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- 80% of general practitioners under 50 use basic e-health tools (Drees study)
80% of general practitioners under 50 use basic e-health tools (Drees study)
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The fourth observation panel of practices and conditions of practice in general medicine is a survey conducted in 2018-2019 in France, outside Mayotte, by the Drees, regional health observatories (ORS) and regional unions of the professions of health-liberal physicians (URPS-ML) in the Provence-Alpes-Côte d'Azur (Paca) and Pays com la Loire regions, with 3,300 liberal general practitioners, installed on January 1, 2018 and having at least 200 patients of whom they are the doctor.
Eight out of 10 doctors under the age of 50 said that they use the three basic e-health tools on a daily basis: the computerized patient record (DPI), prescription aid software (LAP) and secure health messaging ( MSSanté). But only 48% of their colleagues aged 60 or older use them, the study found.
In detail, 97% of general practitioners under the age of 50 say they use a DPI, 89% an MSSanté messaging service and 93% a LAP, compared to 79%, 68% and 61% respectively among those aged 60 and over. "The use of these base tools decreases with age, and even more strongly when we consider the use of these three tools together," noted Drees in his study.
The study also reveals that doctors practicing with other general practitioners, those who are approved as training supervisors, who were already part of a territorial professional health community (CPTS), who have a secretariat or have a larger patient base of 'attending physician' patients have more extensive use of these e-health tools.
"In addition to a marked generational effect, the use of these basic tools seems to be more frequent among general practitioners with an elaborate collective organization, which is probably due to the opportunities and constraints linked to it. For example, sharing an IT infrastructure is part of the compensation criteria of the conventional inter-professional agreement (ACI) concerning multiprofessional health homes (MSP) ", underlined the panel.
More recent, the shared medical record (DMP) and telemedicine are outside the scope of this study, said Drees.
Another effort on coding and data security
If general practitioners under the age of 50 are greater users of basic e-health tools, among those using PGD, only 1 in 5 says that the results of their consultations are correctly coded in the file.
As a reminder, the classification of medical procedures makes it possible in particular to define the fees for treatment procedures performed during a consultation, in addition to the population monitoring that it allows. "The structuring of the DPI and the codification of the information it contains are prerequisites for the exploitation of the information collected by the doctor during the consultation: it is, for example, the means of carrying out the follow-up vaccine of its patient base by identifying people who are not up to date with their vaccines or detecting diabetic patients whose glycated hemoglobin is not standardized, "recalled Drees.
Thus, almost half of the doctors structuring the information within the DPI indicate using the international classification of diseases (ICD), 17% a personal coding and only 11% say they use the international classification of primary care (ICPS), which is specifically dedicated to the codification of the results of general medical consultations.
More worryingly, 1 in 10 do not know which coding system they use. Again, Drees noted that "younger" practitioners code the content of their consultations "more often" than their older counterparts.
In detail, men also code their acts more often than women and – as for the use of basic services – exercising within a CPTS, being approved as a training supervisor and exchanging with his patients outside the consultations are elements significantly and positively associated with the coding of PGD. On the other hand, the volume of activity is not significantly associated with it.
The "security of exchanges and data" component is also to be further improved.
In fact, according to the Drees panel, if only 8% of the treating physicians surveyed declared that they interact with each other or with patients via unsecured messaging (MSSanté), 58% use another channel than messaging to communicate: telephone (9 out of 10), secure or unsecured emails (6 out of 10) or instant messaging (3 out of 10).
Same tone on the side of data security. The study first reveals that 75% of general practitioners use means to secure access to their DPI and have a device for this to secure their patient files. However, 17% of respondents said they did not know if they had such a device.
These devices are "physical" (key, anti-intrusion alarm in their office, etc.) for 1 doctor in 10 and IT (anti-virus, password change policy etc.) for 3 professionals out of 4.
"Beyond securing access to data, hosting patient data is an area where improvements can also be made," noted Drees.
Almost half of general practitioners state that they only store their patients' health data on their computer's hard drive, and 13% add another unsecure storage tool (external hard drive, for example) to this storage mode.
Only a quarter of doctors declare that they host their patients' health data on a local or regional platform, or even at a host approved for health data (HADS).
The law of January 26, 2016 of "modernization of our health system" replaced the procedure for the approval of health data hosts by a certification issued by a certifying body accredited by the French Accreditation Committee (Cofrac), recalls- your.
The list of HDS certified hosts is available on the website of the Digital Health Agency (ANS, ex-Asip santé).
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