The development of a quality system for neuromodulation in the Netherlands

We present here a descriptive article on the development of a national quality system for neuromodulatory techniques in the Netherlands. In 1994, due to reimbursement difficulties in the Netherlands, a Neuromodulation Working Group (WGN) undertook an initiative to develop a national quality system for neuromodulation. It was believed that with official recognition of neuromodulation as a therapy by the health authorities in the Netherlands, a quality system for monitoring would then follow. To that purpose an observational study was performed. Integration of this entire primary process (from intake to control phase) was based upon an inventory of the practices of the most experienced medical specialists practicing neuromodulation in the Netherlands. Based on the study data, nine quality indicators were identified that would allow monitoring of the quality of care to patients in the Netherlands. The study resulted in a positive feedback to the National Health Insurance Board and the Ministry of Health in the Netherlands. Neuromodulation for chronic pain and disabling spasticity is now recognized and fully reimbursed within the limits of the newly developed quality system. We therefore conclude that developed quality systems can provide a basis for medical specialists to cooperate around groups of patients or diseases. These quality systems can facilitate implementation and innovation within the health care system. The role of medical specialists and their will to cooperate is essential.