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Better in, better out | The power of (p)rehabilitation

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Care IQ

Working on fitness, for faster recovery after surgery

The idea has been around for much longer, and there is a pile of scientific research that shows that the approach works, but 'Better in, Better out' (BiBo™) is still not routine practice in Dutch healthcare. It is a question of ensuring that patients who have to undergo surgery are in the best possible condition. This speeds up their recovery after the operation, prevents medical complications and saves a lot of money.

Bibo Innovations, a company founded in October 2017 by Maastricht University, Care IQ and TNO, helps break the deadlock. With the support of the Ministries of Economic Affairs & Climate Policy and Health, Welfare and Sport, 'Better in, better out' should become a matter of course for patients at risk of delayed or incomplete recovery. Meanwhile, representatives of patients, parties in primary and secondary care, insurers and other parties involved have agreed to cooperate in national scaling up. They are preparing a so-called 'health deal' to implement this care innovation quickly and widely.

Improve condition

Over the years TNO has published various studies that show that the combination of early risk assessment and preparatory condition improvement works. Various hospitals, such as Nij Smellinghe in Drachten and Gelderse Vallei in Ede, have shown in practice that the BiBo™ method is bearing fruit. Particularly vulnerable patients such as the elderly benefit from it. A number of weeks before the operation, a healthcare professional, usually the physical therapist, assesses whether the physical condition of the patient may give rise to an increased recovery risk. In consultation with the general practitioner, dietician and other primary care providers, it is determined how the condition can be improved by, for example, individualised training and adapted nutrition.

Change of lifestyle

The efficacy of individualised (p)revalidation has been extensively researched and demonstrated in practice and scientifically. The patient exercises at home under careful supervision and adjusts his or her diet to become physically as strong as possible before surgery. A positive side effect seems to be that older people who were prepared for hip or knee surgery, for example, also started to feel mentally better and changed their lifestyle as a result of the physical training.

Digital data exchange

Bibo Innovations brings parties together to apply the BiBo™ method nationally, for example by including it in the relevant guidelines. This is another condition for reimbursement by health insurers. In addition, major organisational successes can be achieved by improving the digital exchange of information between healthcare providers and with patients, taking into account all rules on security and privacy. TNO provides the necessary expertise for this. By organising the cooperation well, the efficacy of individualised (p)revalidation is optimised.


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