1 european co-operations in the health care sector, basel, september 27, 2005 opportunities and ways...
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1European Co-operations in the Health Care Sector, Basel, September 27, 2005
Opportunities and ways of cross-Opportunities and ways of cross-border co-operation in the health border co-operation in the health care sector: care sector: the Euregion Meuse Rhinethe Euregion Meuse Rhine
Jacques Scheres MD PhDEuregional Co-ordinator AZM Maastricht
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2European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cross-border Health Care in the Cross-border Health Care in the Euregion Meuse-Rhine Euregion Meuse-Rhine
Topics:Topics:
The Euregion Meuse-Rhine, what is it?
The euregional health care policy
Cross-border activities of alliance of hospitals, sickness funds and others in the EMR
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3European Co-operations in the Health Care Sector, Basel, September 27, 2005
Aims of the EuregionsAims of the Euregions
Improvement of the integration of the population on both sides of the border
Eliminate the obstacles for cross-border economical, social and cultural co-operation
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4European Co-operations in the Health Care Sector, Basel, September 27, 2005
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5European Co-operations in the Health Care Sector, Basel, September 27, 2005
The Euregion Meuse RhineThe Euregion Meuse Rhine
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6European Co-operations in the Health Care Sector, Basel, September 27, 2005
Euroregion Meuse RhineEuroregion Meuse Rhine
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7European Co-operations in the Health Care Sector, Basel, September 27, 2005
5 partner regions with own authorities
3 different national law systems (B, G, NL)
3 languages (G, F, NL)
4 different cultures (G, Flem, Wallon, NL) great asymmetry ( inhabitants, competences)
The Euregion Meuse-Rhine is complex:The Euregion Meuse-Rhine is complex: “ “Europe in Miniature”Europe in Miniature”
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8European Co-operations in the Health Care Sector, Basel, September 27, 2005
Purpose of the cross-border health care policy Purpose of the cross-border health care policy in the Euregion Meuse-Rhine: in the Euregion Meuse-Rhine:
improve cross-border access and cross-border co-operation
remove obstacles presented by borders
create new chances
improve quality of life in the EMR
which is in line with the “European thought”
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9European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cross-border health care in the Euregion Cross-border health care in the Euregion Meuse-Rhine: Meuse-Rhine: along which ways?along which ways?
European freedom of movement of citizens / patients / workers, services, goods
European jurisprudence ( f.i. Decker-Kohll )
Euregional co-operation of care providers, insurers, and other organisations
Specific supporting projects (f.i. INTERREG)
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10European Co-operations in the Health Care Sector, Basel, September 27, 2005
Euregional Health Care ConferenceAlden Biesen (B) 18-12-1998
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11European Co-operations in the Health Care Sector, Basel, September 27, 2005
Universitätsklinikum Aachen
Academisch Ziekenhuis Maastricht (azM)
Centre Hospitalier Universitaire de Liège (CHU)
Ziekenhuis Oost Limburg Genk (ZOL)
St. Nikolaus Hospital Eupen
Cross-border Health Care Network in the EMR: Cross-border Health Care Network in the EMR: Participating Hospitals Participating Hospitals
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12European Co-operations in the Health Care Sector, Basel, September 27, 2005
Belgium ( CM, SM ) The Netherlands ( CZ , VGZ ) Germany ( AOK, BKK, VdAK,
etc.)
Cross-border Health Care in the EMR: Cross-border Health Care in the EMR: Participating Insurers Participating Insurers
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13European Co-operations in the Health Care Sector, Basel, September 27, 2005
What has been achieved already? What has been achieved already?
