By working with healthcare providers and care providers from the start, we conceived the platform as complementary to the existing instruments in the field.
1. The platform is a cloud-native SaaS solution consisting of a combination of microservices.
2. We use the FHIR standard (intelligent data exchange) to connect patients/citizens, healthcare providers and care pathways. We have also "plugged in" the existing "open data" sources that we use (e.g. national database of healthcare providers) via an FHIR layer in order to be as future-proof as possible.
3. We have made it easy for to add new resources and configure almost the entire platform dynamically and intuitively via a "wysiwyg" interface.
4. To enable Single Sign-On from other environments we have provided a number of APIs.
5. Thanks to the extensive GDPR test and a clear "user access management" organization, the privacy of pregnant women is guaranteed and care providers only have access in relation with their role.

From September 2018 to June 2019, expert panels were organized with more than 130 professionals active in perinatal care. Based on this input, the platform was technically built in 2020 by LeapStation. Existing public databases were integrated. A data protection officer is hired, the platform complies with current GDPR regulations, the necessary DPIA documentation, informed consents, privacy statement, user conditions and data processing regulations have been drawn up. Implementation in practice started in 2021. Over 125 organisations are partner in the project, over 35 organisations use the platform extensively of which 13 hospitals. Over 4000 women are supported through the platform. Monthly webinars and training to facilitate uptake are organised. The main objective is to screen every women on psychosocial vulnerability in Belgium, 120 000 deliveries annually. We continue to support the implementation process in the different Belgian Regions.

The national health insurance body finances our team. We engaged with stakeholders in the field of perinatal care and set up partnerships with different health care organisations in private and public sector, in primary and hospital care, regional and federal entities.
LeapStation, a software company focused on solutions for the healthcare and welfare sector constructed the platform. A data protection officer was hired. Existing national databases for referral were involved.

We involved our stakeholders as ultimate users: midwives, pharmacists, gynecologists, (child) psychiatrists, educators, social workers, governmental bodies for child welfare, ... Over 130 organisations were involved. They have provided input concerning both the construction/design of the questionnaire and the content of the platform. The platform is accessible via integration in medical files or a weblink, Our team supports implementation in practice and offers material, training and license.

Besides the development of the platform in Dutch, English and French, we translated our questionnaire in 15 languages. We made on boarding easy through our website, we offer information leaflets, posters, instruction video's to care providers.
We developed information video's and leaflets for women in different languages.
The platform is technically integrated in over 10 vendors of medical records.
We organise monthly 4 webinars since 2022. We offered over 40 days of training with experts on conversation techniques and held over 10 conferences.
Over 128 organisations are partner in the project, over 35 organisations intensively make use, over 4000 pregnant women were offered integrated care to ensure their psychosocial wellbeing.

Involving stakeholders is very important, it is a challenge to bring together a sufficient number of diverse stakeholders. Reaching consensus, especially in our country where regional differences are current, is also not easy. Our platform is a form of an integrated and shared file, this is innovative, and remains an innovation that has not yet been accepted by every healthcare provider, leading to resistance in several cases. Legally, there are many challenges associated with this project, even though the platform complies with GDPR legislation, some remain anxious about data sharing. In terms of credibility, it is crucial that the government provides clarity and transparency about the sustainability of the project in order to enthusiasm

A good implementation plan with well-chosen implementation strategies is crucial.
Everything starts with bringing together professionals who provide care in the field of the various indicators of psychosocial vulnerability. Including regional healthcare providers together in primary care and hospital care is crucial. In addition to transferring knowledge, working agreements must be made. Care pathways should be agreed upon and personnel should be trained in how to ask the questions and use the care pathways.
In addition to healthcare providers, stakeholders such as management, technology (IT) and legal services are also crucial. After all, technical integration and signing of contracts depend on them. Process and behavior change takes time!

Healthcare providers are convinced of the importance of interdisciplinary collaboration, the fact our platform enables interoperability between existing systems and it's "user-friendliness" facilitates this. The built into patient file systems, allow healthcare providers to use our platform as a natural extension of their daily workflow. BIB is intuitive and accessible, even for those without a technical background. New developments can be easily integrated thanks to the accessible "wysiwyg" interface. No new software updates are needed to manage decision trees, care pathways, integrations with other systems. This integration in as many information systems as possible and an example for other healthcare domains.

Pregnant women are happy to share their psychosocial wellbeing with care providers, only 0.5% of women refuse to take part in the use of the platform. Care providers admit that they did not expect women would be this open.
Care organisations integrate the platform in their medical files, we reached over 4000 women. In 20% of the cases indicators of depression and in 10% social isolation was present, the care pathways in the platform support care providers in how to take action. In case of a referral to another health care institution, shared-information is available in the platform.