Custom software for submitting indicators to DHD and the Zorginstituut
A quality indicator is not a field someone fills in. It is a calculation over files, with a numerator, a denominator and a definition that can shift from one reporting year to the next. Whoever only performs that calculation when the submission season opens ends up, in spring, with a figure built from sources that have since been changed.
What is submitted each year
Hospitals and rehabilitation centres submit their quality indicators annually via OmniQ, the central portal of DHD. Behind that one portal sit several recipients: the Transparency Calendar of Zorginstituut Nederland, the improvement targets for medical-specialist care from the Inspectorate, Inzicht in Revalidatie from Revalidatie Nederland, and the choice questions from the Patient Federation. All indicators are submitted, checked and approved there.
The portal is not open all year round. The submission season runs from autumn until mid-April. That means the question is not whether you can submit, but whether the figure you enter in March can still be traced back to the files it was built from.
In addition, the National Hospital Care Basic Register runs alongside. Mortality rates, the length-of-stay indicator and the readmission ratio, among others, are derived from that submission. These are derived figures: they do not arise from a form but from records that are captured throughout the year in the primary process.
That is where the real problem lies. An indicator that does not add up is rarely an error in the submission. Usually it is a definition that was interpreted differently, a file that was amended after the reference date, or a selection someone made by hand and did not write down.
How we build this
The core issue is not the data-entry screen but the route back: from the submitted figure to the files underneath it. Whoever cannot walk that route cannot explain a discrepancy.
Numerator, denominator, inclusion and exclusion criteria, and the reporting year to which they apply. The definition belongs in the system, not in a document beside it.
The indicator is computed from the data already held in the file, rather than being tracked on a separate list.
At the moment of submission the calculation is locked in with the files as they were then. Later amendments do not change the submitted figure.
For every figure, you can look up which records counted and which were excluded. That is the answer you need when someone questions a number.
What the software actually does
Traceability underpins the whole. What else you need depends on your size and on whether specialisms keep their own registrations.
Definitions per reporting year
An indicator calculated differently this year from last year is a different indicator. Both definitions are kept alongside the outcomes.
Calculation at record level
The numerator and denominator are built from the registration itself, so no second administration emerges to take on a life of its own.
Frozen submissions
What has been submitted stays as it was submitted, with the underlying selection attached. Changes made afterwards are visible as changes.
Explaining differences between years
If a figure jumps, the system shows whether that is due to care, to the registration, or to a changed definition.
Progress during the reporting season
Which indicators are populated, checked and approved. In spring, this is the overview that is missing.
Connecting to your source systems
We draw data from the electronic patient record and existing registrations, and keep those as the source.
Who we build for
Who compiles the indicators differs from one institution to another. Four situations.
Quality departments
They oversee submissions and receive the questions when a figure deviates. For them, what matters most is that the answer is in the data.
Medical managers and specialist groups
They do not always recognise their own practice in a figure. Being able to click through to the records makes that conversation substantive.
Rehabilitation centres
They submit through the same portal to a different set, with their own definitions and their own rhythm.
Business intelligence and information management
They build the reports and do not want every indicator to become a separate script that only one person understands.
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Definitions are revised each reporting year, indicators come and go, and registration agreements change. Calculation rules, criteria and reference dates should be configurable and not hard-coded.
Why Appfront
A figure without justification is just an opinion
The question about an indicator is almost never what the number is, but how it was built. We reconstruct that first, not as an afterthought.
Definitions change, outcomes remain
A revised definition does not make old figures wrong, but it does make them incomparable. We keep both and show the difference.
We do not replace your EHR
The records stay where they belong. We build the layer that calculates from them and integrate with what you already use.
We do not submit on your behalf
Submission and approval remain with the institution. We ensure that what you submit matches your own records.
Security and privacy
An indicator is calculated from patient data, even if the result is a figure at institution level. As soon as someone can click through to the underlying records, it involves special category personal data. We set access per role and per department, show no traceable data at overview level and log every access. Integrations run through secure connections to your existing software.
For this subject, the reliability of the moment is the key point. A figure recalculated after the outcome proved unfavourable is no longer accountability. We freeze the calculation at the reference date with the selection attached, and any correction becomes a visible correction alongside the original submission. How we handle security ourselves is set out in our information security policy.
Frequently asked questions about indicator submission
The submission season runs from autumn through to mid-April. During this period, indicators are submitted via the portal, checked and approved.
Through a single portal, the data goes to several recipients: the Zorginstituut's Transparency Calendar, the Inspectorate's improvement targets, Inzicht in Revalidatie and the Patient Federation's choice questions.
That could be due to the care provided, the recording, or a changed definition. Without the underlying selection, that distinction cannot be made, and that is precisely what software resolves.
From the basic registration, figures such as mortality rates, the length-of-stay indicator and the readmission ratio are derived. These are calculated figures drawn from records, not standalone indicators to be entered manually.
Usually not. Many institutions already have reporting in place. We build the layer that handles definitions, freezing and traceability, and integrate with what is already there. This can be a standalone application or a web application within your existing environment.
Yes, and that is often the biggest gain. A department that can click through to the records behind a figure has a very different conversation from one that is simply sent a number.
Can you show us which records sit behind our indicator?
Take one indicator you submitted last year and ask for the list of records that counted towards it. If no answer comes, a figure is in the public domain that nobody can account for. We build this as a standalone tool and as part of a broader custom software development project.