Health reform: how Luxembourg is digitising medicine
Piron Guillaume, Unsplash
Luxembourg is moving steadily towards full digitalisation of its healthcare sector. Since 2023, around two-thirds of all doctors in the country - that's about 1,900 people - have implemented the Immediate Direct Payment (PID) system, which allows patients to pay only their share of the medical bill, with the rest automatically covered by the National Health Insurance Fund (CNS). According to the CNS, about 1,600 doctors actively use the system each week.
Among the first fully digital facilities are the Paediatric Medical Centre (Maison médicale pédiatrique) and the Children's Clinic. The other three medical centres will also join soon. The state-run Policlinique CHL already has a PID in place, and other hospitals are modernising their systems. The introduction of PID in the psychotherapy sector is also under discussion - expected to start in 2026.
The advantages are obvious: "It saves us time and money," explains Dr Sébastien Diederich, a general practitioner and general secretary of the Association of Medical and Dental Doctors (AMMD). Doctors no longer send payment reminders and patients are spared having to pay the full amount at once.
However, not everything is going so smoothly. Problems with anaesthetists' billing are still not resolved, the SAMU emergency medicine service cannot yet use PIDs. Correcting errors, such as a wrongly entered code, remains labour intensive.
Important to note: PID remains a voluntary system. Some patients deliberately refuse automatic refunds for personal reasons, and CNS respects this. About 10% of medical services are still incompatible with PID - they require pre-checking before reimbursement.
But digitalisation is not limited to PIDs. From 1 January 2026, all doctors are required to have the technical ability to e-bill - even if they do not participate in PID. This will create an alternative: patients will be able to pay the bill as usual, but will receive a digital receipt and be able to upload it directly to the CNS app for a quick refund.
According to Christian Oberlé, head of CNS, the infrastructure is ready - doctors have six months to update their IT systems. However, according to Diederich, not everyone will have time to do so.
The next stage of reforms is the digital health insurance, followed by electronic prescriptions. By the end of the year, it is planned to launch a new CNS application integrated with the state portal Guichet.lu. All this brings Luxembourg closer to a healthcare model where paper forms are a thing of the past and the medical process becomes faster, more transparent and more accessible.
