Updated: Dec 6, 96
NETHERLANDS

The organisation of health care is currently being reformed. There are seen to be four partners in its provision: the Government; health care institutions; health care insurers; and patients' associations and consumer councils.

Thus, health care is managed and administered decentralised, with Government providing the legal framework, setting the income-related insurance contributions, and monitoring activity. Under new legislation the patient/consumer is an "equal" partner in health care delivery and have their own information requirements. At the local level care provision is negotiated between the insurers and health care bodies, with agreements on data exchange, either as part of contracts or through agreements between "umbrella" organisations. Each of the four parties has its own data requirements and thus has its place in setting the information systems. The Government has set a specific initiative to bring the parties together.

Central government collects and registers very little data, relying on access to data stored elsewhere. As far as possible the government obtains access to data stored elsewhere voluntarily. There are however several areas where government has responsibility for general issues, which cannot be addressed by individual health care institutions or insurers. Such issues are:

• information infrastructure
• standardisation and classification
• data protection legislation
• uniform patient identification
• research and development

Platforms for EDI and chipcards: although health care providers and insurers must decide for themselves if they wish to apply and use EDI and/or chipcards, umbrella organisations can make general agreements on standardisation and organisation. The Government stimulates these developments within the framework of the Public Health Transparent (Volksgezondheid Transparant) research programme, and will ensure the dissemination of knowledge. The Government is also supporting the foundation Interconnectiveit Telematics Nederland and the National Chipcard Platform as platforms for respectively EDI and chipcards.

Standardisation/classification: the national Council for Public Health is engaged on classification work, and the EDI initiative is influencing the adoption of standards.

Debate on national patient identifiers: privacy legislation means that the patient has to give permission for the use of identifiable data for purposes other than the original. The National Council for Public Health has made recommendations on the circumstances under which data could be exchanged without the patient's specific permission. Similar considerations apply to the development of a national patient identifier, and whether this should be linked to the social/fiscal number of municipal administration identifiers.

R&D: The Government has instituted the three year Public Health Transparent programme including work on innovation, dissemination of knowledge and strengthening of the infrastructure. 50% funding is being provided for approx. 140 projects dealing with quality, efficiency, standards, data exchange, information to consumers and new IT. Dfl 54 million (approx. 25 mecu) has been committed in 1992 through 1994.

[ Send your Comment ]

[ View Comments ]

	Copyright 1997 © EHTO All rights reserved This server is the only official EHTO WWW knowledge repository. Mail suggestions to: webmaster@ehto.org