Montpellier Management Institute, Montpellier University, France.
Health Policy. 2018 Sep;122(9):937-940. doi: 10.1016/j.healthpol.2018.07.022. Epub 2018 Aug 2.
To support care coordination, a national electronic medical record (DMP), has been created by law in 2004. Because of technical difficulties and delays during implementation, the project was entrusted to a dedicated technical agency in 2009. But 3 years later, only 160,000 DMPs had been opened contrary to the several million expected. Physicians criticized the technical and administrative burden, but the main factors highlighted were resistance to sharing information with patients and with other professionals. Failing to cross the critical threshold of users that gives value to the system, the project failed. After this first attempt, the project was entrusted by law to the national health insurance fund in 2016. The new policy was addressed to patients, professionals and software companies. The policy has allowed patients to independently access and modify their DMP data already in possession of the national public medical insurance, and has introduced financial incentives for physicians opening a DMP. As a result the deployment of DMPs has accelerated substantially: 350,000 new DMPs were opened in nine pilot departments within a year. If scaled-up to the entire country, this number would correspond to 4 million DMPs.
为了支持医疗协调，2004 年法律规定创建了一个国家电子病历（DMP）。由于在实施过程中遇到技术困难和延误，该项目于 2009 年委托给一个专门的技术机构。但 3 年后，仅开设了 16 万个 DMP，而预期开设几百万个。医生批评了技术和行政负担，但突出的主要因素是抵制与患者和其他专业人员共享信息。由于未能跨越系统有价值的用户关键门槛，该项目失败了。在第一次尝试之后，该项目于 2016 年被法律委托给国家健康保险基金。新政策针对患者、专业人员和软件公司。该政策允许患者独立访问和修改他们已经拥有的国家公共医疗保险的 DMP 数据，并为开设 DMP 的医生引入了经济激励。结果，DMP 的部署大大加快：在一年内在九个试点部门开设了 35 万个新的 DMP。如果扩展到全国，这个数字将相当于 400 万个 DMP。
