Cross border hospital and emergency care between NL-GE-BE Brigitte van der Zanden (Msc) 10. Mai 2013, Perugia
Content • Brigitte van der Zanden.....???? • Reasons for cross border (XB) care • General challenges • Examples XB hospital care • Examples XB emergency care • Specific XB challenges • EPECS • Conclusion
Brigitte van der Zanden • … years old…, living in Maastricht (NL) • Studies: Nursing (BSc) and Health sciences – policy and management (BSc and MSc) • Project manager and advisor specialized in EU/cross border health care - since 1999 • Member/advisor of multiple XB and EU organisations (AEBR, Euregha, EMR, EPECS...)
Reasons for XB healthcare • Necessity • Knowledge exchange • Innovation • Chance • Improvement of regional economic and social systems • Improvement of citizens quality of life
Reasons for XB healthcare neighbour cousin children YOU!
General challenges • Language differences • Different cultures • Asymmetry in: – Rural and urban areas – Economic and social system and development – Political culture • Differences in healthcare and legal systems
Examples of XB hospital care
Examples XB hospital care • Euregional vascular centre (NL-GE) • Neurophysiologic (NL-GE) • Infectious disease control (NL-GE-BE) • Cooperation of healthcare insurances • Burn victims (NL-GE) • BE children with psychiatric problems are treated in GE hospital • In general - NL patients go to BE hospitals • Cooperation NL-GE concerning Brest cancer • Cooperation concerning percutaneous angioplasty • ENT specialism (NL-BE)
Cardiovasculaire cooperation • Between 2 university hospitals – Aachen (GE) and Maastricht (NL) • Prof. is head of department in both hospitals • Use of videoconferencing • Operating in both hospitals • Exchange of staff
Cardiovasculaire cooperation What was done to achieve this: • Prof. needed to do an exam • Agreements needed to be established concerning infectious disease control • A contract needed to be signed (liability, payment, and so on) • Paid for by hospitals and insurance companies
Neurophysiology • Between 2 university hospitals – Aachen (GE) and Maastricht (NL) • Online cross border data transfer of neurophysiologic data during operation of patient • Prof. from Maastricht (NL) is in direct contact with his assistant in Aachen (GE)
Neurophysiology What was done to achieve this: • Research concerning delay in data transfer was done • Research concerning the legal aspects of online cross border data was done • The NL staff needed to be acknowledged • A contract needed to be signed (liability, payment, and so on) • Paid for by hospitals and insurance companies
Infectious disease control • Between hospitals, nursing homes, GP’s and so on along the GE-NL-BE border • Prevention of multi-resistant pathogen in hospitals and nursing homes • Quality seal for hospitals and nursing homes • XB education of staff • Information for citizens • Implementation of XB guidelines
Infectious disease control What was done to achieve this: • Set up a XB network of hospitals and nursing homes • Compare existing guidelines and develop new guidelines for XB healthcare • Develop and hand out a quality seal for hospitals and nursing homes • Set up prevention measurements for staff and citizens • Develop educational trainings for staff
Infectious disease control What was done to achieve this: • Created awareness among different healthcare stakeholders • Research concerning pathology of multi- resistant pathogens • Paid for by EU project eurSafety healthnet and Foundation euPrevent in the Euregion Meuse- Rhine (XB cooperation of healthcare providers)
Cooperation of healthcare insurers • ‚ Gesundheit (Health) Card International’ ( GCi card) NL-GE • Euregional healthcare portal NL-GE-BE • Contracts between healthcare insurers concerning administrative procedures NL-BE-GE
GCi-Card • GCi-Card includes specialist care, medication, hospitalization and medical supplies • Between insurance companies in GE and NL • Indirect reimbursement = insurer is intermediary • Direct reimbursement = insurer has contract with hospital • Started in 2000 with INTERREG, since 2005 paid for by insurance companies
Examples of XB emergency care
Examples XB hospital care • Cooperation Acute Care EUREGIO (NL-GE) • Daily XB emergency care • Eumed Ambu – emergency care in large scale accidents (NL-GE-BE) • Eumed Hospital – Spreading of injured people at large scale accidents (NL-GE-BE) • Along almost the total GE-NL border the German rescue helicopter is deployed
Cooperation Acute Care EUREGIO
Cooperation Acute Care EUREGIO • Between hospitals, acute trauma centres, emergency care transport/units in GE-NL • Goal: ‘In the EUREGIO the cooperating partners will realize qualitative high acute care without borders.’ • Worked out a 10 year strategy plan on Organisation, Governmental and Scientific level
Cooperation Acute Care EUREGIO What was done to achieve this: • Work plan 2013 – new communication devices, app, start research official acute XB healthcare region • Dutch Hospital is official authorized to the German Trauma network • Director of the GE trauma network is official partner in the ROAZ (a statutory established NL body) • AZE (Dutch umbrella organisation for acute care) has GE and NL personnel
Cooperation Acute Care EUREGIO What was done to achieve this: • A-Z App EUREGIO; includes specialized dictionary, nearest ambulance and acute hospital (borders don’t exist in the app), contact information, general XB information • Language courses for NL-DE staff • 90% Own funds, 10% EU funds
Cooperation Acute Care EUREGIO
Daily XB emergency care • Partners: local governments, insurance companies, hospitals, emergency care transport • Countries: Between NL and GE (vv) and between NL and BE (vv) • Transport: ambulances and helicopter • Paid: insurance companies, local government • Long lasting, mostly bilateral contracts
Specific challenges XB care • Liability • Payment procedure • Differences in education of staff • Acknowledgment of function and education • Prescription • Data-protection • Infectious disease control • …..
EPECS • Independent EU patient organisation • Focus only on XB healthcare • Nicolas Decker (Kohll-Decker ruling) is board member • Gives advice concerning XB healthcare • Organises round tables with patients • Has ePanel • Developed EU brochures concerning XB care
EPECS Medical treatment in the Example: What are my EU – What should I keep rights as a GE patient in NL? in Mind? (NL, GE, FR) (NL, AT, CZ, GE, FR)
Conclusion • Lively XB regions • Long lasting cooperation's • Supported by patient organisations • Lot of own investments • Still a lot to do, but it is going forward • XB focus slowly swifts to prevention
Thor Heyerdal Borders? I have never seen one, but I know they exist in the minds of some people. ---------- Lets get rid of them
Information: Brigitte van der Zanden Info(at)bzconsultancy.com 0031 6 360 620 39
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