Net-centric working in the medical network: who informs who?
Introduction
The Netherlands has a great network of healthcare providers. Everyone has a piece of the puzzle, but nobody
has seen the bigger picture. And that is exactly what you as a care provider need. To ensure that (impending)
incidents do not get further out of hand, we need to share and pool information promptly.
The GHOR has a large network of parties with whom it collaborates. And not one of these parties is under the
GHOR’s direct control. This means that collaboration within this network is mostly dependent on a good
exchange of information. So, information management is vital for enabling the ‘white pillar’ (care providers) to
function properly. Information management within the ‘white pillar’ is therefore one of the GHOR’s most
important processes.
Watch the animation by clicking the links below:
 Working for the medical network in The Netherlands
 Netcentric working in the medical network in The Netherlands
Net-Centric Information Supply: the concept
Net-centric working is an approach whereby clear agreements are made about the provision of information, so
that under crisis conditions and in other situations decisions are always taken on the basis of an up-to-date and
consistent picture of what is happening. With Net-Centric Information Supply, the information is not
communicated via hierarchical lines but shared with everyone to whom the information may be relevant as
quickly as possible. The goal is to provide information more quickly and more effectively.
The figure below illustrates the transformation from the classical hierarchical model to the net-centric model.
Decision requested, situation report
ROT
CoPI
112
Decisions taken, situation report
BT
BT
ROT
Total picture
- shared
- up-to-date
CoPI
112
BT=Policy Team; ROT=Regional Operational Team; CoPI=Command at Place of Incident; 112=Emergency Centre. Left: classical information
supply. Right: net-centric working
Application of Net-Centric Information Supply in the Medical Network
Net-centric working in the medical network means that this process takes place within the network of care
institutions with which the GHOR collaborates. By working net-centrically with one another within the care
provider network, everyone receives an up-to-date picture of the incident. This enables crisis teams and care
institutions to take quick decisions and act with speed. After all, less time is needed to gain an impression of
the situation so more time can be spent on forming an opinion and collecting information. Working together
net-centrically allows the ‘white pillar’ to make far better use than before of the knowledge and information
available within the various parties in this pillar when responding to disasters and crises. What is more, signs
that a medical crisis may be about to happen can be recognised as such earlier because information about
isolated incidents is pooled at various care institutions.
Aligning regular care with crisis situations
Information management is a process that does not just take place when a situation is scaled up. In fact, ideally
the process of net-centric working will have been running long before this happens. The strength lies in the link
between everyday care and scaled-up care. If care organisations already make use of information-led decisionmaking during times without a major incident, the transition is seamless when an incident occurs.
In everyday healthcare, too, the net-centric approach needs to offer added value. Over time, this will make
working together net-centrically ‘simply’ the way in which we collaborate and no longer something
exceptional. This will have a positive effect on teamwork during disasters and crises and on the ability to
recognise signs that a medical crisis is about to happen. Given that information-led decision-making in everyday
practice leads to efficient and better care for the patient, the development of net-centric working in the
medical network holds great appeal.
The GHOR as a linking pin between the Safety Region and healthcare providers
In the medical network, the information coordinators (ICo) collect information from their own institution. The
Head of Medical Care Information (HIN) at the GHOR uses this to produce a summary of what is happening
within the healthcare sector. He is responsible for the ‘shared medical picture’. The Head of Medical Care
Information is also the filter between the medical network and the Safety Region because some information
cannot and must not be shared (for privacy reasons) or is simply not relevant to other parties.
The GHOR has control over the shared medical picture. More specifically, the Head of Medical Care Information
is the one who:
 contacts the information coordinators of the care institutions
 asks them to share information
 composes the medical picture
 shares the medical picture with all concerned in the ‘white pillar’
 is the linking pin between the Safety Region and the ‘white pillar’.
The Tool: National Crisis Management System (LCMS) for the Medical Network
Information management in medical care is supported by a net-centric system: the LCMS for medical care. This
system ‘talks’ to the multidisciplinary LCMS, enabling all relevant information to be exchanged between them.
This meant that specific content from one environment is also published in the other environment.
The figure below provides an alternative representation of the relationship between the medical network and
the multidisciplinary network. The GHOR is the linking pin and filter between the multidisciplinary network
(‘Safety Region’) and the medical network.
Ambulance
Service picture
MHC
picture
Security Region
Ambulance
Service
GHOR
Mental Healthcare
ICo
ICo
HIN
Overall medical
picture
Hospitals
picture
Hospitals
ICo
ICo
Doctors
(GP’s)
ICo
Public Healthcare
PHC
picture
GP’s
picture