Trans-European healthcare support network for Europe’s mobile citizens

Challenges of cross-Member State healthcare services

Published: 09/24

BRUSSELS, BELGIUM - (HealthTech Wire) - Travelling abroad for pleasure, education, or work has become a natural part of life for many European citizens. All across Europe, more than 400 million visits to other countries were estimated for 2006 alone.

Mobility of people is increasing, products and services can be bought in another Member State when the need arises, but obtaining healthcare outside their residence country is still problematic for many Europeans.

And this in spite of the legal framework for healthcare provision across Member States having been set up already in 1971 by the EU and its Member States with the so-called E-forms. In 2004 this procedure was improved through the introduction of the European Health Insurance Card (EHIC), which should allow every citizen who is insured through the public health system equal access to healthcare in another Member State when in need. However, knowledge about this is not widely spread, and the administrative processes accompanying cross-Member State provision of healthcare have not developed at the same pace as leisure travel and labour mobility.

The TEN4Health service: borderless healthcare provision

To alleviate this situation, the TEN4Health service package contributes towards improved healthcare provision for mobile European Union citizens. Initiated by leading public health insurance providers, it assures access of citizens to healthcare in participating Member States’ hospitals, based on a secure web service and its integration into developing Euro-pean eHealth infrastructure networks. The package’s key components include:

• information on local rules, co-payments and other aspects of healthcare for citizens in their respective language at the point and time of treatment abroad
• instantaneous online verification of insurance status for healthcare providers and assurance of cost coverage
• efficient support for fast electronic post-processing at the national level
• electronification of reimbursement procedures across Member State borders, with special attention to interoperability.

The TEN4Health service package thereby fundamentally contributes to the ubiquitous acceptance of the European Health Insurance Card and prepares for the later introduction of its eCard version. It greatly enhances and extends its utility by integrating efficient support for electronic post-processing at the Union level.

How the TEN4Health service works

The participating insurance companies sign contracts with partner hospitals abroad, initially in regions frequented by their clients when travelling for leisure. When clients, in unplanned need of treatment, go to a participating hospital, they only show their national health insurance token/EHIC. They receive information in their mother tongue, via the web-portal or a call-centre, about the conditions of treatment, their rights and obligations in the country of treatment, including regulations on co-payments. After verifying their insurance status online, they receive treatment like local residents.

The person at the administration desk of the hospital enters the unique EHIC ID number onto the system. This creates an electronic administrative record for the particular case of treatment. The validation of insurance status, either from the actual insurer, or the hosting insurer in the country of treatment, is returned instantaneously. All further administrative information exchange, including reimbursement, are based on the electronic administrative record created and use the same web-based technical infrastructure. Staff at the hospital can enter and receive data either directly via a web-portal, or via the country-specific administration interface they use for local patients. The latter can be a web-interface, like VECOZO in the Netherlands.

Locations of validation activities

The TEN4Health service will be validated at 11 hospitals directly participating in the consortium, and several other, indirectly participating hospital sites across six Member States – Austria, Belgium, the Czech Republic, Germany, Italy, and the Netherlands.

Presentation at The World of Health IT, Vienna, Thursday 25 October 2007:

This service will be presented at 10:15 in Session ES51:
eHealth Implementation: From Plan to Action
Supporting Mobile Citizens: Integrating Healthcare across Europe

Hans-Willi Schemken
Karl A. Stroetmann

Acknowledgements:
The TEN4Health project is supported by the European Commission through the eTEN Programme (ec.europa.eu/information_society/activities/eten/ ).

This information reflects solely the views of the TEN4Health team.
The European Community is not liable for any use that may be made of the information contained therein.

CONSORTIUM:
The project is coordinated by:
empirica Gesellschaft für Kommunikations- und Technologieforschung mbH (DE)
Oxfordstrasse 2, 53111 Bonn, Germany
Tel.: +49 228 985 30 0
Email: ten4health@empirica.com
www.ten4health.eu

Partners:
AOK Rheinland/Hamburg – Die Gesundheitskasse (DE)
CZ – Actief in Gezondheid (NL)
CM – Christelijke Mutualiteit (BE)
IZIP Inc., in cooperation with VZP, the General Health Insurance
Company of the Czech Republic (CZ)

Members:
VECOZO B.V. (NL)

Participating hospitals:
Universitätsklinikum Aachen (DE)
Kreiskrankenhaus Grevenbroich (DE)
Landeskrankenhaus Villach (AT)
Regione Del Veneto (IT)
Academisch Ziekenhuis Maastricht (NL)
Medisch Centrum Alkmaar (NL)
Walcheren Ziekenhuis (NL)
Rijnland Ziekenhuis (NL)
Gemini Ziekenhuis (NL)
AZ Koningin Fabiola (BE)
Nemocnice Karlovy Vary (CZ)