You want to improve your business processes, but you are wondering :
- What does a digital solution do for my administrative circuit?
- Does the organisation of my institution allow the implementation of the exolis solution?
- How do I divide the roles within my departments?
- …
On Tuesday 1 June 2021, we organised a dedicated webinar with the Pôle Santé Saint Jean to answer your questions.
Below you will find a replay of the presentation and a FAQ with the discussions.
Speakers:
Sydne Massiera
Deputy Director General
Saint Jean health centre
Grégory Cintas
Information System Director
Saint Jean health centre
Christophe Rosso
Co-founder
exolis
Gwenaëlle Fleury
Interoperability Manager
exolis
Frequently asked questions
Administrative circuit
PSSJ - It's all about interoperability. Today, at the level of information systems, all exchanges are centralised on our EAI. Our DPI tool, our GAP tools and our patient portal communicate with each other on the basis of bilateral exchanges. Thus, any information entered in one software is immediately distributed to all the other software. There is a real uniqueness of information that allows us to exchange all our patients' details with peace of mind.
exolis - In cancerology, we work a lot with patients who have recurrent chemotherapy sessions. In this case, we have a slightly different concept from pre-admission. We don't ask patients to fill in all their information each time. We have a global view of the administrative file and we simply ask patients to inform the establishment of a modification or new elements, such as a health insurance card, so that we have up-to-date information and do not have a tedious task each time when the visits are very close in time.
PSSJ - For our part, the setting up of the portal responded to a problem that we had had for a very long time. In the centre, we have different groups (MCO, SSR, etc.) which may use separate business software. Patient information therefore had to be shared between the sites. For example, a patient who is treated in the MCO department and then goes to the SSR department.
Today, the fact that the patient carries out his or her pre-admission on exolis allows us, through various interoperability mechanisms, to send the information and identity documents for a treatment to the business software of the different groups.
Pre-admission
PSSJ - This is a very good question because the completeness of the pre-admission by the patient is quite subjective.
The portal provides us with a completeness indicator. This is a percentage indicator that allows us to monitor in real time, for the patient and for us, the completeness of the file. However, there are many patients who will fill in 94-95% of the file and who will not reach 100% completion. But we will consider that the pre-admission is complete.
To deal with this, we decided on a procedure, made possible by the adaptability of our admissions organisation:
- We look to see if the patient has logged on. This is the first referral. If they haven't logged in, they're sent back to the conventional system. And if they have logged in, their digital pre-admission will be processed at the admissions office on D-2.
- From the moment the case is processed, depending on the progress, we will contact the patient digitally. We have the ability to interact with the patient directly through the portal. If the patient is 95% complete and a document or information is missing, we will contact them to ask if it is possible to complete it.
- If the document cannot be delivered in time, the appointment is kept and we ask the patient to bring it back on the day or we try to get it back on our own if we have the capacity.
So it is quite difficult to say whether the admission is complete. However, we see the portal as an additional service that we offer and we adapt according to the use that the patient makes of it.
exolis - The answer to this question depends on the circuit of each establishment. This is also the added value of exolis: it adapts to your organisation. Each institution has its own administrative circuit, which varies greatly depending on its processes and circuits.
exolis - What is important is to assign the right role to each software. The patient portal is the showcase and the ability to communicate with the patient. The administrative management software does all the work behind it, all the functions for managing the stay, the billing, etc.
The trick is to define the right boundary. We allow you to decide according to the context, and even the type of field. E.g.: is it information that can be modified by the patient (i.e. directly in the GAP software), is it information that is integrated after validation (with a validation gateway in our back office application tool) or is it information that cannot be modified, such as identity traits?
All this is set to music according to the organisational choice, the choice of data management present or not in the IS.
PSSJ - Globally, we recover all the information entered by the patient in our business tools:
- the strict features of the patient,
- all the information concerning his or her situation (civil status and contact details),
- all trusted persons, persons to be notified
- all the documents sent by the patient.
exolis - It doesn't just depend on exolis, but also on the actors and the involvement of the management. In a typical case, we would talk about 3 to 4 months. The strong involvement of the various business players enabled the Saint Jean Health Centre to make rapid choices, which allowed for rapid implementation of the pathway. And from there, we start and build and finally improve. The most important thing is to target a sufficiently coherent initial organisation, and then to readjust and modify it according to feedback from the field. This is what allows us to arrive at an efficient course.
