[{"data":1,"prerenderedAt":290},["ShallowReactive",2],{"update-en-20260602-huisartsenpraktijk-de-ronde-tafel":3},{"id":4,"title":5,"body":6,"description":262,"extension":263,"meta":264,"navigation":283,"ogImage":284,"path":285,"robots":284,"seo":286,"sitemap":287,"stem":288,"__hash__":289},"updates/en/updates/20260602-huisartsenpraktijk-de-ronde-tafel.md","Ask Aletta is just like a librarian",{"type":7,"value":8,"toc":250},"minimark",[9,13,16,21,24,27,42,46,49,52,55,59,62,65,75,78,81,84,87,91,94,97,106,109,112,115,119,209,213,216,219,222,228,231,234,237,241,244,247],[10,11,12],"p",{},"\"My god, is that even possible?\" A woman called about her puppy from Australia, a Labradoodle. The animal had had diarrhoea from a roundworm or a coccidiosis, and now she had developed intestinal complaints herself. GP Bram Smits did not know the answer off the top of his head. Whether it even involved pathogens that could also settle in the human gut: no idea. In the old days he would have had to call the microbiologist about this, or consult one of those LCI websites. \"Then you're easily half an hour further along before you've found the answer to your question.\"",[10,14,15],{},"He pasted the whole question into Ask Aletta under the e-consult heading. Answer about coccidiosis: cannot affect humans. Follow-up question in the same chat about roundworm: also not. The two answers combined, entered into the file. Everyone happy.",[17,18,20],"h2",{"id":19},"an-early-discoverer","An early discoverer",[10,22,23],{},"Bram had heard of Ask Aletta for a while, but never used it. Until he was sitting in an AI continuing-education session at the GP training programme. There a paediatrician, Wouter, ran through a number of useful AI tools for clinicians. Ask Aletta was among them. During a working-group moment he tried it out. \"I thought: what the…! An adequate answer and it used reliable sources. Fantastic.\"",[10,25,26],{},"Bram is not an easy mark for tech hype. He was CMIO of Huisartsen Eemland for five years and looks critically at innovations in care. So for the first few months he kept checking the sources. Whether they really were regular practising clinicians and good protocols that he sometimes consulted himself. These days he no longer really does that.",[28,29,32,33,32,38],"figure",{"className":30},[31],"portrait-right","\n  ",[34,35],"img",{"src":36,"alt":37},"/images/updates/de-ronde-tafel-bram.jpg","Bram Smits, GP and partner at de Ronde Tafel practice",[39,40,41],"figcaption",{},"Bram Smits, GP and partner at de Ronde Tafel practice.",[17,43,45],{"id":44},"how-the-ball-got-rolling","How the ball got rolling",[10,47,48],{},"He took it back to the practice. \"Everyone was like: yeah, yeah, nice, okay.\" And then nothing happened.",[10,50,51],{},"He started using it himself in the consulting room, grew more and more enthusiastic, and arranged a free month for the whole team. And then came the routine he can still laugh about now: at every coffee break he asked the same question. \"Have you used Ask Aletta yet?\"",[10,53,54],{},"The first two days: no. On day three he noticed something. Medical assistant Marjolijn sent him a query: \"Ask Aletta says this and that, do you agree?\" The answer was always yes. After that his wife Debora started using it. And then the rest followed. Of the nine employees, six now use it regularly. \"People who use it more often also get more enthusiastic about it.\"",[17,56,58],{"id":57},"marjolijn-medical-assistant","Marjolijn, medical assistant",[10,60,61],{},"Marjolijn has been at the practice for a little over a year, qualified since last July. She retrained for it and finds it tremendously enjoyable work: the dynamics, the rapid switching, the patient contact. For her, Ask Aletta has basically always been there. She does notice, because she also works at another practice, that de Ronde Tafel uses somewhat more innovative solutions.",[10,63,64],{},"She has four fixed tabs open: Thuisarts, the Pharmacotherapeutic Compass, the NHG triage guide. Plus Ask Aletta. Each source has its own place. She reaches for Thuisarts for the standard things: coughing, earache, the advice that parents should also be able to look up themselves. The triage guide for determining urgency over the phone. The Compass for names, dosages, side effects. Emergencies and repeat prescriptions do not go through Ask Aletta.",[28,66,32,68,32,72],{"className":67},[31],[34,69],{"src":70,"alt":71},"/images/updates/de-ronde-tafel-marjolijn.jpg","Marjolijn, medical assistant at de Ronde Tafel practice",[39,73,74],{},"Marjolijn, medical assistant at de Ronde Tafel practice.",[10,76,77],{},"She uses Ask Aletta for the more complex or compound questions that aren't found one-to-one in Thuisarts. Can a four-month-old baby have paracetamol? What are the side effects of the shingles vaccination? Can a six-year-old have codeine, and how do you explain that properly to parents? How long can a three-year-old wait with earache complaints? \"Things like that are often hard to find in Thuisarts. Then you can sometimes find it a bit faster in Ask Aletta.