Citizen Services for Borderless Healthcare - EU Workshop Presents Successful Solutions

Travelling abroad for pleasure, education, or work has become a natural part of life for many European citizens. Products and services can be bought in another member state when required, but obtaining healthcare outside their country of residence still presents a problem to most European citizens.

This was the starting point for a recent workshop which was part of the eHealth 2008€ť conference in Kiel, Germany, organized by the European Commission€™s TEN4Health project. The workshop focused on current e-Health solutions of cross-border healthcare from a variety of European countries.

At the workshop, Pascal Collotte from the European Commission described the current and future European policy and funding schemes which the European Commission has established to support the further development of cross-border e-Health and related developments. These include the former eTen Programme and its successor, the CIP - Competitiveness and Innovation Programme with its sub-programme ICT PSP with an overall budget for funding of ‚¬728 mn.
As member of European parliament, Milan Cabrnoch from the Czech Republic, provided a comprehensive overview of relevant European Parliament resolutions, European directives, and communications from recent years with a direct impact on and relating to cross-border healthcare.

This was followed by presentations of practical experiences and solution starting with the TEN4Health service. "This service, called €?electronic GesundheitsCard Europe€™, can be seen as a successful example of a cross-border healthcare service which has started to penetrate one country after the other", said Heike Au of developer AOK Rheinland/Hamburg. The service package assures access of citizens to healthcare in participating member states€™ hospitals, based on a secure web service and its integration into developing European e-Health infrastructure networks." The TEN4Health service offers the following key components: pertinent online information for citizens in their language at the point and time of treatment abroad, instantaneous online verification of insurance status, online billing and reimbursement procedures across Member State borders and assurance of interoperability. "Its implementation and use by various hospitals in several countries has resulted in an online verification of the insurance status followed by an online receipt of a permission to treat the patient, which provides a guarantee to the hospitals that they will be reimbursed for the services provided to the patient", concluded Au. Alexander Thomasser of Landeskrankenhaus Villach in Austria - one of the pilot sites - reported that the service also resulted in a substantial streamlining of all administrative processes and in a significant reduction of payment duration to the hospitals from a previous one to two years down to less than two months. "Using the TEN4ealth service the number of unsuccessful claims is now down to zero, making the service a real success story for the hospital and the patients", Thomasser stated.

Dr. Dario Zanon from the Veneto region in Italy - a further candidate region where implementation and use of the service is about to start - reported about current problems in handling foreign patients in a region with around two million holiday makers per year and more than 11 mn days of stay, with the majority of patients originating from Germany. "Today and through the current processes involving the national contact offices, the average time the reimbursement by health insurance organizations for these patients takes to arrive at hospitals averages three years. The value of current outstanding claims amounts to almost ‚¬1 mn which the hospitals are required to pre-finance. The expectation now is for a reduction of this duration from 36 down to a maximum of two months which has been achieved already in the Austrian case", Dr. Zanon said. The hospitals in Veneto are confident that this can be achieved for the AOK Rheinland/Hamburg and Techniker Krankenkasse patients by using the TEN4Health service.

Prof. Dr. Jacques Scheres from the Academisch Ziekenhuis Maastricht (AZM, the Netherlands) presented achievements from a large number of cross-border health care initiatives and projects in the Euregion Meuse-Rhine region at the borders of the Netherlands, Belgium, and Germany which have been implemented and run over the past 15 years. These have now resulted - amongst many other achievements - in cooperation between the University Hospital Aachen, Germany, and the AZM with the establishment of an outstanding trans-national clinical top centre.

Finally, Claus Nielsen from MedCom International in Denmark reported about the Baltic Health Network which has been established between various Nordic countries and Baltic States to provide better services in ultrasound and radiology-based diagnosis particularly in rural areas lacking specialists to carry out these services.

In the very lively plenary discussion chaired by Cabrnoch, a series of topics ranging from language issues to legal requirements and regulations were addressed. Cabrnoch even asked the provocative question whether systems like the ones piloted and presented are going to promote better services across more developed health systems and those countries at comparable (high) levels of economic wealth leaving aside those with less economic power - like the new EU member states, where health insurance providers will not be able and willing to compensate their customers for health treatment in much more expensive countries, thereby creating an even greater healthcare divide across the Union.

"In sum it became apparent that the practical examples presented at this workshop show that health insurance organizations like AOK Rheinland/Hamburg and European projects like TEN4Health have managed to develop and successfully operate citizen services for borderless healthcare in and across countries of the European Union to the benefit of the patients, the hospitals, and the insurance organizations", Werner B. Korte of workshop organizer empirica summarized.

More info:

• www.ten4health.eu/workshop.html