Marc Jamoulle. marc@jamoulle.com
The availability of an electronic or printed medical record by the GP including personal administrative data, problem list, therapeutic index and reports of medical specialists and other health providers is granted by the Belgian national health insurer.
The GP receives 22€ /year per patient who has formally accepted the management of his/her data. This process is known in Belgium as the Comprehensive Medical Record (Dossier Medical Global or DMG).
GPs are private practitioner with a general fee for service system reimbursed at 75% by the national insurer. Free choice is generalised and patients have free access to medical specialists. Referral and counter referral are not mandatory.
The onset of the DMG in the late 90’s has been an evolution as important as the apparition of the Maisons Médicales (private integrated multidisciplinary health centres) in the late 70’s for Belgian GP/FM
The DMG gives incentive for the management of the medical data of a set of patient.
This represents a third way between pure fee for service and capitation. The link is triangular. Patient and doctor are linked by the management of data. The patient is still free to take and advice from an other doctor. The freedom of choice is conserved but information has to be gathered and managed by a designed GP.
It’s the first public acknowledgement of the function of GPs who is recognised by this process at the joint between individual and public health. The presentation gives and update on Belgian DMG, its actual use and its perspectives