PARIS — During MEDEC 2009, the annual conference for general practitioners held here last week, the French leader for practice and patient management software, Cegedim (Boulogne-Billancourt, France), previewed an integration package that aims to serve as a work-around solution for the flailing government program intended to create patient dossiers and a national electronic healthcare system.

The software developed by Cegedim, DM Pro (for Dossier Médical Professionnel), was formally presented at MEDEC by the French Association for Medical Information Exchange (AMEI), a subgroup recently created by the leading organization of medical practitioners, Conféderation des Syndicats Médicaux Fran ais (CSMF).

The sneak preview of DMPro had the full support of Cegedim and featured a debate during MEDEC with the newest head of the government's program for personalized citizen records, the Dossier Medical Personnel (DMP), and the pathology-specific branch for clinical use, the Dossier Medical Partagé, or "shared."

More significant than the Cegedim software package is the cooperation of frustrated general practitioners with a private company to create "a patch, or a bridge, or whatever you want to call it, for sharing patient information in the medical community so that patients can benefit from the information," said Christian Espagno, who is responsible for DM Pro for CSMF.

All parties to e-health development throughout Europe repeatedly assert that technology is not a barrier to implementation of shared patient records, and that it is the political and legal sensitivities and lumbering government-run initiatives that are causing the delays.

France's long-awaited program to create the DMP has been stopped and restarted at least twice since it was launched by the legislature in 2004 (Medical Device Daily, June 9, 2008).

The third tender for companies to host the massive distributed database will be launched by the government later this year, the previous two efforts having been cancelled.

"Doctors and their patients cannot wait years for these tools to help improve practice and care," said Espagno.

Key to the Cegedim package is its ease of use for general practitioners with a promise of no need for re-entering of data for doctors already using one of the many practice management software on the market.

The files can also be accessed in a browser-based application for physicians working outside their software or for physicians who do not have a compatible software package.

DMPro also adds a novel feature, reaching into the French database for reimbursement to display a patient's medication history as well as prescribed imaging, procedures, prosthetics, implants or services, such as specialized nursing care.

"Simplicity is the key," said Espagno with an exasperated note, adding that he would rather go online to complete an income tax form than to enter information into the government's DMP in the current version being tested.

Access to patient records requires a professional care provider smart card held by all physicians, pharmacists and licensed care givers and any computer trying to access the files must be connected to a smart card reader.

The dossier for shared information in the DMPro community can be created only with the consent of a patient, which remains on file, and the software assigns an encrypted patient identification based on the national healthcare insurance card, which has been approved by the Commission Nationale de l'Informatique et des Libertés (CNIL).

CNIL challenges to the government's DMP for encryption standards have sparked controversy and caused long delays in the second version of the program.

The Cegedim-driven DMPro package also helps clinicians align their vocabulary with accepted nomenclature.

"For years we have been entering our data faithfully into various programs but in our own fashion, sometimes saying a patient was pregnant or that she was expecting," Pierre Bruneau, chief medical officer with Cegedim, said in a presentation.

DM Pro also assist doctors in sharing a lingua franca for pathologies, progressively building records that will conform to accepted international standards.

"This is just a beginning step, but what we are showing today is not science fiction, it exists and is being tested by general practitioners now," said Bruneau.

He said Cegedim has informed the government's DMP program of the new DMPro. "We are closer to working together, and we want very much to participate actively, but we are not yet integrated into the project."

Cegedim in February, 2009 reported consolidated revenues of €849 million ($1 billion) for 2008, up 12.7% over 2007 revenues of €752,994, which was also valued at $1 billion due to the value of the euro in February 2008.

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