Concurrent with the 23rd Rapid Exchange Forum, the third Special Edition REF took place. To avoid duplication of work, we believe it is highly relevant to be aware of other international activities, mechanisms and expert groups already in place, or established during the pancemic, which exchange information on population health developments that require rapid action. 

To shed light on such activities, REF Special Editions invite key guests from relevant international organisations to report on their main activities, boards/expert groups, and different COVID-19 actions.

The guest speakers for the third Special Edition REF were:

• World Health Organization Regional Office for Europe (WHO/EURO) – David Novillo Ortiz 
• European Medicines Agency (EMA) – Rosa Gonzalez-Quevedo 
• Vaccination Task Force Portugal – Admiral Henrique Gouveia e Melo

Concurrent with the 32nd Rapid Exchange Forum, the fourth Special Edition REF took place. To avoid duplication of work, we believe it is highly relevant to be aware of other international activities, mechanisms and expert groups already in place, or established during the pancemic, which exchange information on population health developments that require rapid action. 

To shed light on such activities, REF Special Editions invite key guests from relevant international organisations to report on their main activities, boards/expert groups, and different COVID-19 actions. 

The guest speakers for the fourth Special Edition REF were:

• European Health Emergency Preparedness and Response Authority (HERA) - Christian Wimmer
• European Centre for Disease Prevention and Control (ECDC) – Marie Heloury & Ettore Severi
• European Commission, Directorate-General for Health and Food Safety (DG SANTE) – Federico Pratellesi
• Organisation for Economic Co-operation and Development (OECD) – Gaetan Lafortune
• European Observatory on Health Systems and Policies (OBS) - Matthias Wismar

Tourism - Payment policy / testing policy

1. Who is or should be paying COVID-19-tests for tourists in your country?

2. Does your country have a specific testing strategy for tourism in place?

• If yes, please share further information.

​​​​​​Vaccine priorites and trials addressing public health needs

• Which of the following issues have the highest public health priority in your country in relation to future COVID-19 vaccination strategy and vaccine trials: Vaccine efficacy, vaccine development, specific populations, or any other?
• Is there any example in your country of COVID-19 vaccine trials that are addressing public health needs?

Digitalisation - going from a paper death certificate to an (100%) electronic death certificate

• Could you describe the dataflow, from the source filling in the death certificate to the final destination (statistical institute or others)? The different stages through which a death certificate passes would be of interest.
• If necessary, could you describe the process of making this transition between paper registration and electronic registration? What were the specific periods & phases? Have you planned a hybrid situation (paper/electronic) or an exit from the paper system and a direct transition to electronics?
• Have you implemented direct cause-of-death coding using ICD-10 codes in the registration tool or does the doctor have to type? If you implemented direct ICD-10 coding in the tool, who set it up and is there still manual code checking? Does it contain a kind of decision tree to fill it out/to avoid obvious errors?
• Is there a real time use of this digital data? And if not, have you planned a direct use of the data in case of epidemiological emergencies (such as COVID-19).

Update on Long COVID management

• Have there been any major changes in your country following your possible original response in early 2022 (29 REF) when it comes to existing or planned processes for coordinated management of care for long COVID patients in your country?
• Specifically, do these processes also relate to tools for (differential) diagnosis / symptom screening for clinicians, and standardised treatment pathways for long COVID patients?
• In addition, could you briefly describe how your country organises the treatment/management of long COVID patients? Specifically, are there specialised clinics/departments/centres and are these clinics stand-alone entities or part of larger institutions such as hospitals or primary care centres?
• Does your country have a registry of Long COVID patients?

Diagnosis Coding

Are the health care providers (hospitals and publicly/privately funded outpatient care centres) in your country obliged to use a coding system for diagnoses?

If yes,

• Did the implementation predate COVID-19, or has it only been implemented since then?
• Please describe the coding system in place (e. g, ICD, ICPC, SNOMED, CT, other or combinations).
• Please describe the usage of the data (who’s the data holder, COVID analyses, analyses in general, scientific studies regarding COVID...).

Waiting list for scheduled hospital care / Data on waiting times

Are waiting lists and/or wait times for the following types of scheduled hospital care an issue in your country?

• Inpatient/Day Case procedures
• Outpatient appointments (i.e., specialist assessment?

Does your country publish data on waiting lists and/or wait times for scheduled hospital care? This may include total numbers currently waiting on the list and numbers waiting over certain time bands (e.g., 12 months) for

•  Inpatient/Day Case procedures
• Outpatient appointments

If yes, what breakdowns does your country report for waiting list data, which may include e.g.

• Categories of waiting lists (e.g., patients waiting for an appointment date, patients who have received an appointment date and are waiting to come in)
• Time period waiting (0-3 months, 3-6 months etc.)
• Geographical disaggregation
• Any other disaggregation

How are wait times measured? For example,

• Outpatient waiting time: time from GP referral to specialist consultation
• Inpatient waiting time: time from when the patient is added to the treatment waiting list to when they are treated
• Referral to treatment waiting time: time from GP referral to treatment.

Does your country publish data on the level of inflows to and outflows from waiting lists (i.e., the numbers being added to and removed from waiting lists)?

What formats are the data published in (e.g., open data, PDF reports, others)?

Analysis of telemedicine and/or artificial intelligence 

Is there an analysis of the use of telemedicine and/or artificial intelligence in your countries' inpatient sector (published or ongoing)??

If yes,

• Who has carried out/is carrying out this analysis? Which authority (or other partner) is or has been commissioned to carry out such an analysis?
• What conceptual framework do you use for the definition of telemedicine and/or artificial intelligence (e.g. functions like storage and forwarding/monitoring/interaction for telemedicine; prediction/diagnosis/treatment for AI))
• What were the methods used (literature search, web search, expert interviews, etc.)?

If no, are there plans to carry out such a study?

Has there been an increase in the use or implementation of telemedicine and/or articifals intellegence since the beginning of the pandemic? If yes, please give examples.

Health of healthcare workers (HCW)

• What kind of monitoring is your country doing to protect the health of HCW?
• What factors are you looking at, when it comes to protection of HCW? (e.g. anxiety, depression, burnout, …)
• Is data on the health of HCW collected routinely in your country?