An information system for multidisciplinary health centres
Services | 21 Jun 2010
How does ASIP Santé plan to respond to the emerging phenomenon of multidisciplinary health centres and healthcare groupings? How can it contribute to the gradual construction of a homogeneous information system? The first answers to these questions have already been given.
Professionals and the authorities are in agreement over the threat posed by medical demography and changes in the public health landscape. With an ageing population and the gradual predominance of chronic diseases over acute pathologies, the primary care mechanism is in need of an overhaul.
This mechanism, described as the weak link in the French healthcare system, has proved itself incapable of providing an adequate response to treatment and prevention needs; it is also failing to monitor chronic diseases effectively, and to ensure equal access to care for all of the French population. As well as all this, it no longer meets the expectations of healthcare professionals. Multidisciplinary teams working together in a single health institution would appear to be a good response to the current situation, as is demonstrated by the host of different initiatives in various regions.
Multidisciplinary health centres, healthcare groupings and medical centres: the patient at the heart of the organization
Multidisciplinary health centres are institutions organized around several general practitioners and nurses working together under the same roof, alongside other healthcare and non-healthcare professionals. Multidisciplinary health centres have a specific healthcare objective, which underpins and structures the way they organize and deliver services.
Healthcare groupings can be regarded as transitional points between individual medical practice and the coordinated care offered in a multidisciplinary health centre. They are also formed on the basis of a healthcare objective, but the professionals remain in the place where they normally practise medicine. A multidisciplinary health centre can be part of a healthcare grouping.
A medical centre is a more traditional type of organization in which (normally salaried) healthcare professionals work together in an institution managed by a non-profit organization or a local authority. Despite the fact that it has an old-fashioned image – that of a "community clinic" – and structural deficiencies, the differences between medical centres and the more modern multidisciplinary health centres are becoming less marked, which suggests that potentially they could be merged in the medium term.
A legal and institutional environment with strong potential
By devoting several articles to these new ways of practising medicine, the law on hospital reform and on patients, healthcare and the regions, has paved the way for the first institutional report entirely dedicated to this subject, published in January 2010. The report highlights the obsolescence of the tools serving multidisciplinary health centres and healthcare groupings, calling them "archaic and out of step with multidisciplinary practice", particularly as far as information systems are concerned. It also states that "the deployment of shared information systems is becoming a priority for establishing cooperative ways of practising medicine and providing genuinely coordinated treatment". ASIP Santé is cited prominently in the report, as the agency capable of helping to produce national specifications for the information system for these new structures.
A clear political will
Soon after the report of the inter-ministerial taskforce was published in February 2010, the French President, Nicolas Sarkozy, when visiting the Mondoubleau health centre in the Loir-et-Cher region, announced that the government would be working with regional communities on a three-year plan to create multidisciplinary health centres designed to "more than double" the existing number in France. The president also declared that the French state and its national insurance scheme would help to finance 250 multidisciplinary health centres over three years.
Organized in successive phasesTo continue the momentum gathered at regional level, which has now reached institutional level, in 2010 ASIP Santé plans to produce national specifications for the information system for multidisciplinary health centres and healthcare groupings. These specifications will ensure that data gathering is standardized and systems are interoperable, since they will be based on the Reference Frameworks Repository (RFR) and interoperability framework already promoted by ASIP Santé.
Following on from this, the agency will create a context which favours the emergence of operational solutions that adhere to the national specifications. To achieve this, it will use the know-how it has garnered from regional projects delegated to local project management teams.
A four-stage development process
1/ Drafting national specifications for the information system for multidisciplinary health centres and healthcare groupings, which includes defining:
- the joint and specific functional needs of each of the professions represented in a multidisciplinary health centre;
- how authentications are managed and information is shared between the medical, paramedical and social professions;
- the support functions: managing schedules and meetings, directories, etc;
- billing and management tools;
- services: gathering of epidemiological data, access to protocols, self-assessment services, etc.
When defining the above, ASIP Santé will take into account the needs for secure, standardized management so that health data can be shared and exchanged between healthcare professionals in a secure, well-managed space.
2/ Delegating the creation of the information system to a regional project management team in conjunction with its regional health agency (ARS).
Based on the national specifications, following a call for tenders, the chosen region will draw up detailed specifications and conclude a contract with a company in the sector to create the information system.
3/ Creating the information system.
This will be done by the regional project management team and its contractor, who will design, create and deploy the information system in the multidisciplinary health centres and healthcare groupings in the region participating in the project.
4/The rollout phase
Once the solution is stabilized, since it is the property of the company that created it, it will be a product available on the open market, and as such will be accessible to multidisciplinary health centres in other regions under market conditions. In accordance with the market, it will not prevent the emergence of competing products. This stage will mark the end of ASIP Santé's involvement in the multidisciplinary health centres and healthcare groupings project, which is scheduled to finish by the end of 2011.
To find out more
download the report of the Juilhard-Crochemore-Touba-Vallancien inter-ministerial taskforce on multidisciplinary health centres and healthcare groupings
download the "Instruction framework for projects financed by ASIP Santé" brochure