The Future
of E-health in Belgium
This week
we had the opportunity to hold a seminar together with Flanders Investment & Trade to explore the latest digitalization
partnership opportunities within the Belgian healthcare system. The
interest for the seminar was high and it was very nice to see so many Swecare members
represented; Zenicor Medical Systems, Raytelligence, Camanio Care, WeCare AB, Predicare,
Doctrin and Karolinska Institutet.
Mikael Larsson, foreign investment advisor opened the seminar with a short
introduction of Flanders Investment
& Trade, which is a government agency supporting companies interested
in investing in Flanders with assistance and information. They have more than
70 regional offices worldwide.
Elucidating the Belgian healthcare system within a couple of hours is no easy task
but invited guest speaker Peter
Raeymakers, from Zorgnet Icuro, gave an excellent presentation.
To
understand the basics, he opened the presentation by letting us know that Flanders is the Dutch-speaking northern
portion of Belgium. The capital of Flanders is Brussels, which is also the
capital of Belgium and home to the headquarters of the EU and NATO. Flanders
has its own parliament and government. Flanders, despite not being the biggest
part of Belgium by area, is the area with the largest population (68.5%).
7,876,873 out of 11,491,346 Belgian inhabitants live in Flanders or the
bilingual city of Brussels.
Present-day Flanders
(dark green) shown within Belgium and Europe.
Brussels is
considered part of the geographical region but is politically separate.
The Belgian
healthcare system is mainly organised into two levels: federal and regional.
Responsibility for healthcare policy is shared between the federal government,
the Federal Public Service Social Security, the National Institute for Sickness
and Disability Insurance (INAMI), and the Dutch-, French-, and German-speaking
community Ministries of Health. The federal government is responsible for
regulating and financing the compulsory health insurance, determining
accreditation criteria, financing hospitals and so-called ‘heavy’ medical care
units, as well as legislation covering different professional qualifications,
and registration of pharmaceuticals and their price control. The regional
governments are responsible for health promotion, maternity and child health
services, some aspects of elderly care, implementation of hospital
accreditation standards, and financing of hospital investment.
The Belgium
healthcare system is divided into state and private sectors, with fees payable
in both, funded by a combination of Belgian social security contributions and
health insurance funds. With mandatory health insurance, patients are free to
choose their own medical professionals and places of treatment. Patients
generally pay costs upfront and are reimbursed a proportion of the charges for
medical and dental fees, hospital care and treatment, maternity costs and
prescriptions through their Belgian health insurance fund. Doctors work in
public and/or private settings. Dentists are almost all private. Hospitals and
clinics are private and usually managed by universities, religious
organizations or mutuelle/ziekenfonds.
In 2013,
Belgium’s total health expenditure was 10.2% of the GDP, which is 6th
highest among the EU-15 (OECD, 2015). The Belgian health system is primarily
funded through social security contributions and taxation. Public sector
funding as a percentage of total expenditure on healthcare fluctuates around
70%.
1/3 of the
Belgian hospitals are operating in the red and that is due to the increasing cost
of healthcare. Another substantial factor in Belgium, are the costs of medical
professionals. This is a wake-up call to restructure funding and provision
approaches.
As Belgium
is on the verge of reforming its health care system, it is the perfect moment
for Swecare members to engage in this transformation and benefit from new
opportunities. With 11 million inhabitants, an ageing population which
increases the need for collaboration in efficient healthcare, couple with the
fast pace of technological change, Belgium needs to invest in innovation.
The Swedish think tank Health Consumer Powerhouse (HCP) has been comparing 35
European care systems since 2005 and presented a study in February this year
showing that Belgium has risen to the 5th spot in the European health index, up
from 8. Belgium is lauded for its quick and good treatments, high levels of
child vaccinations, and the affordability of health care. Long waiting lists in mental health care and a lack of information are
identified as points where action should be taken.
Now, start-ups are rising in the e-health sector. They provide solutions that
combat the healthcare challenges of today:
- People are making worse lifestyle decisions with higher risks of chronic diseases as a result
- Rising costs creates friction to democratize healthcare for everyone
- Seniors are getting older and older
Just to
name a few examples of the challenges, Belgium aims to be the place-to-be for
HealthTech innovations, attracting talent and innovations from all over the
world.
Belgium has
big plans for implementing E-health in the healthcare system. It’s now possible
to share medical information and ‘documents’ of patients on secured platforms.
