First piloted in 2006, the DMPs will be gradually deployed throughout the territory under the jurisdiction of the Agency for Shared Health Information Systems ('ASIP Santé', in French). The DMPs are computerised records created for each beneficiary of the health insurance, if they wish so. These records will enable health professionals and institutions to share patient information that is needed for the coordination of care, provided the patients give their prior consent to the sharing.
The DMP was created by the Act of 13 August 2004 on health insurance, with the purpose of improving to coordination and quality of healthcare, and thus, its continuity. The DMP system will be hosted by a consortium of solidarity companies selected following a tender by ASIP Santé. The consortium was approved by decision of the Minister of Health dated 10 November 2010, after the CNIL and the Committee for the Approval of Hosts (Comité d'agrément des hébergeurs, in French) had delivered their opinions on 30 September 2010 and 1 October 2010 respectively.
DMPs have a number of features that differentiate them from other shared medical records:
- They are intended to follow the patients throughout their lives and to enable, through the centralisation of information, the sharing of data that are relevant for the coordination of care between professionals and institutions that may have to provide care to the same patient, anywhere in the country. DMPs thus implement a new patient data sharing method.
- They have been designed as the 'patient's file', in that patients control both the content and the access to their records. Patients can access directly, from their PCs, their DMPs and determine which health professionals they wish to give access rights to; likewise, patients have the ability to hide some of the data contained in their records.
The first phase of wide-spread deployment of the DMPs should last for three years. It will be devoted to the gradual implementation of a "basic" medical record which will be fueled in particular with the hospitalisation and consultation summaries. The aim is to place the healthcare professionals in a position to share documents, with the consent and under the control of their patients.
It is worth noting that DMPs are not intended to substitute the paper or computer based records stored at the practice of private doctors or at health institutions; instead, they will add to the existing ones. Their gradual deployment will build on the converging of five regional projects that have already focused on data exchange devices. In contrast, the integration in the DMPs of the information contained in pharmaceutical records as provided by law has been postponed.
The CNIL acknowledged that the development of the DMPs' legal framework will depend on feedback and lessons learnt, but the authority recalled that the definition of such framework is essential to the management of the project. The second deployment phase will therefore have to be part of a regulatory framework defining the DMPs' content and access conditions, as well as the national health number and the conditions for its use. Moreover, the data protection authority indicated that it should be referred to regarding the assessments achieved during the first deployment phase of DMPs and at its end.
Once the update of the software of the professionals and health facilities has been performed according to the requirements defined by ASIP Santé, the existing information systems will be able to 'communicate' with the DMPs; this will save professionals the need to re-log their patients' information. As for professionals who have not yet adapted their software, they will access the DMPs from a website. Any health insurance recipient who has a personal health card (Vitale Card, in French) will be able to create their own DMPs at a health professional's office or at the reception of a health institution and then access them directly through their PCs.
The DMP's creation is voluntary and each patient has to give their consent to such creation. Likewise, patients have a right to close their DMP at any time; closed DMPs will first be archived for ten years and then deleted. During the aforementioned ten year period, DMPs may be reactivated upon the patient's request. A definitive deletion will be possible, without delay, at the patient's request.
Patients will have access to their DMPs and to the history of their records, and they will be able to ask the host for a copy. Last but not least, patients will have the possibility to hide some information contained in their records or to ask a professional to do so.
Further information:
- Original news article - CNIL (© CNIL - droits réservés)
- Related ePractice news article - FR: Patients' access to own electronic medical records - Tests announced for 2011
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Quelle/Source: epractice, 13.01.2011
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