In 2010, following a report exposing alarming operational and technological weaknesses in the IT infrastructure of the SAMU (France’s emergency medical service), the government launched a nationwide programme to modernise the emergency call centres, involving implementing a single solution sharing all the technical tools. This large-scale digital transformation project, called SI-Samu, was handled by ASIP Santé, the French national agency for shared healthcare IT systems, and overseen by Project Manager Sébastien Bachem:
“ASIP Santé is in charge of streamlining the ecosystem of healthcare IT systems. One of its tasks involves implementing standards and conducting digital transformation projects, such as electronic medical records,secure email, and setting up portal for logging IT incidents for the future National Public Health Agency. That’s what the SI-Samu programme is part of.”
So how to modernise the SAMU’s complex, heterogeneous infrastructures? What sort of benefits can be expected from the programme? How have staff reacted to the project? We found out the answers to these questions when we met Sébastien Bachem at the Sante Autonomie expo which took place in Paris on 19, 20 and 21 May.
Every day, all over France, the SAMU receives and handles thousands of calls. Their job involves anything from giving medical advice to sending ambulances, which requires permanent availability and reliable IT tools so they can store and share information with the various people involved. Among the essential technologies used by the teams are an “advanced telephone” system to process calls, radio to contact other emergency services such as the fire brigade, as well as applications such as medical regulation and mapping software. Such programmes require complex integration and make the medical emergency service’s infrastructures a completely separate system from the other healthcare organisation IT systems.
|SAMU: key figures– 102 call centres and 450 emergency centres
– Between 3 and 4,000 ambulances and helicopters which perform 750,000 interventions a year
– Around 31 million calls a year, i.e. more than one call per second. Activity is cyclical, with peaks at weekends (Saturday night drinking binges and Sunday morning DIY accidents!).
– 5% lost calls nationwide
ModernisING THE samu: digital TO THE RESCUE!
The SI-Samu programme has a number of objectives: prepare France for handling national health crises (such as the H1N1 flu in 2009), ensure high availability and improve interfacing with partners, whilst guaranteeing confidentiality and security of healthcare data.
Since September 2014, the programme has been in the operational phase: ASIP Santé is currently working on the specifications to give to project managers. The pilot phase will begin next year with the new systems rolled out at around ten SAMU centres. A few months after that, there will be an appraisal of these centres before the solution is rolled lout at other centres.
How did the idea for this programme come about?
Sébastien Bachem: We noticed a constant sense of vulnerability at the SAMU centres. We also realised that they weren’t equipped to cope with a nationwide public health crisis. So the aim of the programme was to find a solution to this problem.
What exactly is SI-Samu?
It involves replacing the SAMU’s existing infrastructures with an outsourced service, hosted at several data centres so the service can be accessed remotely.
That way we can concentrate needs and financing. The solution is also scalable. It’s a very complex set of tools, as it covers IT, telephone and radio.
“At the regional SAMU centres, it’s difficult to find all the technical skills for this. And the niche players that the SAMU works with, particularly where the medical regulation software is concerned, can’t offer the right level of 24/7 support or respond quickly for things like upgrades, handling bugs, etc. That’s what we’re working on, and that’s the basic principle of the SI-Samu programme.”
What sort of advantages can the SAMU centres expect from this programme?
The aim is to protect the centres from any technical difficulties and offer them 24/7 support, but also bring them added-value services in innovative areas such as crisis management and mutual assistance and cooperation between SAMU centres. The idea is also to have a database where we can run clinical studies and analyse the activity so we can learn from it.
Speaking of innovation, will people in France now be able to communicate with the emergency medical services via photo or video?
At the moment you can’t text a photo to the ambulance services. We will eventually be implementing a multi-channel system, but at the moment we have to focus on the difficulties the SAMU currently has to deal with, before moving on to future innovations.
How are the staff reacting to the IT modernisation programme?
“We’ve implemented a volunteer-based strategy and so far the feedback has been good.”
The programme has been very well received by the industry, which is one of the reasons Marisol Touraine, the French Health Minister, has pledged her support to this IT overhaul project, which is one of the government’s strategic healthcare projects.
There was a real change in mindsets during the pre-project phase when we were working with the healthcare community. There were a few sceptics at the beginning, but now people are really on board. That said, some other projects at regional SAMU centres have been launched: they didn’t wait for SI-Samu to try out some effective solutions of their own!
The 11 SAMU pilot projects were announced during the Salons Santé Autonomie health expos (Mulhouse, Albi, Rodez, Besançon, Dijon, Mont de Marsan, Bayonne, Pau, Guéret, Tulle and Limoges). The other projects will be rolled out in a few years but eventually, all the country’s emergency medical services’ IT systems will be overhauled.