It is termed the EPD (Elektronisch Patiënten Dossier) in Belgium. Every
caregiver will have access to the relevant information of their patient. Easier
access supports multidisciplinary care and drives collaboration between the
specialists. These elements increase the quality of care. Patients are included
in this e-health transformation. They can have access to their medical records,
which helps them to be on track with their health. Furthermore, communication
between patients, caregivers and other stakeholders will improve with the EPD.
Electronic platforms ensure processes to run even smoother.
However, while many health data are being collected and published in Belgium,
some data are collected but are not used (e.g. morbidity indicators), while for
other areas such as nursing, primary care, psychiatry, elderly and nursing
homes, and non-reimbursed payments only limited data are available. In
addition, the coordination to integrate the data available for policy decision
should be strengthened.
Peter
explained more about the national project “eHealth Hubs & MetaHub”
coordinated by the eHealth platform is meant to make medical results from
hospitals (and in the near future medical laboratories) available to any
caregiver who currently is treating the patient. For detailed information see https://www.ehealth.fgov.be/nl/zorgverleners/online-diensten/hubs-metahub. This system supplements the
traditional system of addressed ‘email type’ communication to individual
referrers.
Before
medical data about a patient can be shared, that patient has to grant the “eHealth
informed consent” (see http://www.patientconsent.be). Further, care providers
declare a therapeutic relationship with the patient.
M-Health Belgium
Peter also talked
about mHealthBELGIUM, which is the Belgian platform for mobile applications
that are CE-marked as a medical device. It offers all the relevant and
necessary information to patients, healthcare professionals and healthcare
institutions regarding these mobile applications. The information on this
platform covers CE-marking, GDPR, compliance with security and authentication
rules and how the app is financed. mHealthBELGIUM is an initiative of the Federal
Belgian Government. This platform of 24
selected projects are operated by Agoria & beMedTech, in close cooperation with NIHDI, FAMHP & the eHealth Platform.
The Belgian government with Maggie De Block (minister of Public Health) at the
forefront sees these life-changing opportunities. Her aim is to incorporate
M-health into the healthcare. But before M-health solutions are implemented,
they will go through a validation pyramid. The validation pyramid analyses
whether an application is safe, secure and provides benefit to the patient,
caregiver or the healthcare system. That is to say healthcare is one of the
slowest sectors to adopt healthcare technology. Therefore, to fast-track these
applications, this evaluation model will ‘test’ and ‘fail solutions quicker. No
more delays of valuable innovations accessing healthcare.
De Block
has performed the validation pyramid on 24 M-health applications and published
the first results. As expected, the main benefit is that patients are more
involved in their health maintenance. They are more willing to follow through
with their treatment, feel supported and safely tracked by a caregiver on
distance. Giving the patient control, also drives healthier choices in
lifestyle.
Peter
mentioned that there’s a good chance for you to enter the Belgian market with
your health app, but it must be a medical device. Please visit; www.mhealthbelgium.be and read the FAQs and how to apply, etc.
Peter
represented Zorgnet Icuro which is a network of health care organizations,
general hospitals, elderly care clinics with around 775 members and employing
around 129.000 people. Their goal is to exchange information, knowledge and
ideas in health care. And to discuss several issues in the healthcare sector.
Before the
seminar ended, we had the pleasure to listen to Collective Minds Radiology AB a small start-up which sells a
platform for Radiologists. They’ve just entered the Belgian market by landing
on a right contact through LinkedIn and had the same morning signed a contract
with AZ West Hospital in Veurne and will during next week introduce their
platform to other hospitals in the region.
Amber
Ryckewaert from Flanders Investment &
Trade wrapped up and invited all participants and members of Swecare to
join them on a 2-day study visit to
Flanders some time during week, 21-25 October 2019. The outline is not
ready yet as they wish You to come with your wishes! So, if you’re interested
in entering the Belgian market please contact Amber RYCKEWAERT, amber.ryckewaert@flanderstrade.com for more
information!
We say a big thank you to Flanders Investment & Trade for making this an interesting event
for our members!
Socialdepartementet och Swecare var i Indien för någon vecka sedan och tog då tillfället i akt och träffade våra kollegor på hälsoministeriet. De
är fortsatt entusiastiska till samarbetet och vårt jubileumsår. 
Vi fick träffade även några stora (svenska) och små (indiska) bolag, tjänstemän på lokala hälsoministerier i Maharashtra och Karnataka, och Indiska key opinion leaders inom vården. Vi pratade om innovationshub (Delhi) och test beds (Bengaluru) men vi behöver utveckla idéerna i samband med våra lokala partners, Business Sweden, och Svenska Ambassaden i New Delhi.
