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21 May 2024 | Country Update
Latvia launches cross-border e-prescription data exchange with other EU member states
5.2. Patient pathways
Almost every Latvian citizen (96%) is registered with a GP based on free choice (children under the age of 18 years can be registered with paediatricians). A partial gatekeeping system exists, with patients requiring referrals from GPs to access most secondary ambulatory and hospital care services, with some exceptions (e.g. for gynaecology).
In case of illness the GP either treats the patient directly or issues a referral: 1) to a specialist; 2) for laboratory examinations or diagnostic evaluation; 3) to a day care centre; or 4) to a hospital (Fig5.1). If the patient requires further evaluation or treatment, the specialist may refer the patient 1) to another specialist; 2) for laboratory examinations or diagnostic evaluation; 3) to a day care centre; or (4) to a hospital.
Fig5.1
A patient with a referral can freely choose any ambulatory or inpatient care provider (institution). The choice depends on whether the patient expects a publicly paid service or is willing to use private insurance or pay for the service out of pocket. In the case of publicly paid services, provider choice is limited since NHS-contracted institutions provide the services and their availability depends on the annual contracted number of services for each provider. If waiting lists are substantial or if providers exceeded the number of patients to be treated according to their contracts with the NHS, patients have the option to pay directly (100% of costs) for the treatment at contracted or non-contracted providers. Public provider choice can be limited because of waiting lists and limitations in infrastructure which leads to substantial distances to the closest provider, particularly in rural areas.
EMA services can also refer patients to hospitals (see section 5.5). After hospital discharge, patients may be referred for rehabilitation or home care. Fig5.1 shows a typical patient pathway through the health care system in Latvia.
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.