The first financing package for French hospitals under the government's Hospital Plan 2012 was outlined by the Minister of Health last week with an accent on support for regional projects just ahead of regional elections where polls show the majority party trailing the opposition Socialists.

A front-line soldier for the presidential party, Minister Roselyne Bachelot detailed the government's outlay of €4.5 billion ($6.22 billion) for facilities and health information systems, and another exceptional allocation of €910 million ($1.23 billion) to bring aging facilities up to required standards.

The previous week, Madame Bachelot tried to calm tensions among the 'Mandarins' of French medicine, the leading surgeons and heads of specialty practices at the massive 22-hospital group Assistance Publique – Hôpitaux de Paris, who threatened to quit their posts if the government goes through with plans to lay off between 3,000 and 4,000 employees.

No decision will be taken until June, she said, which the Mandarins quickly and loudly noted in the media only pushes the debate until after the regional elections.

"Lets stop spreading the wretched image of the pitiful state of our hospitals," said Minister Bachelot in reporting the new financing plan, adding "two-thirds of French hospitals are exceedingly well managed."

In the first 'tranche' of financing for Hospital Plan 2012, facilities claimed the lion's share of the funding with €3.88 billion ($5.28 billion) dedicated to 161 approved projects, while health information systems represent 15% of the investments.

Announced in 2007, this first financing package represents roughly half of the €10 billion ($13.6 billion) the government promised under the plan. (Medical Device Daily, Feb. 26, 2007)

Two-thirds of the approved projects are for public hospitals supported by three-fourths of the financing, while just under 14% of the funding will be used to assist projects at private hospitals.

The country's university and regional hospital complexes represent only 16% of the financing allocated for construction and physical plant improvements.

The plan puts an accent on restructuring clusters of public-private facilities around shared facilities to assure health service coverage, such as projects in Arcachon, Fontainebleau or Villeneuve-sur-Lot, as well as reorganizing centers of excellence in Orleans, Angers and Strassbourg.

Complete reconstruction projects were approved for hospital centers in Belfort-Montbéliard, Troyes and Clermont de l'Oise while an entirely new hospital will be constructed in Calais.

Projects for upgrading facilities to meet required standards include anti-seismic construction for hospitals in French territories of Guiana, Guadalupe and Martinique.

Despite the Minister's accent on projects for regional centers, it was again the Ile de France, which includes Paris, that claimed the greatest share of funding with €432 million ($587 million), followed by Rhône-Alpes with €239 ($324 million), Provence-Alpes-Côte-d'Azur with €160 ($217 million), Nord-Pas-de-Calais with €146 ($198 million) and the Pays de la Loire with €142 ($192 million).

For eHealth, EHRs win over PACS

Almost 500 health information system projects were approved for more than €1 billion ($1.4 billion).

Twelve major projects estimated at more than 110 million were approved while a third of the projects will receive between €1 million and €5 million.

Three-fourths of the financing are for public hospitals and here the university medical centers and large regional complexes fared better winning almost two-thirds of the financing, recognizing the influence such centers can exert on surrounding clinics and specialized practices.

A project to construct a secured patient information system region Nord Pas de Calais will link 28 health establishments.

Projects requesting financing for building electronic health records (EHRs), patient pathway support and medication tracking won 72% of the funding, while technical support for laboratory reporting, picture archiving and communication systems (PACS) and digitalizing the surgical suite won just 15% of the government's financing.

Fourth RFP for French EHR network

Three consortiums of IT companies have responded to a request for proposals to host the future French electronic medical record, the dossier médical personnel (DMP).

Four consortiums responded to the call but the group including GE Healthcare (Waukesha, Wisconsin) and the telephone operator Orange (Paris) were eliminated for failing to comply with required paperwork, according to a report by the online publication tracking e-health in France, TICsanté.

The Orange-GE combination had been considered the favorite to win as the bidding process closed in mid-December.

Launched in late October, 2009, this latest RFP is the fourth qualifying round in the erstwhile efforts to find a host for the DMP, a company capable of managing the health records for every French citizen in a national distributed network.

ASIP Santé (Agence des Syst mes d'Information Partagés de Santé), the agency charged with supervising the bidding competition, was expected to make a decision by March, 2010 to meet the government's stated goal of having a pilot system operating by the end of this year.

The Minister of Health, Roselyn Bachelot, announced last year the allocation of €900 million for this latest resurrection of the troubled DMP project that was declared clinically dead by a three Ministry commission in 2008, but re-launched six months later. (Medical Device Daily, Jan. 11, 2008 and June 9, 2008).

Full deployment of the secure network for sharing patient records is projected for 2013.

In the RFP, ASIP Santé estimates the host for the network needs to be ready to handle two million citizen records this year, five million in 2011, 11 million by the end of 2013 and 13 million by 2014, equivalent to roughly 20% of the French population.

In the first year, according to ASIP Santé, the pilot network will need to handle patient data received from 20% of general practice offices, or 54,000 physicians, 10% of laboratories reporting test results, and 20% of the nation's 710 public and private hospitals.

The three Paris-based consortiums whose bids have been accepted include Santeos, an affiliate of the Atos Origin group along with the French postal service, La Poste, and SNR, a company specializing in health informatics and secure data storage; the medical software leader in France, Cegedim, which joined with the Cap Gemini affiliate Sogeti; and, Groupe SQLI with the mobile telephone operator SFR and Hewlett Packard.

TICsanté, which said neither the ASIPsanté agency nor any of the industrial partners were willing to comment on the bidding competition.

A source at Orange, which is owned by France Telecom, told the online journal that the company has not officially received any notice of irregularities with the completed bid it submitted.