HealthchainStories
DELSIS
Smart Decisions for Lifestyle Care
The need
Because of the growing demand for healthcare and the decreasing number of healthcare professionals, transformation is necessary to guarantee accessible and affordable healthcare in the future. This means, among other things, moving hospital care to the home setting and increasing patients’ self-management.
In other words, facilitating patients to be able to longer and better take care of themselves at home and only get professional care (physically or at a distance) when it is necessary. An important aspect of self-management is to promote a healthy lifestyle, e.g., healthy nutrition and physical activity.
The main objective is to improve patients’ self-management by providing the right extent of lifestyle support that fits patients’ needs. We need a solution to automatically determine the extent of support that is needed, so not the content of the support but the support process. By increasing self-management, we aim to decrease unnecessary healthcare demand in order to guarantee access to healthcare in the future
The HealthChain Support
HealthChain supported Healthcare Organisations in identifying their innovation challenges and selecting companies to address them. They worked closely as an interregional team to co-create, test, and validate a solution aligned with real clinical workflows, patient needs, and organisational constraints. The project provided financial and business support to boost the solution’s market-readiness and commercialisation.
The
Solution
DELSIS is a digital lifestyle triage process that classifies patients’ self-management levels. It uses a decision tree and the validated PAM-13 (Patient Activation Measure) questionnaire integrated directly into the hospital’s Electronic Health Record system (Chipsoft HiX). This enables professionals to match patients to the most appropriate level of support—ranging from digital tools to in-person consultations—without requiring new IT systems.
It is centered on its integrated approach to lifestyle care:
Integrated Lifestyle Triage and Activation
The solution is unique in combining a lifestyle triage process with direct behavioral-change activation. This allows for a quick assessment of the support level a patient needs while simultaneously encouraging them to manage their own health.
Seamless Infrastructure Integration
It is designed to fit directly into existing hospital environments, specifically the ChipSoft HiX electronic health record (EHR) system, without requiring new IT systems or complex training for professionals.
Scientific and Data-Driven Foundation
The triage logic uses the validated PAM-13 (Patient Activation Measure) questionnaire and a custom decision tree that incorporates additional data like BMI and educational level to refine self-management estimations.
Focus on Efficiency and Personalization
The model differentiates itself by matching support intensity—ranging from digital self-help to in-person consultations—to individual patient needs. This maximizes the use of hospital capacity while ensuring that highly self-reliant patients do not consume unnecessary resources.
Impact
The pilot indicated theoretical time-saving potential under norm-time assumptions; real-world net efficiency depends on workflow automation and reliability improvements.
- Healthcare professionals recognized the potential value of the tool for improving patient guidance, though they emphasized that reliability and deeper automation are necessary before a full-scale rollout.
- While patients generally accepted the digital screening, some expressed a preference for personal interaction over telephone consultations, highlighting a need to balance efficiency with patient preferences.
- Market analysis suggests that such lifestyle interventions can reduce cardiovascular disease incidence by up to 6.1% and slightly increase life expectancy by matching support intensity to patient needs.
Outcomes
During the four-month pilot (April–August 2025), 56 patients from Cardiology and Internal Medicine participated, with a 77% questionnaire completion rate and 64% providing consent for data analysis.
- Feasibility and Process: The pilot demonstrated that a structured lifestyle triage process using the validated PAM-13 questionnaire integrated into the hospital’s Electronic Health Record (ChipSoft HiX) is technically feasible without requiring new IT systems, though implementation required substantial ICT alignment and the pilot revealed limitations in monitoring and workflow integration that must be improved before scale-up.
- Triage Accuracy: Lifestyle coaches rated the triage outcomes as accurate in 68% of cases. In the remaining 32%, the tool either overestimated or underestimated the level of support needed.
- Hybrid Care Model: The pilot successfully tested a hybrid model where patients were directed to different levels of support, including remote (telephone/video) and in-person consultations.
Sustainability
Two commercialization routes are planned:
Route A: Upscaling to other Dutch hospitals using ChipSoft HiX (such as the MProve network).
Route B: Expanding the behavioral-support and triage logic to municipal prevention programs and social-employment organisations between 2026 and 2030
- Multi-Sectoral Collaboration: Long-term sustainability relies on continued partnership with a Dutch Municipalities), which co-finances the Health Square (Gezondheidsplein), to align triage goals with broader public health and prevention policies.
- Financial Model: The transition from project funding to financial sustainability will involve a mix of one-time setup fees, annual licenses, and recurring SaaS income as the solution matures.