Interreg

The ENDO-CARE project refers to the redefinition / reorientation of endoscopic care in the Nijmegen-Boxmeer-Lower Rhine-Ruhr region through sustainable cooperation and activities in patient care, training and education as well as product development in the border region. The focus is on screening for colorectal cancer.

The ENDO-care project is divided into 3 main areas of activity
1. patient care
Care close to home
Patients from the Lower Rhine region are referred to the Ruhr region for complex endoscopies, whereas they could also be treated close to home at the Radboud University Hospital, e.g. for the removal of large colon polyps. The Radboud University Hospital, in turn, regularly refers patients to other Dutch university hospitals, while endoscopic expertise centres at the top European level are much closer in the Ruhr region. Better cross-border referrals mean that patients can be treated closer to home.

Uniform patient referral
A uniform patient referral format/form is necessary for good referral among each other, where agreements exist for a safe and complete patient referral.

E-health
For better patient-centred care and improved convenience, an e-health application will be developed (together with First8) to enable referrals to each other and to generate patient-based quality of life and satisfaction outcome reports.

2 Training and education
Optimal endoscopic interventions require good training and teaching of gastroenterologists. Training is provided at EVK, Radboud UMC and KLK (dan ook MHW???). However, not all techniques can be learned everywhere. For example, the POEM technique can only be learned at EVK and not at other hospitals. ESD cannot be learned in KLK, PZB, MHW. therapeutic EUS cannot be learned in LKL and less in EVK/EKE, but well in RadboudUMC. In order to make good use of each other’s expertise, there should be a mutual exchange of doctors in training for advanced interventional endoscopy and nurses between German and Dutch hospitals.

between German and Dutch hospitals. In addition, joint training evenings will be organised regularly for all participating hospitals and training positions will be exchanged among each other.

3 Optimisation, innovation and validation of endoscopic techniques
Optimisation and validation of EMR procedures with a focus on recurrence and detection of polyps. To reduce polyp recurrence, a new technique has recently been developed by a renowned Australian gastroenterology clinic. They were able to show that the risk of recurrence could be reduced by 50% if the edges of the wound area were well post-treated by re-burning / coagulation. We will introduce and validate this technique together. In addition, we will assess the scar tissue after large polyp removals by means of image recognition and investigate whether we can distinguish polyp recurrences from scar tissue with a normal colonoscope (study group Prof. de With, TU Eindhoven / Philips).

Developing new endoscopic materials and interventions
by promoting collaboration between doctors and companies developing these products. We will do this with the company MTW-Endoskopie (Wesel), a reliable and innovative partner with a good service. Here we can use each other’s knowledge to adapt medical products, which will eventually lead to better patient care and better (technical) development in the endoscopic field. The Netherlands has no production and no development of endoscopy materials, but has a lot of experience in the field of e-health and image recognition techniques. These developments are progressing very quickly in the Netherlands and can easily be transferred to the German situation. Therefore, a cooperation between the Dutch and German side with first8 and TU Eindhoven-Philips is very valuable.

Validation and cost-effectiveness calculations of existing endoscopic techniques:
There is an increasing demand for validation of modern endoscopic techniques. There is little or no knowledge about the returns (PRU, success rate and cost-effectiveness) for physicians, patients and health insurers, especially regarding long-term effects. Research links with the producers of endoscopic materials and the special expertise centres RadboudUMC, EVK and UE(EKD) make it possible to increase the development quality and speed.