France's CNAM plans Rx database expansion

France's national federation of sickness insurance funds (CNAM) has announced the go-ahead for a computer-based system that already allows 3,000 doctors to access a 12-month history of treatment, drug prescribing and reimbursement of their patients. The personal medical dossier (DMP) system has so far been been tested in four areas of the country.

When first conceived, in 2004, the DMP was regarded as a highly useful measure of health service reform but has since been held up by a series of reviews by the government's inspectorates. The CNAM now argues that the DMP should no longer be delayed and has now obtained approval to extend pilot schemes across the whole country.

Some aspects of the system such as the pharmaceutical dossier are becoming well established, notably in pharmacies. However, the CNAM wants to extend the computerized history of patient reimbursement across the country. This will allow doctors to obtain a history of prescribing and can be accessed both by doctors and patients by different smart cards. It will enable a rapid overview of drug prescribing when a patient is new to a practice and should reduce problems caused by incompatible prescribing. Patients who seek multiple consultations and examinations, which tends to generate over-prescribing will be discouraged.