Patrice Blemont, Director, Regional Hospitalisation Agency of Franche-Comte, France

[taken from the translation feed so errors of understanding may have crept in]

We often wonder why in High Burgundy how we manage to launch a comprehensive healthcare information system while other regions lag behind. Before our system became a model we had to prepare the ground with the principle of “The minimum of force and maximium of conviction”.

1st objective - to optimise the flow between doctors to improve medical strategies
2nd objective - to make our patients responsible partners which means they need access to medical information
3rd objective - to set up a regional authority and partner to overcome the fragmentation between medical establishments to encourage collaboration and teamwork.

We were able to concentrate our funds and efforts, co-operating with associations of stakeholders and asked for public support, and promotional work, starting small and then raising the bar and giving ourselves higher targets, we also spoke about the funds available and making sure that we have sufficient to achieve what we want. We very transparently came together with our industrial partners and re-used things that had worked elsewhere to improve efficiency.

Seeing that things were running smoothly, we gave autonomy to the players and freedom to manoeuvre. I think we’ve done well.

[Presentation taken over by a technician - didn’t get his name]

Since 2002 we’ve had a guideline plan which has been implemented locally. So the technical side of it was to install electronic elements while the doctors, hospitals etc were negotiated with as stakeholders. We wanted to network better the health services in the region. The advantage was that the communication between the individual hospital specialists could be improved. So we demonstrated that our project was feasible and we had better networking between hospitals on the one hand and I’d like to stress in particular the information needed to admit someone to hospital the issue now is we have specialists like gerontologist they have linked up with specialists in alzheimers so we want to attain an integrated medical care and the regional administration has been very active providing co-financing.

Let me now come to the doctors who work in their own surgery, we have 5,000 doctors linked to our system so far. As Patrice has mentioned, we have not gone to extremes, but we proceeded step by step. Our approach was centralised, we have our israeli partners with whom we could sort out issues including the centralisation of the French health system. Another task was to network data coming from the health authorities available to private doctors and to network all this data and build a platform to co-ordinate all of this. Now 100% of blood samples taken are now recorded in IT - all results are computer readable and can be communicated wherever needed. The patient has the right to quick access to all the information. In France we don’t have a uniform ID code, though we’re introducing a patient code system which means we need a key for doctors and patients that we can link them as quickly as possible so that the disease can be identified quickly. Then we have to collect the information and the users at the various levels may need to be networked too. So when I have my id number it is sufficient to get some medical information. We also have to take into account that we border Germany and Switzerland and their systems are quite different. Medical images are now available online so a certain physician in the region can get access to certain images for this particular patient. Quite interesting is also the fact that we have other complementary information systems like in the emergency hospital units. We have a monitoring system installed which lets us report the situation in emergency wards - 15 months ago this was all on paper cards. The electronic information system plays a special role here because they have to act very quickly, so it is not only about identifying a patient but also what needs they have.