The use of regional platforms for managing electronic health records for the production of regional public health indicators in France.

BACKGROUND

In France, recent developments in healthcare system organization have aimed at strengthening decision-making and action in public health at the regional level. Firstly, the 2004 Public Health Act, by setting 100 national and regional public health targets, introduced an evaluative approach to public health programs at the national and regional levels. Meanwhile, the implementation of regional platforms for managing electronic health records (EHRs) has also been under assessment to coordinate the deployment of this important instrument of care within each geographic area. In this context, the development and implementation of a regional approach to epidemiological data extracted from EHRs are an opportunity that must be seized as soon as possible. Our article addresses certain design and organizational aspects so that the technical requirements for such use are integrated into regional platforms in France. The article will base itself on organization of the Rhône-Alpes regional health platform.

DISCUSSION

Different tools being deployed in France allow us to consider the potential of these regional platforms for epidemiology and public health (implementation of a national health identification number and a national information system interoperability framework). The deployment of the Rhône-Alpes regional health platform began in the 2000s in France. By August 2011, 2.6 million patients were identified in this platform. A new development step is emerging because regional decision-makers need to measure healthcare efficiency. To pool heterogeneous information contained in various independent databases, the format, norm and content of the metadata have been defined. Two types of databases will be created according to the nature of the data processed, one for extracting structured data, and the second for extracting non-structured and de-identified free-text documents.

SUMMARY

Regional platforms for managing EHRs could constitute an important data source for epidemiological surveillance in the context of epidemic alerts, but also in monitoring a number of indicators of infectious and chronic diseases for which no data are yet available in France.