The dossier médical personnel (DMP) is dead. Long live the dossier médical partagé (DMP).
Following a scathing report that all but killed the French national e-health program, a follow-on plan to re-launch the program submitted six months later by the same inter-ministerial task force has been endorsed and funded by the Health Ministry.
The most significant change is lifting the accent on a "personal" health record, which could only be unlocked with a patient's e-health card and code, and instead shifting the informatic architecture to a dossier "partagé," or shared record, which can be accessed by all health professionals, the government, and likely private payors.
The doctors won their fight for access to, if not control of, the electronic record.
With a generous three-year pilot period and a vague estimation of 2011 as the date when French citizens will be able to use the re-launched system, it may be a long time before anything is reported again on what was once proclaimed to be the "magic button" that would fix the dysfunctions in France's health system and relieve the sagging financial burden.
Far more sober and "réaliste" than the first announcement of the program in 2004, the new plan describes formidable technological barriers and takes into account the treacherous legal ground the program will cross by creating inter-ministerial groups to tackle the thorny issues.
At Hospital Expo, held in Paris the final days of May, Jacques Sauret, chief executive of the DMP organization, the Groupement d'Intérêt Public DMP (GIP-DMP), said he continues to believe the program could technically be up and running in three years, possibly two, but that working through the "change issues" is going to take considerably longer.
In late May, Health Minister Roselyne Bachelot endorsed the 120-page report submitted by Michel Gagneux, the Inspector General of Social Affairs, and reported the annual budget would be set "between €30 million [and] €50 million" ($46 million to $77 million). Some 20 regional pilot projects will be developed over the next three years, building on programs started under the previous program, and significantly, these projects will share the seemingly simple goal of demonstrating a secure exchange of patient identification numbers as a first step.
At Hospital Expo, the GIP-DMP showcased three regional projects showing interoperability of lab records in Aquitaine, dynamic links between general practitioners and hospitals in Picardie, and patient identification on Réunion, the French island in the Indian Ocean.
The right of French citizens to see and control their personal medical data is a hard legal issue that cannot be made to go away with ministerial reports and commissions. The right to control of personal data is encoded in French law and enshrined in the European Union treaty.
Control is interpreted in the French program as an ability to mask certain data, at the discretion of the patient, and to the consternation of doctors.
The newly launched DMP program tip-toes around the issue and concludes that some other task force will need to reconcile this personal right with the medical requirement for shared information.
Lisi Group creates medical division
Manufacturing conglomerate Lisi Group (Belfort, France) reported the creation of a new medical division that will consolidate its recent acquisitions of medical implant makers.
Over the past 18 months the aeronautics division of Lisi bought four companies with strong portfolios as subcontractors for medical and dental implants and this month formally set up a stand-alone group with consolidated revenues of €25 million ($38.5 million).
Customers for the consolidated operations include original equipment manufacturers Zimmer (Warsaw, Indiana), Stryker (Kalamazoo, Michigan), Synthes (Solothurn, Switzerland) and DePuy (also Warsaw), as well as France's Scient'x (Guyancourt) and Medicrea (Lyon).
"This new group is growing in a dynamic market with high growth rates in certain segments in double digits," said Emmanuel Viellard, who heads up the aeronautics group and also serves as vice president and directeur général for Lisi Group. Viellard added, "To be sure, Lisi is not entering the medical sector just to stay at the current levels of the affiliates, which are very low on the scale of the group."
Lisi reported revenues for 2007 of €816 million ($1.2 billion) with 52% from automotive, 42% from the aeronautics division, and 6% from cosmetics.
The acquisition of Hugueny (Fleurieux sur l'Arbresle, France) in January 2007 was a first, but small step, in the strategic move by Lisi, as that manufacturer of spinal and orthopedic implants serves primarily French OEMs and reported revenues of revenues of €3.2 million ($5 million).
Four months later Lisi reported that it had acquired Jeropa Swiss Precision (Escondido, California), a dental implant manufacturer with revenues approaching $11 million.
In December 2007, Lisi fully took over the companies Seignol and Intermed Application, both located in Neyron, France, near Lyon, with combined 2007 revenues of €11 million ($17 million).
Seignol is a specialized subcontractor for surgical implants for feet, hands, traumatology and maxillo-facial uses, as well as a manufacturer of surgical instruments.
Through Seignol, Lisi also picked up the manufacturing operations of Lixus Industrie (Tanher, Morocco).
Intermed Application specializes in metal and surface treatments, laser cutting and quality controls, primarily for medical applications.
In reporting the creation of the new division, Lisi executives said combining the companies creates opportunities for organic growth with prototypes already being developed with customers that include acetabulum of the pelvis, screws for the vertical column, shoulder prosthesis, cervical disks and dental implants.
Siemens moving diagnostics research
Siemens Healthcare (Erlangen, Germany) said it will set up its European research center for molecular diagnostics in Cologne, Germany, moving out of the Bayer Technology Services campus in nearby Leverkusen.
The move is part of the heavy lifting as Siemens integrates the operations of Bayer Diagnostics that it bought two years ago for $5.3 billion, catapulting the radiology giant to the top ranks of in vitro diagnostics competitors.
