Université Lyon I - CNRS-UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Lyon, France.
BMC Med Inform Decis Mak. 2012 Apr 3;12:28. doi: 10.1186/1472-6947-12-28.
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.
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.
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.
在法国，医疗系统组织的最新发展旨在加强公共卫生在地区层面的决策和行动。首先，2004 年的《公共卫生法》通过设定 100 个国家和地区公共卫生目标，在国家和地区层面引入了公共卫生计划的评估方法。同时，管理电子健康记录（EHR）的地区平台的实施也在评估之中，以协调在每个地理区域内部署这一重要的护理工具。在这种情况下，尽快开发和实施从 EHR 中提取的流行病学数据的区域方法是一个必须抓住的机会。我们的文章解决了某些设计和组织方面的问题，以便将这种使用的技术要求纳入法国的地区平台。本文将以罗纳-阿尔卑斯大区卫生平台的组织为基础。
法国部署的不同工具使我们能够考虑这些地区平台在流行病学和公共卫生方面的潜力（实施国家健康识别号码和国家信息系统互操作性框架）。罗纳-阿尔卑斯大区卫生平台的部署始于 21 世纪初在法国。截至 2011 年 8 月，该平台已识别出 260 万患者。由于地区决策者需要衡量医疗保健效率，因此出现了一个新的发展步骤。为了汇集各种独立数据库中包含的异构信息，定义了元数据的格式、规范和内容。将根据处理数据的性质创建两种类型的数据库，一种用于提取结构化数据，另一种用于提取非结构化和去识别的自由文本文档。
管理 EHR 的地区平台可以成为在流行病警报背景下进行流行病学监测的重要数据源，也可以监测法国目前尚无数据的一些传染病和慢性病指标。
