The ARSs – providing regional healthcare system management

Public Policy | 20 May 2010
The creation of regional health agencies (ARSs) is revolutionizing the organization of healthcare. With sole responsibility for the efficiency of healthcare provision in the regions, the ARS are in the front line in the deployment of shared health IT systems. 
As of 1 April 2010, the regional and departmental directorate of health and social affairs (DRASS and DDASS) and the regional hospital agencies (ARHs) have been replaced by a single public body, the regional health agency (ARS). 
 

A clear objective to improve healthcare provision

Created by the HPST (a law on hospital reform and on patients, healthcare and the regions), ARSs will have a clear role to play: 
 

“To define and implement regional healthcare policy while respecting national objectives, so as to improve the health of the population and increase the efficiency of the health system.” 

 
The ARSs have been tasked with helping reduce inequality in healthcare, ensuring financial equilibrium and respecting medical insurance national spending objectives.
 

A new regional organization 

Placed under the authority of the ministers of health, medical insurance, elderly people and people with disabilities, the ARSs each have their own supervisory board and are run by a director general. There are also delegations in each department, so as to ensure proximity to the general public.
 
The ARSs are assisted by: 
  • A regional conference on health and autonomy, which helps define the objectives and activities of the agency, through the opinions put forward,
  • Two health policy coordination commissions, bringing together the services of the state, local authorities and social security bodies.
 
A wider area of operation
This new key player in the healthcare system offers more coherent decentralized management, by bringing together the seven bodies currently responsible for healthcare policy in the regions. 
Its area of operation is larger than the former ARHs, which looked solely at hospitals. This will enable barriers to be brought down between community medicine and hospitals, as the agencies are responsible for the monitoring, security, and organization of independent medical practice, as well as the medico-social sector. The ARSs also have authority on public health matters and can adapt health and prevention policies at the regional level.
The ARSs supervise the modernization of health systems locally, including the relaunch of shared health IT systems and developing the use of IT in different health structures. They have taken over from ARHs in restarting regional projects and contribute to the regional management strategy of healthcare IT system projects.
 
The ENRS regional healthcare information system hub
From 2010, the ARSs will establish regional digital health environments (ENRS). Under their authority, the ENRS will represent the points at which regional shared healthcare information systems converge.

The ENRS are to act as environments for electronic services. Managed regionally, they will enable the deployment of the electronic health record (DMP), specialist service testing (cancer research, diabetes, etc.), and services that meet the regional needs of healthcare professionals (health networks, cooperative tools, telemedicine, etc.), while respecting interoperability and the national Reference Frameworks Repository (RFR) promoted by ASIP Santé.