InsurersInsurers
Simplification of permission and payment procedures ( IZOM project)
International Health Card (AOK, CZ)
Contracts with hospitals abroad
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14European Co-operations in the Health Care Sector, Basel, September 27, 2005
Internationale Zorgpas/GesundheitsCard Internationale Zorgpas/GesundheitsCard of CZ-group (NL) and AOK (G)of CZ-group (NL) and AOK (G)
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15European Co-operations in the Health Care Sector, Basel, September 27, 2005
In 2001 sloot het ziekenhuis van Genk een speciaal contract met CZ
Opgenomen Patienten
Ambulante patienten
Dag-opnamen
2001 125 771 104
2002 681
(2.35%)
5982
(2.33%)
740
(0.33%)
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16European Co-operations in the Health Care Sector, Basel, September 27, 2005
Aachen
Maastricht
Tongeren
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17European Co-operations in the Health Care Sector, Basel, September 27, 2005
University hospital MaastrichtUniversity hospital Maastricht
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19European Co-operations in the Health Care Sector, Basel, September 27, 2005
4-ärmiger Operations-Roboter Da Vinci in Maastricht
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20European Co-operations in the Health Care Sector, Basel, September 27, 2005
What has been achieved already? (1) What has been achieved already? (1)
HospitalsHospitals
Univ. hospitals Aachen (G) and Maastricht (NL):
Heart surgery for children Maxillofacial surgery PET-Scan Gamma Knife Cardiovascular surgery (Gynaeco-oncology)
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21European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cross-border alliance betweenCross-border alliance betweenUniversitätsklinikum Aachen – azMUniversitätsklinikum Aachen – azM
Complementarity in advanced care such as: - burns surgery- transplantation (heart, kidney, bone marrow) - metabolic disorders, etc.
Centre of Excellence (Euregional, European) for: - cardiovascular diseases and surgery - gynaeco-oncological diseases - medical imaging / molecular imaging, etc.
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22European Co-operations in the Health Care Sector, Basel, September 27, 2005
Vision am Horizont
• Fusion der Universitätskliniken zu einem Euregionalen Zentrum für Spitzenmedizin
+
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23European Co-operations in the Health Care Sector, Basel, September 27, 2005
MaastrichtTongeren
Liège Eupen
Aachen
Genk
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24European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cross-border alliance betweenCross-border alliance betweenA.Z.Vesalius Tongeren (B) – azM (NL) A.Z.Vesalius Tongeren (B) – azM (NL)
Patients from azM to Vesalius and v.v.
Specialists work in both hospitals
Education co-assistents of UM in AZV
Training assistents of azM in AZV
Research AZV participates in UM projects
Within 10 years AZV part of the transnational university medical centre of Maastricht?
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25European Co-operations in the Health Care Sector, Basel, September 27, 2005
AZVesalius TongerenAZVesalius Tongeren
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26European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cooperation (already achieved)Cooperation (already achieved)A.Z.Vesalius Tongeren and azM on fields ofA.Z.Vesalius Tongeren and azM on fields of
General surgery ( gallbladder, inguinal rupture, varices, etc.)
Gynaecology Medical Imaging ( MRI ) Surgery of morbid obesity Paediatric Intensive Care Throat-, nose-, ear surgery
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27European Co-operations in the Health Care Sector, Basel, September 27, 2005
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28European Co-operations in the Health Care Sector, Basel, September 27, 2005
Verdere specialistische contactenVerdere specialistische contacten
Chirurgie Obstetrie en
Gynaecologie Radiologie Oncologie (CONCERT)
Oogheelkunde Neurochirurgie
Pulmonologie Neurologie Paediatrie Urologie KNO Psychiatrie Klinische Genetica
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29European Co-operations in the Health Care Sector, Basel, September 27, 2005
Grensoverschrijdende Zorg in de EMR,Grensoverschrijdende Zorg in de EMR,
Wat loopt er al? (3)Wat loopt er al? (3)
Delivery of blood products
in emergency cases
Ambulance, trauma-heli
Euregional Health Reports
etc.
