The electronic health record will be meaningless, in Languedoc-Roussillon and elsewhere, unless it really is shared

Languedoc-Roussillon | 16 Mar 2012
Following the official launch of the electronic health record in the Gard region on 25 January, Dr Martine Aoustin, director of the Languedoc-Roussillon regional health agency , (Agence Régionale de Santé, ARS), reviews the challenges of e-health in her region for ASIP Santé.

The policy of the Languedoc-Roussillon regional health agency in relation to e-health

At the centre of the health information systems structure, the electronic health record must not be restricted to individuals, it must also be shared. Although this is an ambitious term, it sums up perfectly the challenges to be tackled by health information systems, including telemedicine. 
Corporatism and tight links between specialisms or independent/hospital practice are incompatible with the notion of transversality and therefore of the rolling out of the electronic health record and medical computer science. There is only one step left to be taken, between the electronic health record and the shared electronic health record (or Dossier Médical Personnel, DMPP in French), and it must be taken.

It is with this in mind that the policy of the regional health agency has been drawn up, covering three areas
  • The implementation of regional governance : this involves bringing together all stakeholders, independent practitioners, hospitals, users and their representatives, local authorities, in order to drive: :
    • a strategic approach in order to share the challenges of “e-health”, both as a way of achieving the modernisation and simplification of the health service, and of ensuring equal conditions of access for users.
    • the organisation of an operational level for rolling out projects on a regional level.
  • The drawing up of a regional master plan for health information systems : aimed at revisiting the objectives of our regional health project (strategic plan, schemes) by screening them through information systems, and thus defining priorities. We will for example find the rolling out of the “pathway” tool enabling the smoothing of the pathways between acute care and follow-up care and rehabilitation, the implementation of the operational resources register (ROR in French), for emergencies, and of course the rolling out of the electronic health record on a regional level.  
  • The telemedicine programme forms an integral part of the regional health plan. Shortly to be submitted for discussion, it will include projects in hand, such as the treatment of complex wounds or remote imaging…
Health information systems, associated with federative initiatives such as the electronic health record, will help to ensure that everything converges and intersects to structure “e-health” in Languedoc-Roussillon.

Launch of the electronic health record in Languedoc-Roussillon

Nîmes University Hospital is highly committed to the computerisation of its services, as part of an integration and transversal exchange programme, from emergency to scheduled admissions, including the management of stretcher services or the management of images. This is a powerful example of the integration of the different services and units around an on-going patient monitoring programme, regardless of the medical environment (A&E, operating theatre, recovery, etc.). 

To achieve this, medical skills have been integrated and combined in the data processing systems. 

This is highly symbolic of a strong desire to ensure that the daily needs of the medical profession can be met by the range of IT services available. Thus, two languages and two environments have been merged, each contributing to the medical or technical progress of the other, with the shared central objective of quality and safety in patient care. 

In this context, the selection of the project at Nîmes University Hospital – from the 33 sites selected in France in the call for projects associated with the electronic health record in healthcare institutions – is a major opportunity for healthcare in the Languedoc-Roussillon area.

The challenge of sharing

To make this experiment a real success, there need to be constant, freely-flowing information channels between the university hospital and healthcare professionals within its environment: treating physicians, clinicians, radiology centres, the regional hospital community and all its component parts. 

The electronic health record must be shared between general practice and hospitals. The agency will ensure that independent doctors and clinicians can, in turn, send and receive medical information which will then be relayed by Nîmes University Hospital. This is an opportunity which must be seized to continue to bring together skills and healthcare professionals in the private and public sectors.

Although healthcare available in Languedoc-Roussillon quite rightly continues to operate on various levels, the health of its inhabitants should not be set at variance, and the mobilisation of proper health intelligence must be ensured, with all stakeholders working in synergy. 

The regional health agency will ensure that this is the case. 

Dr Martine AOUSTIN
Director General of the Languedoc-Roussillon Regional Health Agency