The major milestones in the development of health information systems in France since 2002
Public Policy | 21 Jun 2010
In 2004, the principle of creating an electronic health record (the DMP) was first put forward. Difficulties associated with its environment soon arose, which is why it was relaunched in 2009 and a specific agency (ASIP Santé) was created and tasked with establishing a Reference Frameworks Repository (RFR), relaunching the DMP and facilitating the emergence of telehealth.
THE LAW ON PATIENTS’ RIGHTS AND THE QUALITY OF THE HEALTH SYSTEM
This law was a crucial milestone in the modernization of the health system, laying the foundations for a truly democratic health service and introducing an unprecedented mechanism for compensating victims of medical accidents.
Fieschi report: “Shared patient data: how the culture of sharing and information quality can improve the quality of healthcare.”
13 August 2004
LAW CREATING THE DMP
Law no 2004-810 of 13 August 2004, in articles 3 to 5, sets out the principle for the creation of the DMP. This is also included in the legislative framework for health data hosting, laid down by law no 2002-303 of 4 March 2002, on patients' rights and the quality of the health system. Decree no 2006-6 of 4 January 2006, on the hosting of personal health data, sets out the approval conditions for data hosting companies.
Creation of the public interest group (GIP) prefiguring the DMP.
Call for tenders to host DMP data; procedure invalidated in October 2006.
Launch of iCall for projects for designs for initialization and data input for DMPs during the generalization phase (tender award committees in December 2006 and June 2007).
30 January 2007
Law creating France’s national health identifier (the INS).
31 March 2007
Publication of call for tenders for reference data host; procedure halted in the autumn of 2007.
Review of tenders, initiated by the Minister for Health; report submitted in October 2007.
DMP relaunch project
Briefing letter issued by the minister to Michel Gagneux; report submitted in April 2008.
Dr Jean-Yves Robin named as director of the GIP responsible for the DMP, prefiguring ASIP Santé.
Michel Gagneux appointed as president of the DMP GIP.
Health information systems (SIS) relaunch programme announced by Minister Roselyne Bachelot-Narquin
Why the relaunch?
Created by the law of 13 August 2004, the DMP is a service designed to help improve the coordination and continuity of healthcare, and therefore also its quality. The subject of trials in 2006, then a call for projects in 2007, the DMP faced difficulties caused by its environment: information systems that could not share data; insufficient development of hospital care provision information systems; compartmentalization of healthcare organization; differences in the products available on the market; dispersed governance in the form of multiple stakeholders whose scopes of intervention overlapped significantly in certain areas, etc. For all of these reasons Mrs Roselyne Bachelot-Narquin, Minister for Health and Sports, having had various investigations conducted on the subject, which produced detailed reports (the report by the inspectorate-general of finances – IGF, the inspectorate-general of social affairs – IGAS and the general council for information technologies – CGTI in November 2007, and the Gagneux report in May 2008), decided to take part in the changes needed to support the relaunch of the DMP, at the conference on 9 April 2009. Most notably, she placed the development of the DMP in the context of renewed governance (simplification of the way in which public projects are managed and organized) by associating it with the wider area of shared health information systems. The creation of ASIP Santé responds to this objective.
Publication of the Gagneux report: “Reforming the governance of the health system IT policy. 12 proposals for strengthening the coherence and efficacy of public action in the field of health information systems.”
Evaluation of projects conducted by the DMP GIP since 2006.
Relaunch of the seven regional projects and reorientation of the other projects in coherence with the relaunch programme.
ASIP Santé: the board of the DMP GIP votes to amend its constituent agreement, creating ASIP Santé, a government agency for shared health and medico-social information systems.
Law on hospital reform and on patients, healthcare and the regions (HPST) defining telemedicine, incorporating the DMP within France’s public health code and creating regional health agencies (ARSs)
In a context of demographic evolution, it was becoming imperative to improve the organization and efficiency of the healthcare system. To strengthen the management and coherence of shared health information systems, the minister set up a specific agency – ASIP Santé – to define a national framework by creating the RFR in consultation with the professionals involved, and to relaunch the DMP, which is due to be deployed by the end of 2010. The final mainstay of the strategy is telehealth, ie the development of technologies which facilitate monitoring, diagnosis, expertise and even remote healthcare provision.
2 October 2009
Publication of the health information systems interoperability framework.
- Publication of call for tenders to host the DMP.
- Lasbordes report: "Telehealth: a new way of safeguarding our wellbeing. A sustainable five-year plan for the deployment of telehealth in France.”
Publication of the specifications for the “calculated” national health identifier (INS-C), the first stage in the deployment of the national health identifier (INS) programme.
29 November 2009
Publication in France’s Official Journal of decrees dissolving the health professional cards (CPS) GIP and widening the responsibilities of ASIP Santé.