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30European Co-operations in the Health Care Sector, Basel, September 27, 2005
Some minor and major problems to solve in Some minor and major problems to solve in cross border ambulance servicecross border ambulance service
Dutch ambulance has horn with 3 signals, the Belgian only 2
Dutch ambulance nurse may apply ALS Morphine on board: narcotic! Police has no competences abroad Large tariff differences
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31European Co-operations in the Health Care Sector, Basel, September 27, 2005
Some minor and major experiences with Some minor and major experiences with treatment of foreign patientstreatment of foreign patients
Cultural differences Patient satisfaction usually high Cross-border professional communication Cross-border integrated care (home care!) MRSA protocols Liability and its insurance Doctor’s fees; out-of-pocket payments; Budgettary “punishment”
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32European Co-operations in the Health Care Sector, Basel, September 27, 2005
Subjects of Interreg III Project Subjects of Interreg III Project “Zorg over de Grens in de EMR”“Zorg over de Grens in de EMR”
Website with information for patients, doctors, a.s.o.www.euregiogesundheitsportal.de
Cross-border integrated “chain care” MRSA-Network of hospitals in border areas Transparancy of hospital cost Transcultural aspects Euregional Quality Circle Oncology Circle (mammascreening, tumor biobank)
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33European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cross-border Health Care in the EMR: Cross-border Health Care in the EMR: What’s more ?What’s more ? (4) (4)
Cross-border contacts of patient groups Network Care for the Elderly Euregional Health Care Conferences Euregional Health Report of Public Health
Services Euregional environmental health projects Co-operation in the care for drug addicts Co-operation of Insitutes for Higher Education
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34European Co-operations in the Health Care Sector, Basel, September 27, 2005
Cross-border Health Care in the Euregion Meuse-Cross-border Health Care in the Euregion Meuse-Rhine: pilot for Europe?Rhine: pilot for Europe?
(More) free access to health care abroad
Hospitals in the EMR co-operate
Sickness Funds co-operate, crossborder contracts
Ambulance- and Public Health Serv. co-operate
Patients organize euregionally and participate
Authorities are engaged and support developments
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35European Co-operations in the Health Care Sector, Basel, September 27, 2005
What kind of support do we need from What kind of support do we need from the Member States and the EU?the Member States and the EU?
• Engagement of national authorities!!• Adjustment of national hospital planning systems
to interregional co-operation (as pilots?)• Norms for cross-border contracting• European framework for (mutual) recognition and
accreditation• Monitoring of cross-border mobility in health care• Creation of Network of pilot regions (AEBR,
HOPE?)
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36European Co-operations in the Health Care Sector, Basel, September 27, 2005
Members of the Interreg-III Project groupMembers of the Interreg-III Project group
Assent Jenny UNMS/CHUAu Heike AOKBieler Manfred BarmerBlaudzun Ulrich IKK Bouffioux Christian CHUCarnotensis Patrick CMLCoheur Alain UNMSDaemen Piet azMEngels Jürgen AOKFabry Ursula UKAHeuschen Willy St. Nikol. Hosp.Hofmann Barbara BKKKesenne Jos LCMMeyer Patrick COK
Mohr Ulrich VdAK-AEVPeeters Guy azMSass Henning UKASchemken Hans-Willi AOKScheres Jacques azMSteevens John CZ Stobberingh Ellen azMThielen Jacques MCTietje Mario TKK Van Camp Luc ZOLVandenbergh Joep VGZVan der Zanden Brigitte azM
Wolfs Marianne St. Nikol. Hosp.
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37European Co-operations in the Health Care Sector, Basel, September 27, 2005
Supported by:Supported by:
INTEREG III Programme of the European Union and the Euregion Meuse-Rhine
Provincie Limburg (NL) Ministerie van VWS (NL) Vlaamse Gemeenschap (B) Provincie Limburg (B) Ministerium der Deutschsprachigen Gemeinschaft Belgiens (B) Région Wallonne (B) Province de Liège (B) Ministerium für Gesundheit, Soziales, Frauen und Familie des Landes
Nordrhein-Westfalen (D)