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21 May 2024 | Country Update
Latvia launches cross-border e-prescription data exchange with other EU member states -
21 May 2024 | Country Update
Latvia enhances health data exchange across borders
2.5. Patient empowerment
2.5.1. Patient information
Access to information is guaranteed by the Information Transparency Law (1998) which ensures that citizens have access to information that is at the disposal of the institutions and establishes a common procedure for the right of private individuals to obtain and use information. The authorities shall provide information on their own initiative or at the request of an individual. Any person can ask for state-held information and public bodies must respond within 15 days.
In accordance with the principle of good administration, the institution shall, on its own initiative, provide access to certain types of available information (Table2.2).
Table2.2
The portal www.latvija.lv provides information about public services provided by state and local government institutions, ways of requesting and receiving them, service-related payments and service descriptions, and electronic services including a link to the service receipt resource.
The information available to citizens has increased considerably in recent years. In particular, the MoH developed a portal called “Your Health”, where citizens may obtain information on their rights and responsibilities, health care organization, how to apply for health care services, health prevention, healthy lifestyle, special recommendations for specific patient groups, etc. The MoH also informs patients about regulatory issues, planned reforms and provides links to other national and international institutions.
Public institutions subordinated to the MoH share information within their functions and competences. For example, the NHS provides information on the financing of health services, tariffs and access to contracted health care providers. This information is available on its website and on posters and booklets in territorial branches and health care facilities.
The CDPC provides information on health promotion, infectious disease control, epidemiological data and health statistics. The SAM reports on the pharmaceutical sector regulation, rational pharmacotherapy, and pharmacovigilance and provides statistical information regarding the pharmaceutical market. The HI informs citizens of the compliance requirements for service providers, on reporting of violations, and issues alerts and notifications. Local governments provide information on health care provision and access to health services in the regions.
The Law on the Rights of Patients (2010) stipulates that patients have the right to receive clear information about their diagnosis and a plan of examination and treatment. The same law also guarantees a patient’s right to information about quality of care. The GP usually serves as a health counsellor, advising on planned treatment and health care institutions appropriate for the patient’s needs.
2.5.2. Patient choice
Article 8 of the 2010 Law on the Rights of Patients guarantees the right to choose a physician or medical treatment institution (Table2.3).
Table2.3
Patients can freely choose to register with any family doctor in Latvia and may decide to change their doctor at any time (see also section 5.3). However, in practice, choice of GP exists only in urban areas; in rural areas there may be only one GP covering a relatively large geographical area. The main reason for a change of doctor is a change of residence.
In case of statutory health care a patient is also free to choose a diagnostic institution, specialist or hospital, as long as the institution or specialist has a contract with the NHS and the patient has a referral from a family physician (see section 5.2).
For privately paid services, choice is completely free. The price list of fees is determined by each medical institution, and prices may vary among medical institutions. The price list for the fees required by the institution should be clearly visible to patients.
2.5.3. Patient rights
The rights of patients in Latvia (Table2.4) are regulated by the Law on the Rights of Patients (2010), which sets the regulatory framework for patients’ right to information, medical treatment or waiver, the right to choose a doctor or medical institution, and the right to data protection and quality health care.
Table2.4
The purpose of the law is to promote favourable relationships between a patient and the provider of health care services, facilitating active participation of the patient in their health care, as well as to provide an opportunity to implement and protect their rights and interests.
2.5.4. Patients and cross-border health care
The NHS is the competent institution and contact point in Latvia responsible for the coordination of EU cross-border health care as foreseen by the Cross-border Directive (2011/24/EU) on the Application of Patients’ Rights in Cross-Border Healthcare.
Individuals can obtain pre-authorization from the NHS to seek treatment abroad if waiting time for a service covered by the Latvian basic service package exceeds medically justifiable time limit. The scale of reimbursement may be limited to the cost of service in Latvia. Pharmaceuticals are covered for the amount reimbursable in Latvia.
Based on EC Regulation 883/2004, Latvian citizens use the EHIC to receive acute health services within the statutory system abroad when on a temporary stay (for example, as tourists) and the statutory system of the foreign country will subsequently be reimbursed by the Latvian NHS. In 2016, the NHS paid €9.445 billion for health care services provided in other Member States to individuals entitled to statutory health in Latvia (NHS, 2018).
Latvia has initiated cross-border e-prescription data exchange with select EU member states. E-prescription drugs can already be purchased in Estonia, Lithuania, Poland, the Czech Republic, Portugal and Spain, with more countries to be added over time.
From 4 March 2024, residents of participating EU member states can also buy their e-prescription medicines in Latvian pharmacies, provided their country has established data exchange with Latvia. Currently, Latvian pharmacies can dispense medicines that have been prescribed in Estonia, Poland, the Czech Republic, Portugal and Spain.
For up-to-date information on countries exchanging e-prescription data with Latvia, visit the NHS website https://www.vmnvd.gov.lv/lv in the “Cross-border E-health services” section.
Authors
The electronic exchange of basic health data started on 4 March 2024, aiming to improve the availability of health data, the quality of treatment and data-driven decision-making. This initiative allows Latvian residents receiving medical assistance in another EU member state, to have their basic health data (diagnoses and information on surgical interventions, within the last six months) accessible to the medical personnel involved in the treatment process. Basic health data information is already available with Estonian, Portuguese, Spanish and French medical institutions, with plans to expand to all member states involved in the cross-border project.
The NHS of Latvia is implementing the project “Exchange of basic patient health data and e-prescription information with cross-border E-health information systems”. Within its framework, a national E-health contact point has been established.
For more information: https://www.vmnvd.gov.lv/en/cross-border-ehealth-services