Tip 7: ‘Implement the program into the existing care model using substitution of pathway elements.’

An innovative program should substitute current care pathway elements such as the scheduled outpatient clinic visits, thereby truly transforming healthcare practice from an existing base.



Nurse practitioners remotely monitor vital signs and have been given extended responsibilities for patient management, such as changing medications, only referring for specialist consultation in case of emergencies. This way the care professionals can manage large numbers of patients remotely in a fraction of the time which would otherwise have been spent in face-to-face meetings. The program has been deployed at a relatively small scale and has demonstrated positive results. However, the current financial models underlying the Dutch healthcare system will have to change to provide secondary care with compelling incentives to foster large-scale implementation.


Transfer to other settings:
  • Make sure people at all levels of the organization are willing to change and integrate the innovation.
  • Create ownership among healthcare professionals; ensure they believe that this is the way forward.
  • Make a manager and/or a leading organization responsible for the programme.
  • Develop a convincing business case.


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