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    Telemedicine permanently reimbursed in Belgium from 1 August


    Screen care also falls under the new regulation for Telemedicine

    National Institute for Health and Disability Insurance in Belgium has published an article in which the institute indicates that a new reimbursement scheme will be introduced on 1 August regarding 'remote consultation by doctors'.

    During the corona crisis, many healthcare institutions were dependent on telecare for certain treatments. This marked the breakthrough of online care consultations, but also marked a breakthrough in terms of reimbursement system in Belgium. A temporary arrangement came into effect and it was possible for patients to be reimbursed for a video consultation. This temporary arrangement will now be converted into a permanent repayment arrangement from 1 August.

    No limit on number of reimbursed consultations

    Telephone and video consultations will be reimbursed without limitation from August this year. However, there are a number of conditions attached to it:

    • with doctors with whom the patient already has a treatment relationship
    • with a specialist to whom the patient has been referred
    • at an organized out-of-hours GP service

    Higher fee for video consultations

    Higher fees will be charged for video consultations than for telephone consultations. Patients will also have to reimburse part of the treatment themselves (personal share / co-payment). Applying the third-party payer scheme will remain mandatory.

    Which screen care platforms may be used

    The platform used must meet a number of conditions:
    - communication is via end-to-end encryption
    -communication is not stored on the platform
    -if the platform contains other functions, in addition to the possibility of video or audio communication, including the exchange of documents, these are offered in such a way that the users applicable legal provisions comply with, as described on the eHealth website

    It goes without saying that Webcamconsult meets these requirements and is already widely used in Belgium.

    Responses from Belgian healthcare specialists

    We have asked a number of leading healthcare specialists from Belgium to respond to the news:

    Bart Degryse, Project Manager Healthcare Center and Healthcare Innovation Wit-Gele Kruis, “Belgium is lagging behind in the field of telehealth and is slowly trying to make up for this. Our neighboring countries already did this before the Corona crisis. Hopefully the reimbursement will not be limited to general practitioners and specialists and other care disciplines can also make more frequent contact with their clients through this route.

    The challenge remains to see telehealth in a broader sense than simply providing teleconsultations with clients in the context of a medical consultation. Teleconsulation is only one of the ways to facilitate 'care or distance', for example in the context of home hospitalization. To structurally expand telehealth, new care models and forms of financing are urgently needed. A multidisciplinary approach and collaboration with all care actors will be one of the determining factors in achieving this successfully.”

    Philippe Bocklandt, teacher and research assistant online help Artevelde University College – Social Work training: “Belgium remains a complicated country with regard to the organization of welfare work and health care. A large part of the health care is regulated by 'Belgium' and is financed through care-per-performance. Partly by the government and partly by the patient. In that regard, there is now – fortunately – a structural arrangement for video calls at doctors. Such a scheme has also been worked out for psychologists, for example… albeit with different (pre)conditions.

    Welfare work, on the other hand, is largely regulated at 'Flemish level'… there too, video conversations are reluctantly recognized as client contacts in, for example, general welfare work, youth care, home care, from facilities for people with disabilities. But here, too, each 'agency' often sets its own conditions.

    So we're one step ahead… we really are. But it remains a mess. Organize a multidisciplinary consultation with the client, a health insurance fund employee, a home care employee and a general practitioner. It is not obvious if you have to take all conditions and payment arrangements into account. So there is still work to be done.”

    Sofie Staelraeve founder of healthcare consultancy dashplus: “There is now finally a regulation that can ensure trust and further evolution among doctors. Patients are already embracing video consultations, but doctors are often too hesitant. In Belgium, it is now also possible to focus on real-life insights, training and experience. And that is badly needed, because the debate about digital care was still too much in clichés and fears: it would remove contact with the patient, lead to abuse and extra costs, limit the role of the doctor. While experiences abroad show that none of this is the case.

    In any case, we will continue to feel the pressure of increasing demand for care on the one hand and a shortage of general practitioners and specialists on the other in the coming years. Telehealth is a high-quality and efficient solution for this. Not the only one, but a very important one.


    I am therefore convinced that the new regulation will have to evolve further:

    • to all healthcare professionals. Just think of the enormous need for mental help, for example
    • for all Belgians: many people already live in areas with patient stops or a shortage of general practitioners. They should also be able to conduct a teleconsultation, without having to pay for it out of pocket
    • with a completely equal fee between physical and digital consultations

    Health Minister Frank Vandenbroucke has also announced further evolutions as part of his 'new deal for GP practices', so changes are still on the way. In healthcare, as in other sectors, digital working is part of a modern and sustainable system. They are two sides of the same story, and should be equated.”

     

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