PSSJ - Today, the patient always goes through the entrance office again. This is a point of improvement that we still have to work on. But there are reasons for this: amounts to be paid, excess fees... But we are currently thinking about the reception terminals proposed by exolis, which would allow the admission to be finalised.
However, even if the patient goes back to the admission office, the waiting time is drastically reduced.
exolis - Each institution defines its target organisation and adapts the solution accordingly. The patient can be directed to the admissions office or directly to the departments depending on the type of appointment, the rate of completion of the file or the place of appointment. In all cases, a visual check of the patient remains essential on the day.
With our solution, we avoid the need for patients to come to the clinic beforehand and save time on arrival. In time, we hope to bring in a complementary digital identity check.
Special queues can be created for connected patients, with simpler controls and why not with an interactive kiosk in the future.
Online payment
PSSJ - As far as the banking platform is concerned, this is not where the biggest difficulties lie. It is the work of exolis that was of high quality and that made it go well.
The only thing you need to do is to have the right contract with your bank and to have contracted the possibility of setting up an Internet payment platform. Behind that, the integration with exolis went smoothly.
Often, banks provide access to two platforms upstream, the production platform and the recipe platform, which allow you to carry out the battery of tests at the integration level. And then you can switch to the final platform.
exolis - However, you need to take the time to analyse the business processes, just as you did with pre-admission. It is likely that you will end up coordinating several players (editors) to automate the entire billing circuit.
Interoperability
exolis - When a patient document is added to the application, it is automatically transmitted to the information system via a standardised HL7 flow.
To go into more detail, at exolis we can adapt to what is received in the information system, whether it is HL7 ORU or HL7 MDM flows. This has to be discussed again at the time of the project, but in each case we base ourselves on standards to retransmit these documents.
The only thing you need to do is to have the right contract with your bank and to have contracted the possibility of setting up an Internet payment platform. Behind that, the integration with exolis went smoothly.
Often, banks provide access to two platforms upstream, the production platform and the recipe platform, which allow you to carry out the battery of tests at the integration level. And then you can switch to the final platform.
exolis - Today, we are interfaced with all the major classic software on the market. As far as interoperability is concerned, it is very fast. In two working sessions, we exchange the parameters that will enable us to send and receive files. We agree on the formats used and the information that will be included. If there are no specificities related to formats or information, then there is no problem to make a very fast integration.
exolis - At exolis, we want our tools to be part of the national ecosystem. This is essential and will become more and more so as time goes by, particularly with the National Health Space (ENS) which will arrive very soon.
We are in the process of integrating different authentication bricks, whether it be France Connect or itsme in Belgium. Different tools and different methods that will allow us to use digital identity as an entry point into our tools.
exolis - We know how to connect to the LDAPs of institutions to facilitate the connection of care staff.
Patient use
exolis - Based on the feedback from all the projects we have been able to carry out over the last 5 years, whether on the administrative or medical side, the average age is 55. But it will mainly depend on the average age of the establishment.
If the question is asked to find out about the membership of older people, it should be noted that up to about 75 years of age, we have no age bias in relation to membership. We have a more or less constant membership from 18 to 75 years old. In fact, after 75 years of age, membership decreases.
As people age, we see a greater use of the web platform compared to the mobile applications and an increase in the use by carers and relatives. This allows for a takeover and a relatively correct and interesting use.
PREMs and PROMs are standardised questionnaires that measure the patient's experience. This is a key point.
At exolis, we are gradually proposing standardised questionnaires that can be parameterised in the tool to be able to collect the patient's feelings. The completion rate is very good because once the patient is connected, it is easy for him to answer or to be reminded if necessary.
We are ready for the PREMs approach and we are convinced that they will allow for finer indicators of the patient's experience, as recorded by the patient.