\"",[10,79,80],{},"She now handles things independently that she would previously have put to Bram. Not because she remembers it herself, but because the source is reliable enough and the answer matches what she already thought. What she enters in the file is recognisable: with every query she puts \"AA:\" in front, followed by what Ask Aletta said. That way the GP knows which source was consulted, and the colleague who calls later knows what was said. \"So that we keep one line.\" The GP then signs off on her patient contact during the day, but unlike with a query, the contact has usually already been handled by then.",[10,82,83],{},"She usually refers her patients to Thuisarts.nl. Not because Ask Aletta couldn't do it, but because that way she knows for sure the explanation is in language parents understand, in a place they can find again themselves.",[10,85,86],{},"In the beginning she also occasionally got an email with tips on how to ask more specifically. \"I always found that surprising, but nice. It also taught me that I could ask follow-up questions.\"",[17,88,90],{"id":89},"three-types-of-questions","Three types of questions",[10,92,93],{},"Bram recognises three patterns in his own use. They come up four or five times per working day.",[10,95,96],{},"As a replacement for a consult-advice request to a medical specialist. Two of those four or five questions, he estimates. He used to write a ZorgDomein request; now he first pastes the question into Ask Aletta. If the answer is satisfactory (based on a CBO guideline, for example), he no longer needs to consult the specialist. \"That saves the patient money and it saves money in healthcare.\" In terms of time it doesn't seem to make much difference. Consulting a specialist via ZorgDomein takes just as long. But on quality and value for money it does: fewer referrals, an equally good answer.",[28,98,32,99,32,103],{},[34,100],{"src":101,"alt":102},"/images/updates/de-ronde-tafel-wachtkamer.jpg","Waiting room of de Ronde Tafel practice",[39,104,105],{},"Waiting room of de Ronde Tafel practice.",[10,107,108],{},"Questions from the GP in training. The practice structurally trains one GP in training per year, with a daily hour of teaching discussion. Topics sometimes come up there for which Bram doesn't always know the answer off the top of his head. The profession is broad. A GP is a bit of a neurologist, a bit of a dermatologist, really a bit of everything. And all those subspecialties are constantly evolving on top of that. \"Medical science changes too fast to keep up with all the protocols of all those subspecialties.\"",[10,110,111],{},"Questions from patients that he doesn't know the answer to. Just this morning, two of them, both about chemotherapy courses. \"I really know too little about that. Good that Ask Aletta was able to tell me something about it.\"",[10,113,114],{},"Medication interactions he often still looks up directly in the Pharmacotherapeutic Compass. He knows that source well, he's fast in it. Ask Aletta only really wins when he doesn't know where to look. CBO guidelines, for instance, documents of two hundred pages. \"I'm really not going to go searching through that for the answer. I find it very pleasant that Ask Aletta rummages through it.\"",[17,116,118],{"id":117},"who-uses-what-and-how-often","Who uses what, and how often",[120,121,122,138],"table",{},[123,124,125],"thead",{},[126,127,128,132,135],"tr",{},[129,130,131],"th",{},"Who",[129,133,134],{},"Functionality",[129,136,137],{},"Frequency (approximate)",[139,140,141,157,167,176,186,200],"tbody",{},[126,142,143,151,154],{},[144,145,146,147,150],"td",{},"Bram Smits",[148,149],"br",{},"GP",[144,152,153],{},"Replacing a consult-advice request to a medical specialist by first putting the question into Ask Aletta",[144,155,156],{},"±2 of the 4–5 questions per working day",[126,158,159,161,164],{},[144,160],{},[144,162,163],{},"Questions during the daily teaching discussions with the GP in training",[144,165,166],{},"Part of the 4–5 questions per working day",[126,168,169,171,174],{},[144,170],{},[144,172,173],{},"Patient questions he doesn't know the answer to (e.g. about chemotherapy courses)",[144,175,166],{},[126,177,178,180,183],{},[144,179],{},[144,181,182],{},"Searching long guidelines he wouldn't rummage through himself (e.g. CBO)",[144,184,185],{},"When