To support care coordination, a national electronic medical record (DMP), has been created by law in 2004. Because of technical difficulties and delays during implementation, the project was entrusted to a dedicated technical agency in 2009. But 3 years later, only 160,000 DMPs had been opened contrary to the several million expected. Physicians criticized the technical and administrative burden, but the main factors highlighted were resistance to sharing information with patients and with other professionals. Failing to cross the critical threshold of users that gives value to the system, the project failed. After this first attempt, the project was entrusted by law to the national health insurance fund in 2016. The new policy was addressed to patients, professionals and software companies. The policy has allowed patients to independently access and modify their DMP data already in possession of the national public medical insurance, and has introduced financial incentives for physicians opening a DMP. As a result the deployment of DMPs has accelerated substantially: 350,000 new DMPs were opened in nine pilot departments within a year. If scaled-up to the entire country, this number would correspond to 4 million DMPs.
Keywords: Care coordination; Change management; Electronic medical record; France; Policy development.
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