Rehabilitation using a health app in the primary knee or hip replacement is now available to all eligible patients in Belgium

Rehabilitation before or after a primary knee or hip replacement using a health app (“application mobile”) is temporarily reimbursed in Belgium under the specific agreement. This agreement comprises a clinical study of patient-reported outcome measurements (PROMs) and the cost-effectiveness of using the health app. In the first phase, reimbursement was limited to patients participating in the clinical study, coordinated by UZ Gent and KCE. Hospitals and physiotherapists have to sign an agreement with the National Institute for Health and Disability Insurance (INAMI-RIZIV) to participate.

From October 01, 2022, INAMI-RIZIV announced the launch of phase 2 of the agreement, so all patients eligible for rehabilitation before and after a primary knee or hip replacement will now receive it using a health app in combination with a certain minimum number of classic face-to-face physiotherapy sessions. Certain health apps must be included in the list of reimbursable mobile applications. For now, only one app (MoveUP Coach) is included.

The administrative framework for the use of health apps in Belgium is presented on the mHealthBelgium platform. The central part of the framework is the so-called “validation pyramid,” which started in 2018. The overall idea of the pyramid is that individual apps enter the bottom of the pyramid (level 1) with basic requirements (CE mark; GPDR compliance) and move upward by proving that it complies with additional requirements (level 2) and that it has necessary clinical and economic value and can be reimbursed by the compulsory health insurance (level 3). This level is sub-divided into two sub-levels:

• Level 3- ("light"), when the health app has not sufficiently proven social-economic benefits and is still collecting data about social-economic added value and is reimbursed on a temporary basis;
• Level 3+ ("plus"), when an app has sufficient evidence of social-economic benefits and can be reimbursed on a permanent basis.

MoveUP Coach is the first health app that reached level 3- on the mHealthBelgium validation pyramid. Currently, there are no apps at the level 3+ level.

See more information in French here.

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