Introduction

France, one of the top three economies Europe, has embarked on an ambitious national healthcare IT programme based on the development of patient health smart cards to authenticate patients and speed transaction processing, linked to the development of a national system of Electronic Health Records. The government aims to have the system rolled out and working by 2008.

ccording to a study by French Government figures just under half of all spending (49%) finances existing infrastructure, with around 30% going to upgrades and renewal, and 21% to new projects. One of the striking features of health IT investment in the French hospital sector is the extent to which it is concentrated, with just 6% of hospitals accounting for 58% of total spend.

The French national healthcare IT programme

In 2004, the French Government announced a national healthcare IT programme, comprising a number of components. These included:

• Electronic Health Record - and a national electronic patient record.
• Sesam Vitale-2 smartcard - an electronic healthcare smartcard
• Disease Coding - a national disease and cost coding system

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France's Electronic Health Record - the Dossier Médical Personnel The centre-piece of the French healthcare IT programme is its national web-based EHR programme, the dossier médical personnel (DMP), to be delivered through six regional consortia. Sesam Vitale-2 smartcard The centre-piece of the French healthcare IT programme is its national web-based EHR programme, the dossier médical personnel (DMP), to be delivered through six regional consortia. Disease Coding Cost containment and improved quality of care provide the impetus for the introduction of France's new national disease and cost coding system is known as “la Codage”, which provides the basis for introducing activity-based funding formulae known as "Tarification à l'activité", or T2A for short. T2A depends on the Codage system for its clinical evidence base.