between NL-GE-BE Brigitte van der Zanden (Msc) 10. Mai 2013, - - PowerPoint PPT Presentation

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
• rganisations (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 EU – What should I keep in Mind? (NL, GE, FR) Example: What are my rights as a GE patient in NL? (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