Christian BADINIER, director of the GCS Télésanté Lorraine : "T-Lor leads to better quality patient care"

Lorraine | 16 Apr 2013

On 1 December, the GCS Télésanté Lorraine announced that the 10,000th telemedicine intervention had been carried out via the T-Lor system. The landmark offers an excellent opportunity to look back over the work that this important e-halth body has carried out, with its director Christian BADINIER.

What role has the GCS Télésanté Lorraine played in the success of the T-Lor project?


First and foremost, it implemented the tool! We had to fund it as, in general, the services that we provide to our members are free. We have to arrange financing for all equipment, and it is the fact that we rolled out T-Lor immediately across all the institutions in Lorraine that meant that we have recorded 10,000 teleconsultations. We took it one step at a time, starting first of all with tests, and now we use the service mainly for radiology work and for at-home patients: this prevents healthcare professionals on duty from having to travel. We also use it for teleexpertise and in multidisciplinary coordination meetings (RCP in french), in the treatment of cancer patients in connection with our web-conferencing service.

A lot of communication work also then had to be done (group meetings, one-on-ones, etc) to raise our profile among regional healthcare institutions, not just with the directors of the institutions but also with doctors themselves in order to get them on board. In addition, we make use of healthcare institutions’ communications services to relay information.

When does the T-Lor project date back to?


The neurology department of Nancy university hospital (CHU) came up with the idea for this project back in 2006. When it was set up in 2007, the Télésanté Lorraine GCS took over the management of the project. We set up meetings and working groups in 2008 and launched a test phase in 2009, so the tool has existed for quite a while already.

10,000 interventions in three years is still a great achievement


Yes it is, but we would be able to do a lot more if more doctors were to take ownership of the service (which is a change management issue). Furthermore, we need to come up with a new version of the service in connection with the regional project for storing digital radiology images Médiale, in order to improve collaboration amongst healthcare professionals (radiologists, clinicians, technicians and operators). This way, we could far exceed 10,000 interventions a year!

What changes is T-Lor making to doctors’ practices and to the everyday lives of patients in Lorraine?


The main advantage is that it improves the quality of assessment. What I mean by that is that it improves quality, on the one hand, in terms of the time it takes to respond to a request for a consultation and, on the other hand, in terms of the speed at which the report is sent to the clinician. These are huge advantages. T-Lor ensures a certain level of fairness in terms of patient care by pooling assessments across the whole of the Lorraine region. Now that the whole of Lorraine is networked into the system, an X-ray can be assessed from anywhere. The second advantage for patients is that it takes less time for the radiologist’s report to reach the doctor who requested it, and therefore the patient is treated sooner. The average waiting time in A&E, for example, has been reduced, especially at night, as the radiologist on duty no longer needs to spend time travelling.

What will be the Télésanté Lorraine GCS’s major focuses in 2013?


There are lots. However, the main project in Lorraine for 2013 has to be  Médiale, the regional storage of medical images. for exchanging and sharing them. Basically, we now consider images not to be the property of the institution, but rather the patient. When a patient moves from one institution to another, their images need to go with them in order to prevent examinations from having to be repeated, exposing the patient to yet more radiation risks. This service will be invaluable for chronic illnesses as it will allow us to follow the development of the pathology, and patient care will be improved as a result.

The project involves all the healthcare institutions in Lorraine, including private radiology surgeries. This represents almost 2,000,000 X-rays a year across the whole of Lorraine.

The second largest project for Lorraine in 2013 will be the implementation of a service platform dedicated to the medico-social system. It will allow us to improve the availability of information between healthcare institutions and medico-social institutions to ensure better patient monitoring. his platform will respect the reference framework of the french electronic health record (DMP) servicein order to be able to interconnect with it, supply it with documents and use it as a reference base.

Finally, other important projects that the GCS will be developing in 2013 include Odys, a teleconsultation tool (see also our article here in french), Imad, a system that helps with patient referrals, which will be rolled out across other sectors such as residential care homes for elderly dependents (EHPADs), home hospital treatments (HADs) and at-home nursing care services (SSIADs), and the operational directory of resources (ROR) for which work has already begun. This tool was developed by the GCS D-SISIF (Ile de France) which sent us the source code free of charge and with which we share the Third-party software. Other regions are joining forces with us for this project and I am keen to highlight this interregional sharing initiative which should contribute to interoperability and a constructive partnership.


See also video "T-Lor : la téléimagerie en Lorraine"(in french) in the Mag N°6 (available in english)!





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