EMR case study
In order to follow the ask evolution of the corporation, to reply to the new rights of the patients, to favor the coordination of the cares and to encourage the emergence of new methods of exercise for the health professionals, it is necessary to set up of the systems of information of adapted electronic medical records software. These new methods must compete to a bigger responsibility of doctors and patients become more actors in positions touching on their health records (EHR). These evolutions demand a placement in common of information between all the actors of the system of health and the patient in order to improve his taken charge of, the coordination and the continuity of the cares. The recent development of the technologies of information and communication (TIC) allows of such exchange. Set it up of sturdy systems and for the division of these information is technically possible.
These systems rest with a renewed acuity the questions on the respect of the person, the confidentiality of the electronic medical records and the security of the systems of information. The implement mastered adapted systems of information is a necessary condition to the coordination of the cares. Touching the organization of the system of health, the relations between the actors and the role of the patients, difficulties put by such a project are big and numerous. It suits before all, to specify the lawful and statutory measures to take to allow the conception and the implement such a project. To the technical problems to resolve, adds the elaboration of the economic model carrier of the permanence of such systems.
At last, the changes that induces this project on the culture of medical information in our country, ask to borrow a method associating the actors of the system of health. They ask equally an accompaniment, a driving of project and a plan of adapted communications. Conceive an operational project and formulate concrete suggestions on the basis of mastered technologies, such is the objective at the end of an aiming exploratory mission to analyze the project and the conditions of his development.
These suggestions are based on available, simple technologies, acceptable by the professionals, by the patients and by the costs that they represent. They can be implemented in an experimental way, in the field, as early as the beginning 2004. The semantic discussions on the definition of the medical file are able, as by the passed, block the development of the reflection on the necessary division of the news that it contains. We will avoid therefore talk about the medical file to talk about the data of the patient of which the anthology has for object the improvement of the followed by his health state.
In fact, in a pragmatic way, it can be not a matter of a medical structured file, exhaustive, suiting all whatever the specialty of each and interoperable with all the existing systems of information in practice. Set it such a file up cannot be envisioned in the short one run for a very important proportion of the population. It is a matter, of the center the system of information of health on the patient while allowing, for a given patient and for the health professionals that the take charge of, the access to the elaborated or exchanged documents the concerning. Technically these documents will be memorized in of the “receptacles” define regarding the conservation and division of the medical data considering their specificity.
Our gait aims to define the conditions of this division, to test it, to evaluate his quality. The present report, behaves:
· A first party, centered on a presentation of the context, evolution of the medical practices and development of the technologies of information and communication in the domain of health.
· A second party presents the recommendations. They concern o a driving experimental method in the short one run to an allowing evaluation to define the final framework of the project, o the methods of piloting of the project, o a projected calendar of proposed experimentation.