The French Connection: With JiveX to "Mon Espace Santé"

Switzerland has its EPD, Austria has ELGA, Germany the ePA – and France will get its Mon Espace Santé. The fundamental idea behind the patient record concepts in the European countries mentioned above is comparable: it is all about a nationwide networking of the health care system and a central storage place for medical information which can be viewed by any institution - insofar as the patient gives consent to do so.

In France, this objective is to be achieved with the so-called Ségur du Numérique, a nationwide investment program designed to improve the digitization of healthcare in the country. A total of two billion euros has been allocated to the French healthcare system, to facilitate the exchange and sharing of medical data at the national level – be it through software upgrades or new acquisitions. The focus is on the patients. The key is that the investment pays the ambitious goals to accelerate digitization.

First the reports, then the images

The money is distributed in tender phases. The first phase, completed in 2022, was to initially ensure that the primary systems, in other words mainly the HIS, were ready to connect to the infrastructure through which healthcare facilities nationwide would be networked and initially send reports. In a next step, the specifications of which are currently being discussed, additional systems will be connected to ensure the transmission of medical images.

Whereas the overall strategy was defined by the French Ministry of Health, the Agence du Numérique en Santé defines the technological standards for this. Comparable to other models, Mon Espace Santé (including DMP) is also based on a master patient index (INS = Identité Nationale de Santé) which must be used to assign the data in a previously qualified patient context. The data are sent to the file via a so-called DRIM box and retrieved from there. Both the file and DRIM box are based on IHE standards. The DRIM box is an interface between the in-house systems of the facility and the national patient record, comparable to a TI gateway.

The actual design of networking is in the hands of the different regions in France, which can choose the best way of networking for themselves - provided that all data can later be converged nationwide. They are supported in this by the regional health authorities (Agences Régionales de Santé, ARS), to whom the funding applications are also submitted and who distribute the funds. The ARS also take on the technical support and assist in setting up the data networks in the respective regions.

JiveX makes the data "ready for collection"

Same as in Switzerland, Austria and Germany, JiveX helps hospitals to prepare their in-house and national data infrastructure so that the connection to Mon Espace Santé runs smoothly. Here, JiveX does not in itself act as an interface to the INS, primarily because these interfaces are proprietary on a country-by-country basis. But also because the data transfer from the HIS, for example, makes sense. However, as JiveX is based on IHE profiles, the JiveX Healthcare Content Management (HCM) and JiveX Enterprise PACS INS can integrate. This results in the major organizational benefit that the data are "ready for patient records" from JiveX.

In the case of HCM, this means: hospitals can consolidate all a patient's medical data, intelligently structured and thus easily to filter, in just one system to have them ready for transmission in each citizen's Espace Santé at the touch of a button. The same applies to medical images from the PACS. As in the other European countries with digital files, JiveX ensures that all data are ready for collection at the facility's doorstep - they just need to be collected. This form of centralization within the hospital facilitates implementation of the connection immensely, as the relevant data do not have to be painstakingly compiled or possibly even have to be converted by the hospital staff. This means more time for patients and less computer work.