Nederlands Huisartsen Genootschap

CMS for medical guidelines


The Dutch Society of General Practitioners (Nederlands Huisartsen Genootschap - NHG) issues national medical guidelines for general practitioners. The guidelines have been incorporated into the NHG Formulary. General practitioners can use the NHG Formulary when prescribing medication. Approximately 65% of Dutch general practitioners use this via their General Practitioner Information System (Huisartsen Informatie Systeem - HIS).

An outdated application, difficult to use

The previous CMS (Content Management System) in which the NHG managed the Formulary had various problems. Introducing new regulations was complicated and therefore labor-intensive and prone to errors.

In addition, various functions had been created over the years that were no longer used. Delivering the NHG Formulary was also a complicated manual process with a risk of errors. The NHG had many needs for improvement that the old system could no longer meet.

Create a new CMS for clear maintenance of the NHG guidelines

Sping has been asked by the NHG to design and develop an improved custom CMS in which the NHG Formulary can be maintained safely and efficiently.

Design a concept in three weeks, develop agile in three months

The NHG has appointed a product owner to properly supervise this development process. Together with the product owner and other stakeholders, Sping conducted thorough user research over a three-week design period and created a completely new user experience. The new design has been developed into a prototype and extensively tested with users.

The new CMS was developed in various sprints within three months with an agile team from Sping. During this process, we tested regularly together with the NHG in order to be able to process feedback immediately. For the NHG this was also an important introduction to an agile working method. The first version of this CMS has now been put into use and we are making plans for further development with the NHG.

The result: Fewer errors, more focus on content

With the new CMS, the NHG has an application that is ready for the future:

Navigate quicker

Navigating through the content of the application has been completely renewed. The powerful search function limits the number of clicks required and there is much more overview because various panels can collapse and expand depending on the context.

Clear input of data

Entering regulations has become a lot clearer and faster. Thanks to the breadcrumbs and visibly linked models, the user knows exactly what is being edited and what impact it has on the rest of the data. This means fewer mistakes are made and a lot of time is saved.

Worry-free publishing

We have added a changelog that keeps track of which changes were made by which user. Colleagues can now ask each other more quickly to do a review without the reviewer having to find where exactly the first colleague had made a change.

Publishing a new version is almost completely automated, making it less error-prone and requiring less specific knowledge. Other colleagues within the NHG can also take over this (formerly technical) task.

Under the hood: How the software is built

Flexible but robust

The development environment is set up with Docker. This ensures that every developer sees an identical environment as it would run in production. This keeps the software flexible, yet robust. It also better supports the agile working method.

Safety first

We have built the CMS on the most recent version of Ruby on Rails and use the latest standards. The new system is secured behind a firewall and prevents users outside the NHG from accessing the CMS. Furthermore, we replaced manual tasks with automated, asynchronous tasks in Sidekiq. This saves the NHG a lot of time and also ensures that it is less prone to errors.

Migration of data

Upon completion, we imported all content to the new system. This export is line by line compared to the export the old system would make. The result is completely consistent: the data is correct and validated and can now be made available to the general practitioners' system.

Objective achieved before deadline and within budget!

Together with the NHG we look back on a very successful development process. The desired product was delivered within deadlines and within budget. The objectives of replacing the old system and working faster have been achieved. The NHG has been able to learn from the agile way of working and will apply this in more projects. We are currently discussing the goals for 2020. There are various extensions, improvement ideas and functional requirements to keep the CMS future-proof and to make input even easier.

Sping really delved into our situation and was therefore able to connect well with us as a company. You notice that everyone is involved in the project, which means the product keeps getting better. In the end, much more was made than initially thought, which is really great!

Annetje Dieleman Product Owner NHG

At Sping, the balance between business and friendly is well adjusted, creating an atmosphere of transparent and clear communication. The end result is well tailored to us and the technology behind it is tailor-made. A really huge improvement.

Zamire Damen User NHG