The (Re)-Relaunching of the DMP, the French Shared Medical Record: New Features to Improve Uptake and Use.

Health care delivery for patients with chronic conditions is complex and confusing. Care is often fragmented, less effective, and sometimes harmful. Given the potential for EHRs and other health IT systems to facilitate information flow between providers, patients, and settings, health IT-based measures are of particular interest for care coordination. Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, many barriers to HIE use have been reported. Another solution relies on the implementation of a nationwide centralized framework of clinical information sharing with "new" secure online care records stored in specifically created platforms. The French DMP follows this model but the adoption of the tool has been historically poor. In 2016, a renovation of the DMP program was launched in nine pilot French departments and new features have been implemented: the DMP content has been fully specified, patients can create their DMP by themselves, DMPs are automatically filled in by data claims, a mobile app has been developed, and technical issues about DMP and EHRs interoperability have been resolved. In October 2017, over 900,000 people have a DMP with an average new DMP being created every minute. These results have to be confirmed in 2018 when the new DMP will be deployed on the whole French territory.