Country profile: Netherlands

Among the principal actors in the Dutch Healthcare System are the Ministry of Health, Welfare and Sport, which governs and implements health policy, the local authorities, who implement the health policy in cooperation with the ministry, as well as numerous private care suppliers (individual practitioners as well as care institutions), who provide the actual healthcare services.
A complex system of Inspectorates assures the quality and homogeneity of healthcare provided to citizens at healthcare facilities. The Dutch insurance system is organised on three tiers, with uninsurable medical risks covered by the state; universal health insurance covered by the state and insurers; and a complementary voluntary private insurance.

ICT use and eHealth strategy

The Netherlands are one of the EU's frontrunners regarding eHealth and the use of computers in health care, scoring above average utilization rates in almost every aspect of eHealth: nearly all Dutch GP practices are equipped with a computer and Internet access, four fifths of which are broadband connections. Lab results are systematically transferred electronically and data transfer between GPs - while not an established practice - is much more common than in other EU countries. ePrescription is used in three quarters of all GP practices. Administrative data is stored routinely in Dutch practices, which are among the most advanced in Europe regarding data security and the prevalence of user authentication systems. The use of computers during consultations is commonplace as well.

The Dutch national eHealth strategy if focused on improving the affordability, accessibility and quality of healthcare by creating preconditions for the safe, optimal usage of ICT. The strategy is focused on the introduction of keystone technologies, such as EHR, to promote broader utilization of ICT in healthcare. The National IT Institute for Healthcare (NICTIZ) is one of the main actors in the development of Dutch eHealth solutions. The involvement in international initiatives such as large-scale pilots is perceived as a direct extension of national efforts regarding the introduction of EHR and other eHealth solutions.

One of the main assets of the Dutch healthcare system is AORTA, the national communication infrastructure for healthcare, which contains eID authentication systems and allows safe, controlled transfer of health data across the Netherlands through a central hub.

The Dutch EHR implementation will be linked to AORTA and the scope of information contained within will be improved gradually.

Legal framework

In the Netherlands, the electronic exchange of information in healthcare is strictly regulated. Given that the national AORTA hub contains systems guaranteeing the privacy of each user as well as a comprehensive access rights management framework, the legislation regarding the exchange of health information mostly contains provisions forcing users to go through this hub for all transactions. The broader privacy regulation closely follows relevant EU guidelines, thereby guaranteeing that only relevant information is made available in a secure manner on a strict need-to-know basis.