The Dutch Healthcare Authority published the final version of the changes to the 2018 DTC-package for specialist medical care (RZ18b). One of the changes concerns distance consultations via for example Skype, chat or email. This is an important step towards funding eHealth in the specialist medical care.
These changes provide more scope to eHealth consultations taking place screen-to-screen, in writing (email or chat) or by telephone. Such consultations will be considered equivalent to physical face-to-face visits to outpatient clinics from 1 January 2018. This currently isn't the case. Provided that the care and duration meet the conditions set for a regular face-to-face visit to an outpatient clinic, these activities can count towards the diversion of healthcare services.
Furthermore, it is considered to be a general rule for type 11 care sub routes (initial care, ZT11) that at the beginning of a care route (the first 120 days or before the first sub route has been concluded, whichever is the earlier) at least one physical face-to-face meeting with the relevant professional is required. Such a physical face-to-face meeting doesn't necessarily have to be the first contact: the first contact may also take place screen-to-screen, but not via email, chat or telephone. Consultations via email, chat or telephone don't count, unless they replace a repeat visit to an outpatient clinic.
There are, however, two exceptions to the general rule that a physical face-to-face meeting is required at the beginning of a care route. Clinical genetics doesn't require any physical face-to-face meetings at all, but it does require at least one screen-to-screen meeting. Cardiology and pulmonology team meetings also don't require face-to-face meetings because these don't involve patient contact.
The Dutch Healthcare Authority expects the volume of healthcare services to change. In order to avoid the risks of increasing healthcare costs and displacement of care, the Dutch Healthcare Authority emphasises the significance of agreements on this subject between healthcare providers and healthcare insurers.
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Our Digital Health team has broad experience in the field of IT-contracts, privacy, financing and relevant healthcare legislation and regulations. Please do not hesitate to contact Dimitri van Hoewijk or Lars Leemeijer.