Following the announcement of a policy to transform the health system by the president of the French Republic, A national digital health roadmap was created in April 2019 to reflect the collective commitment to implement digital healthcare in France. The Ministry of Solidarity and Health, through the Ministerial Delegation for Digital Health (DNS), is committed to a process of co-construction of the e-health policy in France with all the actors of the ecosystem.

The Convergence Tool makes it possible to measure the degree of maturity of products accredited with good integration into the ecosystem and to develop a convergence trajectory towards a target by 2024.

Designed to assess the maturity of innovation projects across the entire scope covered by the digital health roadmap, the Digital Health Agency (ANS) published the first self-assessment results of the ‘Convergence’ tool at the end of 2020. 300 regional services were contacted and more than 100 manufacturers have taken part in the assessment (statement collected by Wassinia Zirar from the ANS).

Implicity completed the Convergence tool and assessed its solutions to mark its desire to be compliant with the standards of the digital health roadmap.

Meeting with Julien Durand, Product Director at Implicity, who shared with us his experience conducting this meaningful exercise for Implicity.
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You have chosen to participate in the self-assessment exercise via the Convergence tool. Why?
For Implicity’s mission to be successful and for us to provide the best service to our customers, we must be ”fair play” with the rest of the health ecosystem in general, and in particular, meet the expectations of public authorities. The exercise seemed natural to us since it resonates with the values of integrity and transparency on which Implicity was built.

What does this approach mean to you, as Product Director?
One of the things that concern the product team the most is the “roadmap”: identifying and planning the features to be produced and deployed. In theory, the roadmap is decided completely objectively by calculating the cost-benefit ratio. But in practice, it is often complicated to be absolutely objective – it is ultimately a synthesis between the analysis of our clients’ needs, the echoes from the field, market trends… The Convergence tool gave me an objective grid to establish product development priorities on a certain number of subjects.

What would you say about the assessment results in an overall context?
In terms of interoperability, we are well placed in terms of maturity and the results reassure us about the technological choice we have made. Implicity has chosen not to code the entire interoperability itself, but rather to rely on an interoperability brick that has enabled it to be systematically compliant with the requested criteria.
In terms of urbanization, we are thinking about the 2 topics on which we are delayed: the Shared Medical File (DMP) and the identification of health professionals. While this sounds like great initiatives to us, Implicity remains a specialty software. We, therefore, chose not to prioritize these features, especially since the central hospital software, such as the Patient Record, does not always comply with these requirements.

On the other hand, Implicity imposes two-factor authentication on its users: password required to connect followed by a code received by SMS on the phone. Some doctors are surprised when introduced to double authentication – a practice not yet common for hospitals software.

Overall, we are quite satisfied with our results, especially when we observe that actors with more resources and expertise than us are not yet 100% compliant with the expected level, whether in terms of urbanization or interoperability.

Implicity now operates in various countries across Europe and North America. What impact does this have on your compliance prioritization?
We see that Implicity complies with the requirements presented in Convergence on topics that are standard at the international level, such as interoperability, health data hosting security repositories, etc.
On the other hand, on projects specific to France such as the Shared Medical File (DMP) or the national digital identification service, we are lagging behind. Actors like us, who are present in many countries in Europe or outside Europe, need to make sure they are compliant with the systems of all countries they are operating in. The DMP in France for example is an excellent initiative, but there is also a patient record in the UK that works differently… To comply and meet the requirements of the patient record in the UK, or in another country, we must reinvest the same resources.
I think that in France there is a real question of standardization in national projects such as DMP, digital identification, or others. It would be more effective to have common standards so that manufacturers can more easily comply.

What did you learn from this experience?
The Convergence tool gave me an understanding of the issues related to interoperability and urbanization with the health system. In addition, once the assessment is completed, the tool proposes to establish a convergence plan indicating the actions to be implemented to progress on each of the subjects. It is therefore part of a very constructive process of evaluation and identification of areas for improvement. The Shared Medical File (DMP) and the national digital identification service are of course part of our convergence plan!
This tool has also enabled us to realize that a small structure like ours can meet the requirements of public authorities, with an agile and pragmatic approach.

Read the article in French here

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