France went online with the long-awaited Dossier Medical Personnel (DMP) program by opening a portal to enable physicians in five pilot regions to create Electronic Health Records (EHRs) for patients.
All French citizens will be invited within 3 years to visit the portal and create or consult a personal file using any web browser. Our role as a healthcare informatics company is to contribute to the development of a computerized patient record system secured and adequate for medical professionals.
The French DMP was launched with great bravura in 2004, only to be considered unrealistic by a joint commission of three European government ministers in 2008. Later on, the DMP was revived, thanks to a strategic shift from a top-down approach to one that favors collaboration with leading companies providing software to general practitioners. A typical DMP record contains a patient’s medical summary, history, recent prescriptions, reports from lab analysis and exams such as medical images.
My role is to manage the deployment of the computerized patient file in many clinics and hospitals, and to keep in touch with those national agencies and forums...so that the healthcare centers are conformed to the regulations and ready to be connected among others. My challenge every day is to convince physicians and nurses about the goal of that modernisation program of healthcare support... medical team ought to keep in mind that new regulations are supposed to secure and optimize delay and quality of a patient support processing. We, as healthcare informatics company, coordinate with principle national agencies to keep up to date our referential such as: drug lists, medical acts, diagnoses tables…
“The DMP is not DICOM compatible for the moment”, according to Jean-Yves Robin (the director of the program) at ASIP santé (the agency coordinating the program). A framework is being developed to integrate adequate medical imaging. Actually the platform is still not oversized for such implementations. The doctor’s offices are a critical source for compiling patient records for this first generation of the DMP system. Our health care system was deployed in many clinics and hospitals, in addition to the other patient file systems already deployed in many other health centers in France. This will make the DMP the largest medical files overwhelmingly generated, in terms of sheer volume. This DMP will not be mandatory and will be free to all. Patients will be able to upload JPEGs and PDFs to supplement their file, for example, adding monthly blood exams monitoring charts…
As a member of this project management, we follow the instructions of the regional forums (for instance: ARS&HAS) in order to be conforming to the regulations… Patients can control the access to their DMP record, as well as the content, including a controversial right to mask health information. This right was negotiated over the objections of physicians by patient-rights associations fearing the records could be consulted by employers, banks, or insurers.
In an emergency, a physician may involve a "break provision" to obtain access to hidden records, but he may faces an obligation to justify the action. The French Health Ministry has put a priority on creating DMPs that can be shared among caregivers for users of the healthcare system. The Ministry of Health supervises and finances many of the modernization healthcare informatics systems in hospitals to be deemed abroad. Cancer is the first target, integrating the “Dossier Communicant de Cancérologie” deployed in 2007 across 17 regions. Our “Dossier communicant general” for all other health services will take part of the other targets previewed later on. Through our communication and presentation skills in such a deal of an optimized patient support system, I was able to acquire professional business acumen.
On a personal dimension field, I have so far had significant experiences in Healthcare services. Not only, have I used to monitor procedures of that fully installation system, but also to improve health services, to support technical and use constraints, and work with all the contributors.
The DMP framework relies heavily on integration profiles developed by Integrating the Healthcare Enterprise (IHE) and HL7. At full deployment in 2012 the DMP is expected to cost France one euro per year, per record, according to ASIP Santé. Putting the DMP program online vaults France to the leading edge of e-health worldwide, placing it at the head of a class that includes countries such as Germany and the U.K. with similar populations and challenges, and closely following advanced implementations of e-health in Denmark and Canada, as well as in Andalusia, Spain.
Our motivation, our adaptability and our capacity to take on a heavy workload has always allowed us to obtain more than honorable results in such a program; inviting everybody to contribute to that national success.
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