he doesn't know where to look",[126,187,188,194,197],{},[144,189,190,191,193],{},"Marjolijn",[148,192],{},"medical assistant",[144,195,196],{},"More complex or compound questions not found one-to-one in Thuisarts (e.g. paracetamol for a baby, shingles vaccination side effects)",[144,198,199],{},"2× per week",[126,201,202,204,207],{},[144,203],{},[144,205,206],{},"Handling patient contact independently with \"AA:\" in the file, then signed off by the GP",[144,208,199],{},[17,210,212],{"id":211},"staying-sharp","Staying sharp",[10,214,215],{},"A hidden gain, says Bram, lies in the updates. He keeps his knowledge current through Huisarts en Wetenschap, the Dutch Journal of Medicine, the FTO (Pharmacotherapeutic Consultation, once every two months with twenty colleagues from the region) and the teaching discussions with the GP in training. \"But I think I still miss things.\"",[10,217,218],{},"No more wake-up advice for a concussion, for example. Or a different pill for a gout attack. Things he had once learned well by heart, but where the guideline has since been revised. \"Then I give a piece of advice and the GP in training says: no Bram, that's changed. These days we advise this and that.\"",[10,220,221],{},"Bram isn't waiting for proactive emails about guideline changes. He'd rather discover it organically. When he gets an answer from Ask Aletta that makes him think hey, that's new, he dives into the relevant NHG standard. \"It works very pleasantly for me. A bit more your-wish-is-my-command, rather than you proactively pushing knowledge.\"",[28,223,32,224],{},[34,225],{"src":226,"alt":227},"/images/updates/de-ronde-tafel-pelikaan.jpg","Painting in de Ronde Tafel practice",[17,229,5],{"id":230},"ask-aletta-is-just-like-a-librarian",[10,232,233],{},"For colleagues who are still on the fence, Bram has his own metaphor. \"Ask Aletta is just like a librarian. A bad librarian finds the wrong book. A good librarian knows exactly which books the information is in. AI is like that too. You can't say: AI is unreliable. That doesn't hold.\"",[10,235,236],{},"An AI is only as good as the sources it consults. That's what appeals to him about this tool, and that's what he explains to hesitant colleagues. The trust has only grown over time. Bram and Marjolijn now trust the source so much that they combine the outcome with their own judgement and act on it.",[17,238,240],{"id":239},"what-it-delivers","What it delivers",[10,242,243],{},"For Marjolijn: an extra source she knows for sure is correct, and confirmation of what she already thought. \"Often you do know it, but it's nice to get it confirmed once more that what you're saying is right.\"",[10,245,246],{},"For Bram: fewer unnecessary referrals to the medical specialist, and a reliable partner in training a GP in training. Asked whether he ever still doubts this investment: \"No.\"",[10,248,249],{},"He's now spreading it more widely too. Last week he recommended Ask Aletta to the hospice in Nijkerk, where the team regularly ends up in discussions about terminal care. The experienced nurses there often know more than the doctor, Bram says, and that can sharpen a conversation when both parties can look at the same source. He hopes they'll call soon.",{"title":251,"searchDepth":252,"depth":252,"links":253},"",2,[254,255,256,257,258,259,260,261],{"id":19,"depth":252,"text":20},{"id":44,"depth":252,"text":45},{"id":57,"depth":252,"text":58},{"id":89,"depth":252,"text":90},{"id":117,"depth":252,"text":118},{"id":211,"depth":252,"text":212},{"id":230,"depth":252,"text":5},{"id":239,"depth":252,"text":240},"How GP practice de Ronde Tafel in Hoevelaken uses Ask Aletta in their daily work","md",{"subtitle":262,"date":265,"category":266,"author":267,"image":268,"translations":269,"practiceProfile":271},"2026-06-02","case-study","lara.hofstra","/images/updates/de-ronde-tafel.jpg",{"nl":270},"20260602-huisartsenpraktijk-de-ronde-tafel",{"name":272,"location":273,"type":274,"doctors":275,"patients":276,"details":277},"De Ronde Tafel practice","Hoevelaken","GP practice","3 GPs and 1 GP in training (partners Bram Smits and Debora, together since 2008)","Around 2,750",[278,279,280,281,282],"On average a highly educated patient population","Deliberately slightly overstaffed on doctors, assistants and practice nurses to allow time and attention","Permanent training position for one GP in training per year","Bram was CMIO of Huisartsen Eemland for five years","Six of the nine employees use Ask Aletta regularly",true,null,"/en/updates/20260602-huisartsenpraktijk-de-ronde-tafel",{"title":5,"description":262},{"loc":285},"en/updates/20260602-huisartsenpraktijk-de-ronde-tafel","nntgYjgofNMe46UnD4wDhGNPsVWLaOlUCduyacUpku0",1780558557711]