[interview] Marie-Noëlle Billebot – “The patient pathway is complex and can’t easily be modelled.”

10 April 2016

The XL-ENS project in the Aquitaine region is one of five projects selected under the national Digital Healthcare Regions (‘Territoire de Soins Numérique’ [TSN]) call for projects. From now until 2017, a coordination platform and a range of innovative tools will be used in the Landes area with one common aim in mind: to improve the treatment of people suffering from chronic diseases, with a focus on the home environment. Interview with Marie-Noëlle Billebot, Director of the TSN project, ARS Aquitaine.

How is the XL-ENS project creating a new healthcare pathway for residents of the Landes area?

Up until now, there have been lots of different branches of medicine for patients: older people, cardiology, oncology, diabetology etc. But the reality is that someone might be both diabetic and suffering from a heart condition at the same time. The patient pathway is complex and can’t easily be modelled. It depends on random elements and multiple diagnoses and is tied up with social and economic problems, and issues concerning isolation. This is what makes it so difficult to coordinate and to implement what is required. The ‘Santé Landes’ platform aims to combine medical and social actions, such that the person can continue to live at home, under the supervision of the treating doctor.

What solutions have been developed to create this new pathway?

The ‘Santé Landes’ platform comprises a multidisciplinary team and various tools, aiming to improve the long-term treatment of people suffering from chronic conditions, under the supervision of the treating doctor:

  • The regional support committee, made up of eight people from health and social backgrounds who will ensure that the various different parties involved in a patient’s care are coordinated. Whether it’s introducing home help, meal management, or organising medical appointments: under the supervision of the treating doctor, the committee gathers information about the patient’s details and needs, puts services in place, sends information to the other parties and professionals involved, and ensures treatment is followed up.
  • The ‘Santé Landes’ browser, which allows professionals to access their patients’ monitoring data on the move (on tablet, smartphone etc) and to access the regional support committee’s services.
  • The ‘Santé Landes’ app, designed to enable patients and their carers to follow their treatment, giving them access to the therapeutic education tools and information available on the web portal.
  • A ‘Santé Landes’ web portal available to patients and health professionals.

What is the role of a provider like Orange in this project?

We aren’t starting from scratch: it’s about building on what already exists. Coordination already takes place between homes and health hubs, in specific areas and within restricted regions; this new treatment coordination mechanism will mean further solutions to health and social issues can be found, beyond those that health professionals have traditionally been able to turn to. Our platform acts as a support to GPs in Landes, helping them to organise the coordination of treatment. The pro browser mobile app makes information available in real time and therefore saves professionals from having to go hunting for and transferring data. It offers them considerable savings in terms of time and efficiency.

What is the role of a provider like Orange in this project?

In July 2015, the consortium of companies formed of Capgemini and Orange was chosen to develop the platform of services. Orange provides the call centre for the ‘Santé Landes’ regional support hub and, in its capacity as approved hosting provider, is responsible for hosting, storing, networking and securing health data.

How is the project progressing?

The project’s operational phase began in December 2014, with the creation of the platform organisation in collaboration with the regional players, followed by the opening of the regional support hub in April 2015. Since last September, the platform has overseen the treatment of 300 patients, and this is growing steadily. We’re aiming to develop the tool so that it meets the needs of coordination.

What is the future for the ‘Santé Landes’ platform after 2017?

The platform implemented in Landes will remain in place and will continue to grow and develop in accordance with the provisions of the health bill. As for the coordination tool, it’s projected to become a resource used by the greater area to equip the regional support platforms. Because of the crossover between the TSN and PAERPA (Personnes âgées en risque de perte d’autonomie – Older people at risk of losing independence), we’re working to develop a tool which meets the greatest needs and which can be rolled out across the whole country.


Marie-Noëlle Billebot, Director of the TSN project, ARS Aquitaine



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