French Health Record System Goes On-Line
Tuesday 08 January 2019
An on-line personal health record system has been introduced, but there remains uncertainty about whether it will be widely used.
The birth of the Dossier Médical Partagé (DMP) has been a prolonged one, having been conceived in 2004, but then subject to such significant technical difficulties and political controversy that it has only now seen the light of day.
The purpose of the DMP is to provide health professionals with medical information on a shared database
Thus, your medical history, test results, imaging, ongoing treatments can be shared amongst health professionals, such as general practitioners, specialist consultants, nursing or hospital staff.
The intent is that use of this centralised digital record would then improve patient care by ensuring all medical professionals were fully aware of the medical history and circumstances of their patient, particularly useful in the event of an emergency or when travelling away from home.
The system is also intended to create savings, by the elimination of unnecessary treatments and avoidance of duplication of treatment.
It was launched nationally last month, after trials carried out over 18 months in 9 departments.
The development costs to date have been over €500m and the annual running costs are estimated at €15m.
Use of the system is entirely voluntary, for both professionals and patients.
Everyone can now can create their own DMP by connecting to Dossier Médical Partagé or via a smartphone application called DMP, preferably with professional support, from either the local health authority, their doctor or a chemist.
Once created the local health authority will load onto the DMP summaries of treatments received and reimbursements made in the last 24 months.
Patients can also add documents or any information they consider useful for their medical follow-up, such as their blood type or any allergies they may have.
One of the controversies about the DMP has been over the issue of patient privacy, as a result of which the system provides for the patient to control which elements of their medical record are available to health professionals, although their own doctor has access to all elements of the DMP.
Although there appears to be strong public support for the system, many of the DMPs created in trial areas remain empty.
There also remains some doubt as to whether the DMP will be used by professionals, whose participation will be required to keep the record up to date.
The most important figures in all of this is your GP, whose responsibility it is to write a synthesis of the medical history and treatment of their patient, which is then available for all other professionals to use. This is the base document for the DMP.
However, GPs will receive no remuneration for doing so, they already keep their own patient records on their local systems, and the IT systems in a very large number of GP surgeries are not compatible with the software used by the DWP.
As so often is the case, the French national auditor has summed up the dilemma, stating in 2017 that the DMP, "will only be truly effective if it is user-friendly, agile and interoperable and if it contains all the information needed to treat patients. From this point of view, the creation of a shared medical file, which is not mandatory, may run up against the reluctance of patients, who may ask that certain information not be included, and the difficulties of hospital information systems to provide them with routine information "
The UK government tried to introduce an on-line health records system but it was abandoned in 2016 over the issue of patient confidentiality. A previous attempt was also scrapped with a host of failures and cost overruns.