An information system for home hospital treatment

Services | 21 Jun 2010
Many small home hospital treatment institutions do not have high-performance information systems. However, access to health data is of great strategic importance for these institutions as they continue to grow. The hospital-at-home organization (FNEHAD) wants to modernize its information systems, and is working in partnership with ASIP Santé to achieve this.
Most newly opened home hospital treatment institutions are small, as the key figures from FNEHAD show. In 2008, each institution provided 12,372 days of home hospital treatment, which equates to an average capacity of 33 places with a 100% occupancy rate.
A result of budgetary constraints, this context makes it difficult to introduce computer systems to these institutions. The absence of immediately available integrated solutions is a further impediment.
Since improving the coordination of care depends on the performance of IT systems, there is a danger of a discrepancy forming between the needs of the institutions, the market offering and the technological issues – electronic patient files, collaborative operation, use of telemedicine, etc.

A thorough modernization of information systems

In response to these challenges, FNEHAD published a white paper in June 2009 on home hospital treatment information systems. This document calls for a thorough modernization of information systems to enable the integration of all activities:
  • "Professional": access to the electronic health record (DMP), planning interventions, circulating medicines, following care protocols, recourse to telemedicine;
  • "Support": (T2A) billing, management, accounting, HR, logistics chain;
  • "Management": resources, activities and knowledge.
Through this document, one of FNEHAD's major contributions to designing a home hospital treatment information system was outlining all the processes that need to be computerized.

Building an information system in consultation with all the stakeholders

To continue the work initiated by FNEHAD, ASIP Santé and FNEHAD have decided to join forces to work out a modern, complete solution for home hospital treatment institutions. The objective is to develop the architecture of a target system which can be shared and corresponds to the recommendations of the white paper. The feasibility and conditions of the implementation will be analyzed in technical and financial terms. All of this will be done in consultation with representatives of healthcare institutions and professions, and with regional project management teams, and in combination with the regional health agencies concerned. FNEHAD and ASIP Santé will then decide upon a strategy for rolling out the target solution. The initial results are expected at the end of 2010.
What is home hospital treatment?
Home hospital treatment is a means of avoiding admission to hospital by coordinating advanced medical and paramedical care, or by using equipment or therapies ordinarily reserved for hospital use, in the patient's own home. All requests for home hospital treatment must be issued by a doctor (general practitioner or hospital doctor), in the form of a prescription.
The law on hospital reform and on patients, healthcare and the regions (HPST) fully recognizes home hospital treatment as a component of the hospital system. Like hospitals, home hospital treatment structures must obtain authorization from the regional health agency before they can set up, and must provide multidisciplinary and continuous care (24 hours a day, seven days a week).
According to the institute for research and information in health economics (IRDES), the cost to the public finances for one day's hospital follow-up and rehabilitation care is on average 50% higher than for home hospital treatment where comparable care is provided.