How can dependant people access the DMP?

Le Mag Article | 20 Jul 2012
The DMP is a free and secure electronic health record which allows doctors to access a patient's medical details. This public service is available to all state health insurance holders. But what happens when you cannot, for health reasons, request the creation of your DMP yourself? This question applies for many disabled people who are under supervision or legal guardianship. The DMP is a relief for both them and their caregivers who are often the parents. Le Mag has the run-down for you.

What does being under supervision or legal guardianship mean?

By law, protected adults are persons who enjoy a measure of legal protection due to a change in either their mental or physical faculties which prevents them from expressing their will. A judge assigns a supervisor or guardian to help these people with everyday proceedings and, as such, may have access to some of their confidential details.
  • Adults under legal guardianship
The French Civil Code states that persons are placed under legal guardianship when, without being completely unable to act alone, they need on-going assistance with or complete control taken of "important civil matters". Adults placed under legal guardianship still retain the right to exercise their rights. However, when they are not in a position to make an informed personal decision by themselves, the judge or family council may authorise the guardian to assist.
  • Adults under supervision
Supervision enables more responsibilities to be delegated as the supervisor represents the adult in civil matters on an on-going basis. However, this supervision can be varied and negotiated on a case by case basis by the judge who decides on the supervisor's range of responsibilities. This "appointed supervisor" may, if necessary, make decisions concerning the protected person's health.

Can adults under supervision or legal guardianship open a DMP?

For patients under supervision or legal guardianship, changes are planned for their access to the DMP. To be more precise, there are currently no particular methods or restrictions for these patients in accessing the DMP, and the law applies the clauses set out in France's public health code for protected adults.
In the case of adults under legal guardianship, information on the DMP must be delivered to the patient, who holds the sole access rights.
In the case of adults under supervision, the creation of and access to the DMP may be entrusted to the supervisor "acting in the interests of the protected adult". Of course, this authorisation is not exclusive. If they have the capacity, there is nothing to stop adults under supervision accessing their own DMP.
In any event, information on the DMP must be delivered to protected adults in a way they can understand depending on their faculties.
It is important to note that authorisations are on a case-by-case basis. Nevertheless, the law is committed to systematically seeking the protected adult's own will, should that person be capable of expression, and helping that person participate fully in any decisions.

Can the supervisor or legal guardian give their consent for a DMP to be created for the assisted person?

For adults under legal guardianship, if consent can be obtained in the presence of the legal guardian, it must be given by the patient and only the patient. This is the same for authorising DMP data access to various healthcare professionals involved in the patient's care.
Here, too, whether or not the guardian needs to be present when consent is obtained, depends on the extent of the protection measures which have been previously defined by the guardianship judge.
For adults under supervision, DMP consent and access authorisation for healthcare professionals are given by the supervisor, but the consent of the adult under supervision must systematically be sought if that person is able to express a will and participate in the decision.
In accordance with the legal framework relating to health data access by the persons concerned, supervisors can access health data about the person under supervision. For the DMP, this access specifically occurs via the patient Internet access portal.
There are different degrees of access depending on the protected person's situation. For more detailed information, see the legal notice on this subject (in french).