews for them to use, which allowed the team to access reliable numbers for their research," Bas Groot states. "That allowed us to help each other out in the cocreation process. Realising such innovations in cooperation with hospitals – Northwest in this case – is very valuable for patient care in its entirety."

    Inspiring cooperation

    Willem Bax completely agrees and calls the cooperation 'inspiring' and 'very well executed'. "We use medical jargon, while they use IT jargon. When that's the case, you'll have to meet each other halfway. I didn't think the end result would be such a well-functioning tool when we started the process. Bas and Rutger have translated our medical question and input to the screen very well."


    Tens, if not hundreds, of solutions come about each year through these cocreation processes. This already became apparent during several other projects and has been proven over and over again when content user groups gather to discuss their activities. A new way to cooperate is the Round Table. At this Round Table, representatives of healthcare institutions from all over the Netherlands come together to work with ChipSoft's software consultants and developers. Together, they work on new solutions that can be implemented into HiX, based on issues or desires from their respective fields.

    Round Table for Cardiovascular Risk Management

    Bas Groot: "In the near future, we will start the Round Table for Cardiovascular Risk Management with Northwest and several other pioneering hospitals. By working together and developing in coordination with a large group of hospitals, we will create a situation which benefits the patients as much as possible."

    EHR as tool for healthcare improvement

    "All participating hospitals use the same EHR and encounter the same clinical pictures", Willem Bax explains. "So all doctors bump into the same issues. If we discuss these issues with each other and the ChipSoft consultants, we can come up with solutions in order to provide the optimal experience, which, of course, is what we strive for… The EHR is not a notebook, but a tool to improve healthcare." The new FH tool will undoubtedly be discussed at the Round Table. Bax: "Our colleagues might come up with even more suggestions and improvements. I really encourage that. The current tool is not set in stone and is a great starting point, but can be improved as we go on. I am convinced that we are at the start of a lot more of these types of developments."

     Willem Bax - Internist at Northwest Hospital


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