Hervé Lacroix: The shared oncology record is a tool that benefits patients and professionals alike

Points de vue | 27 Sep 2010
The view of Dr Hervé Lacroix, regional medical coordinator (ONCO Pays de la Loire)

The challenges of health data sharing and communication are particularly important in oncology because, within this specialism, treating a single patient involves numerous professionals continually interacting with one another and working in different institutions, as well as in the outpatient sector.
Dr Lacroix
 
The shared oncology record (DCC) provides professionals with an appropriate response to these challenges. The added-value services it offers are centred around the process of decision-making (multidisciplinary consultations); the creation of a treatment plan (personalized care programme); and the implementation of that plan (care paths and assembly of the various reports).

The services of the DCC are designed to be incorporated into the electronic health record (DMP) system, and the tool optimizes these various treatment activities. To sum up, these are:

1.    The multidisciplinary consultation: a computerized multidisciplinary consultation makes the following available in the DCC :
  • A file detailing all of the necessary topics for discussion, created in advance of the consultation. The care plan resulting from the multidisciplinary consultation follows on from this file. Shown during the consultation, it is a decision-making aid enabling the participants to quickly access the essential elements.
  • The proposed therapy, resulting from the multidisciplinary consultation and validated by the clinician leading the consultation. The proposed therapy will be offered to the patient.
  • Support services, such as the list of participants and the directory of consultations including where and when they took place. This directory is essential because it gives doctors a complete overview of the multidisciplinary consultation services, locally, regionally, and even nationally. In that respect, it is the first step on the road to equal access to healthcare.
The traceability resulting from the use of such a tool guarantees the rigour of the information within it, and therefore of quality. It is also a time-saving tool. Now that all medical institutions authorized to provide cancer treatment are required to present all of their multidisciplinary consultation files before proceeding with any treatment whatsoever, the medical profession has rallied behind this practice. The DCC optimizes clinical time during these consultations because it improves collective organization: the inclusion of records enables a list to be drawn up, which leads to better planning of the workload during the consultation; there is rapid access to data thanks to the multidisciplinary consultation file; instant retrieval of any previous care plans is possible; and a more precise and therefore clearer formalization of the care plan thus results.

2.    The personalized care programme: this is the result of the proposed therapy decided upon during the multidisciplinary consultation. It is the point of departure for the care path. It is an essential tool for coordinating healthcare, a unique reference document that is accessible to everyone involved in treating the patient, wherever they practise. It is designed to be amended whenever the care path changes.

3.    The implementation of the care programme: this is usually staggered over several months.
Having a service within the DMP which shows the key treatment stages guarantees better coordination, avoiding unnecessary interventions. It gives everyone access to the full picture, facilitating medical practice and allowing the patient to be informed in a coherent manner. In this respect the DCC/DMP increases patients’ trust in the process and helps them understand it better because of the coherence of the information they receive from the various practitioners.

The DCC is an effective tool for information sharing between professionals in healthcare institutions. It also harbours great potential for encouraging and creating a concrete operational link between these professionals and those in the outpatient sector, as close as possible to the patient’s home.

Since it is a communication tool available to all, the DCC will foster the development of home hospital treatment, and will also enable the general practitioner to become more involved in long-term monitoring protocols (alternate monitoring), so that patients do not have to undergo certain consultations and assessments normally conducted in the hospital sector, while maintaining a close link with the main treatment centre(s).

Hence the DCC/DMP profoundly changes medical practice, as it is an effective tool to aid decision-making, but also a collaborative tool, improving the coordination and therefore the quality of the care path.

Docteur Hervé LACROIX
Regional medical coordinator
ONCO Pays de la Loire, Hôpital saint Jacques - Plateau des Ecoles