Marc Giroud: "Overhauling the French emergency medical services information system"

 

 

Since the first wave of the influenza pandemic in April, France's emergency call centres (Samu Centres 15) have mobilized to respond to calls. The instructing doctor at the call centre has to confirm whether or not a person might be infected, consider other scenarios, and make sure that an infected person remains at home, or direct the patient to the most appropriate healthcare institution. The doctor's medical approach is to listen, talk to the patient, apply methodological rigour, gain the patient's trust and inform them. In both normal and exceptional circumstances, the doctor provides the patient with the right care and helps to improve the overall organization. 

To prepare itself for the second wave of the pandemic, the French emergency medical services (Samu-Urgences) proposed an action plan in May. One of the components of this plan involved setting up a national register for all emergency calls, and noting the nature of each call. The minister then entrusted ASIP Santé with the task of creating a national information system for influenza, to be used by Samu. 

 

The objective was to move from managing the medical information handled by Samu at departmental level to managing it at national level, by offering each Samu a new tool to facilitate medical treatment in influenza cases (with an algorithm to assist decision-making, updated centrally, and therefore automatically, for users). This also gave the authorities a clear picture of the calls made to Samu. The tool had to be simple enough to be used by non-specialist personnel (medical secretaries in hospitals or retired general practitioners called in to provide backup), and capable of being interfaced with the four software packages used by Samu, so that it could be integrated into the systems it was already using. 

 

To an extremely tight deadline, ASIP Santé completed a needs assessment (in association with the users on the ground and the four operators Samu was already using), developed the principles of the architecture (secure web access), and launched the invitation to tender process with the greatest of speed. ASIP Santé also appointed a principal operator (Cegedim), agreed contracts with the publishers of the four Samu software programmes, then oversaw the deployment of the connection mechanisms on the ground, and made sure that everything worked as it should. All of this was done by 30 September 2009, even though the agency had only received the request at the beginning of June.

 

Beyond the impact on performance, the project has been praised unanimously by emergency medical staff as heralding a secure start to a major national restructuring of the French emergency medical services’ information systems ... and has also been praised for breaking down the barriers of what was previously a highly compartmentalized culture. 

Marc Giroud, President of the French emergency medical services.