Dr Jacques Lucas: "What is the right e-health strategy for France?"

Éthique | 30 Nov 2012
Interview with Dr Jacques Lucas, vice-president of the French medical association (CNOM), and spokesperson on health information systems
- An excerpt from the French medical association's Information Bulletin no. 26, Nov-Dec 2012 -

"The rollout of e-health is stagnating. This is most likely due to the fact that there is no national strategy shared by all involved. The French medical association has long supported the principle of creating a national strategic committee, chaired by the minister for health.

This strategic committee should bring into close partnership representatives from doctors' associations, other healthcare professionals, patients, health insurance bodies, industry partners and of course, other ministries.

CNOM is putting forward eight basic principles, based on an efficient healthcare system, the ethical use of information and communication technology (ICT) for access to care and continuity of care, patient rights, professional practices and medical ethics.

  1. The rollout of e-health must primarily involve doctors and other healthcare professionals, as these are the main people involved with the management of people who need care.
  2. To get these groups involved, ICT in health must meet their basic professional needs, as individuals and in the medical and social care aspects of their work.
  3. E-health has to be developed with an eye to ethical requirements, including information for patients, securing their consent on the sharing of personal data, and confidentiality.
  4. E-health must improve access to care. As an illustration, healthcare clusters and hubs, whether real or virtual, need digital equipment, particularly for telemedicine. In parallel with this, there needs to be a national strategy to speed up the rollout of high-speed Internet nationally, in order to bridge the digital divide.
  5. The strategic rollout of e-health should work to meet the greatest medical, social and economic needs, while being rooted in reality: patient care pathways generally involve both independent professionals and those working in hospitals or clinics, as is the case in the health and social care sector. There should be no hindrance to the communication of information that is relevant and necessary to continuity of management.
  6. There will be no positive medical or economic development if ICT is used in a compartmentalized way. ICT in healthcare must not create barriers between hospital-based and independent practitioners. Patient management, whether at home or in hospital, means going beyond old-style models while ensuring that confidential information is protected.
  7. There must be appropriate and sustainable levels of funding for e-health, including industrial-scale ICT and medical devices.
  8. Everyone is responsible for developing medical practices that integrate ICT: the government, in organizing care throughout the country; public and private healthcare facilities; those who provide access to data; third-party technology companies; UNCAM and health insurance bodies.

    A national strategic committee, with ministerial control, would thus clarify governance structures and mean that the government's strategic regulatory role was not mingled with operational concerns, which are the responsibility of national and regional agencies. The French national medical association has been steadfast in this position, which is entirely in line with the recommendations made in public reports by the major government bodies."