ERN The way forward: The Member States perspective Roundtable 4 Till Voigtländer 3 rd European Reference Networks (ERNs) Conference & ERNs Kick-off meeting, Lithuanian Exhibition and Congress Centre LITEXPO, Laisves pr. 5, Vilnius, 9 March 2017
Setting the Scene - Basic clarifications» The way forward» What are strategic goals we should have achieved in 5 years from now?» The Member States perspective» Who is the Member State» National (and regional) health authorities» Payers (National (national centralized system, health insurance funds, federal states)» Ultimately: The general public» ERNs are not final, we are still in a work in progress mode
Strategic goals for the next 5 years» Approaching the ideal network composition and format» Providing evidence for the success of the ERN concept» Solving the reimbursement challenges
Network composition and format» Current situation:» 24 networks covering almost all thematic areas defined by the Commission Expert Group on RD» More than 950 health care providers participating in the different networks» 26 different endorsement strategies» 26 different strategies of identifying national HCPs» Broad range of the number of full members per MS (2 187; 3 MS with no FM)» Broad range of the number of full members per ERN (18 73)
Lack of a more harmonized approach Dysbalance in» 24 networks covering full members almost all thematic areas defined by the Commission per MS Expert Group on RD Network composition and format» Current situation:» More than 950 health care providers participating in the different networks Lack of inclusivity» 26 different endorsement strategies» 26 different strategies of identifying national HCPs» Broad range of the number of full Challenging members per MS (2 187; 3 MS with no FM) size of some networks» Broad range of the number of full members per ERN (18 73)
Network composition and format» Objectives and tasks (1):» Addressing inclusivity:» Further endorsement of and calls for full members» Designation and integration of Associated National Centres and Coordination Hubs as further national links to ERNs (for MS without a full member in a given ERN or ERNs more general)» Developing a more harmonized approach in the MS regarding the identification/designation of HCPs» Strategic re-thinking on the level of the MS» Close link to the elaboration of an evaluation process for ERNs (WG on evaluation and monitoring, BoMS)
Network composition and format» Objectives and tasks (2):» Analysing the relation between size and operation of the networks» Critical review of functioning of huge networks compared to mid-sized and small ERNs» Depending on the results strategic re-thinking of» The number of full members in these networks» The definition of thematic areas» More individualized management/coordination support»...
Network composition and format» Objectives and tasks (2):» Analysing the relation between size and operation of the networks Reduced to a common denominator:» Critical review of functioning of huge networks compared to mid-sized and small ERNs Further shaping and refining of» Depending on the results strategic re-thinking of» The number of full members in these networks» The definition of thematic areas» More individualized management/coordination support»... the networks
Success of the ERN concept» Objectives of ERNs (CBHD; excerpt):» Improve diagnosis and deliver high-quality, accessible and cost-effective healthcare in areas where expertise is rare» Secure cost-effective use of resources» Reinforce research and provide training for health professionals» Facilitate mobility of expertise, virtually or physically» Develop, share and spread information, knowledge and best practice» Help Member States lacking technology or expertise to provide highly specialised services of high quality
Success of the ERN concept» Objectives and tasks:» Development of an evaluation and monitoring process for ERNs and participating full members» Requirement from the legal documents and task of the (Commission Implementing Decision)» Active support and participation of Member States (WG on evaluation and monitoring, BoMS)» Active involvement of ERN coordinators» Evaluation of the networks and full members after 5 years by an Independent Evaluation Body
Success of the ERN concept» Objectives and tasks: Reduced to a common denominator:» Development of an evaluation and monitoring process for ERNs and participating full members Improvements related to the» Requirement from the legal documents and task of the (Commission Implementing Decision) objectives of a given ERN» Active support and participation of Member States (WG on evaluation and monitoring, BoMS) provide the best evidence for the success of the concept» Active involvement of ERN coordinators» Evaluation of the networks and full members after 5 years by an Independent Evaluation Body
Reimbursement challenges» Current situation:» In principle, measures are in place to provide reimbursement of physical cross-boarder Provisions do healthcare not flow smoothly» Regulation () No 883/2004: coordination of social security systems» Directive 2011/24/EU: application of patients rights in cross-border healthcare No provisions available at all» No measures in place to provide reimbursement of virtual cross-boarder healthcare (VCB)
Reimbursement challenges» Objectives and tasks:» Obeying the commonly decided reimbursement procedures and rules by all Member States regarding physical cross-boarder healthcare» Development of a reimbursement scheme for virtual cross-boarder healthcare» Uncharted waters ( Neuland ) for the EU» Need for a cost analysis of virtual care» Experience and data from pilot networks» Based on the cost analysis exploration of suitable instruments for reimbursement
Reimbursement challenges Reduced to a common denominator:» Objectives and tasks:» Obeying The relation the commonly between decided reimbursement costs/ procedures and rules by all Member States reimbursement and the regarding physical cross-boarder healthcare improvement in healthcare» Development of a reimbursement scheme for virtual cross-boarder healthcare provided will be crucial for» Uncharted waters ( Neuland ) for the EU payers when judging about the» Need for a cost analysis of virtual care success of and support for ERNs» Experience and data from pilot networks» Based on the cost analysis exploration of suitable instruments for reimbursement
Summary» Setting the scene» Strategic goals to be achieved in 5 years from now Please keep in mind:» We Approaching are on the a ideal common network composition journey and format and share the majority of tasks» Evidence for the success of the ERN concept» Solving reimbursement challenges» Common denominators for each goal and their potential impact on the continuous support of the ERN concept
Another baby is born today
Das ERN-Konzept in der Computeranimation http://ec.europa.eu/health/ern/ uh board_member_states/index_en.htm Cluster till.voigtlaender@meduniwien.ac.at till.voigtlaender@goeg.at