The European center in Cologne specializes in developing innovative biochips, the lab-on-chip tests that use a combination of microfluidics, electro-chemical reactions and diverse sensors to determine the presence of biomarkers linked to specific disease states.
Siemens set out to become a one-stop shop for medical diagnosis by adding to its established line of radiology and imaging products the emerging bio-chemical technologies that promise a more personalized medicine by quickly screening for diseases and then tailoring therapies to address specific patient conditions.
Siemens moved quickly over the course of a year, spending $14 billion to purchase Diagnostic Products, Bayer Diagnostics and Dade Behring, which were integrated into the Siemens Medical division.
The company reports the division's income up 20% to €9.8 billion ($15.2 billion) and the group's profits up 34% at €1.3 billion ($2 billion).
Solid financial performance for NHS
The UK Department of Health reported last month that the National Health Service (NHS) is in good financial health, with a £1.658 billion surplus for this fiscal year more than triple the figure of the prior year.
The new figures were published in the "Quarter 4" report, which looks at NHS financial performance in January-March of this year, as well as over the year as a whole.
The NHS will end the year with an overall surplus of £1.658 billion that will stay within the NHS to improve patient care. This compares to a £515 million surplus in 2006/07, and a £547 million deficit in 2005/06.
There has also been improvement in reducing the gross deficit, which is now £122 million, down from £917 million gross deficit a year earlier and £1.312 billion in 2005/06.
Commenting on the report, David Flory, director general of NHS finance, performance and operations in the Department of Health, said, "We can look back on 2007/08 with pride. The NHS was set up to meet the health needs of the population. Our performance in 2007/08 has shown that 60 years on, the NHS is still delivering on its commitment to provide the best quality care for all.
He said, "This healthy surplus is a further indication that the NHS is now on a stable financial footing. Thanks to the tremendous efforts of those in the NHS, organizations now have the headroom and confidence to invest in transforming patient services, [while] having the flexibility to respond to fluctuations in demand."
Sympoium eyes doing business In Ukraine
Ukraine's fast-growing healthcare and pharmaceuticals market, which posted 20%+ growth in 2006-2007, took center stage at a symposium held for U.S. business interests in Washington near the end of May.
The "21st Century Pharmaceutical Production and Health Care Research & Delivery in the Commonwealth of Independent States" symposium was held May 28 at the Ritz-Carlton Hotel in downtown Washington, exploring medical and pharmaceutical business opportunities now emerging in Ukraine and elsewhere in the Commonwealth of Independent States (CIS).
MaxWell USA organized and hosted the all-day event. MaxWell USA is a subsidiary of MaxWell Biocorporation, an international medical and pharmaceutical company based in Washington. MaxWell said its focus is on increasing the life expectancy and improving the quality of life in Ukraine and "other underserved emerging healthcare markets in the former Soviet Union."
The MaxWell symposium featured concurrent research and business tracks and a keynote address by former Pennsylvania congressman and Ukraine proponent Curt Weldon. It drew nearly 150 attendees and speakers from the medical, business, legal and NGO communities in the U.S., Ukraine and Russia.
"Given the ... enthusiasm of the many scientists and business professionals who contributed to our symposium, I am optimistic that our work in Ukraine and beyond will progress rapidly," said MaxWell Biocorporation founder/president/CEO Dr. Kenneth Alibek.
He highlighted the "knowledge-sharing" between the U.S. and Ukraine seen since Ukrainian independence in 1991, and forecast "significant opportunities" for U.S. companies and healthcare institutions to expand manufacturing facilities in Ukraine, and for the U.S. to provide direction for and training on clinical care programs.
During the symposium business track, presenters offered insights on how business is done in Ukraine, and emphasized MaxWell's capacity for facilitating market entry and guiding partners through Ukraine's often-challenging regulatory environment, both key to successful project development.
Many healthcare institutions have pledged to share knowledge and provide training to Ukrainian physicians. One such cooperative education program for Ukrainian physicians is sponsored by the West Virginia University School of Medicine.
Representatives from Baker Hostetler, Squire Sanders & Dempsey, and the Russian-Ukrainian Legal Group spoke about successfully conducting business in Ukraine, including cross-border tax issues, corporate income tax, transfer pricing and strategies for addressing double taxation; harmonization of Ukrainian law with European Union law and WTO requirements; and strategies for mitigating business risk.
The symposium's medical track showcased the high rate of morbidity and mortality in Ukraine vs. other countries, prospects for turning around these staggering statistics, and how clinical trial execution in Ukraine is contributing to state-of-the-art clinical care delivery in the country, as well as contributing to advancing medicine.
Latin American expansion for Pall
Pall (East Hills, New Jersey), a company specializing in filtration, separation and purification systems and technologies, reported a five-year geographical expansion initiative in Latin America, which will encompass Pall's life sciences and industrial businesses in Central and South America, Mexico, and the Caribbean.
Felix Diaz was named president of the Latin American region. Diaz previously was president of global operations for Pall Life Sciences.