Insiders say France could serve as model for U.S. data exchanges

张琨

Insiders say France could serve as model for U.S. data exchangesHealthcare IT News

By  Patty Enrado, Contributing Editor

10/18/07

FRANCHE-COMPTE, FRANCE - Since 2004, France and its Ministry of Health have been supporting electronic heath record projects across its 22 regions. Of all the regions, Franche-Comté has the most advanced regional health information exchange, or HIE, in the country. Story Continues Below
Advertisement
[url=http://ad.doubleclick.net/click;h=v8/35f3/0/0/%2a/e;113524269;0-0;0;16821325;4307-300/250;21547977/21565867/1;;~sscs=%3fhttp://www.laserfiche.com]

                               
登录/注册后可看大图

[/url]


As of late summer 2007, approximately 4,000 medical records have been operational and more than 560,000 patient IDs have been recorded and are being managed, according to Agnès Lépine-Lozach, director of healthcare and social services at IBM France, one of the regional HIE’s technology partners.
Lépine-Lozach said the Franche-Comté HIE anticipates recording one million IDs by the end of the year, or 80 percent of the region’s population. As the first region to implement records, she added, “It’s moving quite fast.”
With the help of IBM France and its other technology partner, SQLi, the Franche-Comté regional HIE is currently deploying Israeli-based dbMotion’s interoperability platform, which will allow it to integrate clinical information from disparate systems such as healthcare IT, lab and imaging, and hospital management and patient administration systems.
Industrial strength platform neededAt some point, all 22 regions will be able to exchange healthcare information, but before that can happen, an industrial-strength, interoperable platform is required to accommodate an increase in the amount of data being circulated, said Johan Hjord, director of sales for Europe, Middle East and Africa for dbMotion.
Just as is the case in the U.S. healthcare systems, France must cope with different legacy software systems across its hospitals. The missing link, up until now, was to find the technology platform to interconnect the different systems to be able to share data from the different sources.
SQLi created the region’s Shared Medical Record system, otherwise known as DMP-fc or Dossier Médical Partagé de Franche-Comté, and is now tasked with helping to customize the platform’s extension.
For its part, IBM France will provide services and solutions that will connect existing applications with its WebSphere Enterprise Service Bus product.
Open standards technology is key Gerard Manrique, business development manager for Healthcare and Life Sciences Innovation IBM France, said that the key to connecting the existing enterprise applications is using technology that is based on open standards. Middleware is accepted as a sustainable investment, he said.
“Technology supports all the standards,” said Lépine-Lozach. “There is no issue with technology. The difference is in the model and financial motivation.”
United States could learn some lessonsIndeed, this is where the United States could learn some lessons from the French model, according to Ilan Freedman, vice president of marketing for dbMotion.
Each region’s Regional Hospitalization Agency, or ARH, controls the public hospitals. While the hospitals have their own chief executives, the ARH acts as a single, decision-making entity in charge of the budgets of all the hospitals in its region.
Freedman likens the ARH to regional health information organizations, or RHIOs, in that both are tasked with improving the quality of healthcare within a limited geographical area and regulating and administering funding.
Then there’s the national viewThe DMP is parallel to the nationwide health information network, or NHIN, in that both are working toward a national view of connecting these regional entities.
Freedman noted the ARHs are more similar to integrated delivery networks, or IDNs, in the United States in terms of having a sustainable model for health information exchange - more so than RHIOs.
Hospital by hospital
RHIOs exist for no other reason than to engage entities to share medical records. IDNs, which already exist, “realize the value internally of sharing medical records,” he explained.
Freedman said dbMotion is seeing more IDNs interested in HIEs. It makes sense for hospital systems in major metropolitan areas to connect internally – hospital by hospital – and effectively become building blocks to connect to other IDNs and become the nodes of the NHIN.
He cited the partnership with the University of Pittsburgh Medical Center as an example of a potential trend that could reset efforts on the regional level to realize the NHIN.