Within the framework of the MEDEC and INFORMEDICA exhibition, the Santénergie consortium– formed by Siemens, Bull and EDS, and chosen by the GIP-DMP (the French government body charged with choosing the suppliers for the DMP project) to take part in the demonstration and preconfiguration phases of the program – has sponsored a round-table discussion focusing on, “The content of single electronic patient records and the evolution of hospital and family doctor systems”. Report on this roundtable:
Several hundred doctors in the Lower Normandy, Pays-de-Loire, Limousin, and Midi-Pyrenees regions of France are about to take part in the experimental phase of the French national project to introduce a single computerized record for each patient, with the Santénergie consortium. At the starting line, some of those taking part in the trial shared their experience, and expressed their hopes for the project.
The Santénergie consortium (founded by Siemens, Bull and EDS) is trialing the single electronic patient record (the Dossier Medical Personnel or DMP) in Lower Normandy, the Pays-de-Loire, Midi-Pyrenees and Limousin regions of France. Several hundred doctors in these areas are already using computerized patient records. So one year before the national DMP program is generalized, in July 2007, their experiences are worth listening to. Dr Denis No Mura, chairman of the regional shared healthcare information platform initiative (known as PRiSM) in Lower Normandy, a pioneering project of this type, explains that doctors are keen to take up the challenge of the DMP and quite willing to use it so long as, “it doesn’t demand too much of their time, cost them too much or involve too many practical difficulties”. The introduction of computerized patient records enabled the main hospital in Nantes to make up lost ground in terms of its computing facilities, believes Dr Loïk Lenormand, vice-Chair of the establishment’s medical commission. The file – which holds reports from episodes of hospitalization, operations, anatomical, pathological or radiological procedures, and consultations, as well as any biological or anesthetic interventions – has considerably improved the life of the hospital. “In emergencies, colleagues would not, in any case, go back, because we hold all the information and so we know so much more about the patients,” confirms Dr Lenormand, a specialist in urology. Those responsible for the electronic patient records in the Pays-de-Loire, however, are also keen to improve its usability, including more of the most useful images, developing the prescriptions functionality and eventually including a more detailed care record. “Of course, the extremely comprehensive DMP has the advantage of being very up to date, but it can be hard to understand and writing a summary of it can be complicated,” warns Dr Lenormand.
“A scalable DMP”
The experience of Santé-Limousin (Limousin Health) – a network for exchanging medical information between 70 private practitioners, three healthcare networks and five different establishments – is also rich in learning points. “We are still at the stage where we are surveying the landscape… and we’ve got both feet in the mud!” admits one of those promoting the project, Dr François Lemaire, a private practitioner and hospital consultant at the hospital in Limoges. In this region, the doctors who join the network are given training, provided with a laptop computer and manage a “simple patient record, without any messaging functions or images,” for 2,500 patients who have volunteered to take part in the project. “It’s really a bit of a test, to get our colleagues interested,” explains Dr Lemaire. In the doctor’s opinion, the current system presents something of a barrier, because doctors have to enter their notes twice. “I believe the DMP has a great future,” he continues, “but we should not be making extra work for ourselves, and it’s important to take note of what the doctors are saying about the system otherwise some will be discouraged from using it”.
The head of the hematology and cell therapy clinic at the Limoges hospital, Dr Dominique Bordessoule, is very enthusiastic about the system. She can remember the implementation of an earlier, extremely time-consuming version of a single electronic record, seven years ago. “Today, the system is actually saving time for specialist and general practitioners, nurses, biologists and social workers who have real time access to earlier information and the patient’s medical history, as well as hospital treatments and outcomes”.
The General Manger of Bull Services and Solutions Business, Jean-Pierre Barbéris, is keen to reassure the doctors who have been testing the electronic records. “The DMP must serve the needs of the medical profession”, he explains. “Because the principle of information sharing is at the heart of the system, it should act as a chain of trust between all the various people who use it. The consortium has taken particular care over the security of data held in the system – how it is accessed, transmitted, stored… and its traceability. Santénergie’s DMP will evolve, because we are taking the widest possible soundings from the users on the ground and particularly the comments from those in the medical profession.” ButJean-Pierre Barbéris also recognizes that the widespread introduction of electronic records will be “a different kettle of fish”! “That next stage will take time and there will be costs involved,” Jean-Pierre Barbérisadmits, “but our project is designed to increase in power.”
* Report by the "Quoditien du Médecin" on the round table sponsorded by Santénergie et INFORMEDICA