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Implementing Secondary Use of Healthcare Data Through High-Quality Primary Use: A Primary-Care-Pathway First Strategy

Abstract Secondary use of healthcare data for research, population health management, quality improvement, policy, and artificial intelligence cannot be implemented successfully as a purely technical data-platform initiative. Its reliability depends on the quality, provenance, semantic consistency, and clinical relevance of data generated during care. The central argument of this essay is that healthcare organizations should implement secondary data use through a “primary-use first” strategy: data must first help clinicians, nurses, patients, and multidisciplinary teams make better decisions in real care pathways. Only then can the same data become a trustworthy foundation for research, management, innovation, and AI. This requires clinical governance, workflow redesign, semantic standardization, continuous data-quality measurement, trustworthy access governance, and feedback loops that return value to care delivery. The learning health system provides the most appropriate conceptual ...
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Cheat sheet medische dossiervoering, MZG-codering en BFM-impact - voor artsen in Belgische acute ziekenhuizen

 Inleiding Deze cheat sheet is geschreven als intern ziekenhuisdocument, voornamelijk voor Belgische artsen in een niet-psychiatrisch ziekenhuis. De belangrijkste bron voor deze cheat sheet is MZG , een verplicht registratiesysteem voor Belgische niet-psychiatrische ziekenhuizen. MZG ondersteunt onder meer organisatie en financiering van de gezondheidszorg (BFM); de registratie gebeurt via Portahealth (PH).  Het Belgisch ziekenhuisdossier moet minimaal diagnoses, onderzoeken, adviezen, behandeling, evolutie, operatie-/anesthesieprotocol en ontslagverslag bevatten; het ontslagverslag moet de continuïteit waarborgen en het dossier moet de diagnostische en therapeutische aanpak getrouw weergeven.  Voor MZG worden administratieve en medische gegevens continu geregistreerd binnen semestriële registratieperiodes; overdracht aan de FOD Volksgezondheid gebeurt uiterlijk vijf maanden na het einde van de registratieperiode, na uitgebreide interne en externe controles en valid...
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Managing an Acute Hospital for Clinical Success and Financial Health: An Evidence-Based, DRG-Aware, Patient-Centred, EHR-Enabled Operating Model

Abstract An acute hospital can be clinically successful and financially healthy only when quality management, clinical practice, operational efficiency, patient outcomes, and reimbursement are governed as one integrated system. The Donabedian model provides the conceptual logic: structures shape care processes, and processes determine outcomes. Value-based healthcare (VBHC) adds the strategic objective: maximize patient-relevant outcomes relative to the cost of achieving them. Evidence-based medicine and evidence-based practice provide the epistemic standard for clinical decisions, while Diagnosis Related Groups (DRG) impose a financial discipline by linking hospital revenue to case mix, coding, resource use, and length of stay. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) ensure that “success” is not reduced to mortality, complications, throughput, or margin alone. The Electronic Health Record (EHR), supported by Clinical Decision Support ...
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