The French Communicable Diseases Computer Network

Improving the quality, adequacy, and rapidity of response of public health systems depends mainly on the ability to refine the processes implemented to collect, analyze, and distributc needed information and reinforce interpersonal communication between different partners. Indeed, better and faster control of a field situation is linked first to more rapid and exhaustive gathering of basic information so that evolution can be more precisely assessed. Second, it must be associated with a more cficient analysis that rapidly yields effective synthetic information for decision making. Finally, control of public health problems will be possible only if this information is made available in a timely fashion to all the people involved. Similarly, it is also linked to an enhancement of communication between all partners, enabling improved sharing of knowledge and ideas, particularly by facilitating consultation with cxpert advisers. Thus, in 1984, following our proposal,' the National Department of Health, Paris [Direction GCnCrale de la SantC (DGS)] and the National Institute of Hcalth and Medical Research, Paris [Institut National de la SantC et de la Recherche Medicale (INSERM)] decided jointly to improve the surveillance of communicable diseases by setting up a powerful, computerized, national Information System (IS). This system was viewed as necessary to provide the different partncrs involved in public health dccision making with needed information. This objective could be achieved by gathering data from various sources participating in cpidcmiological surveillance and by distributing, as data analysis results, synthetic information to all partners. Simultaneously, the IS would provide the different partners with appropriate communication means. Six years have passed since the first presentation2 of the challenge undertaken by the French Communicable Diseases Computer Network (FCDN) [RCseau National TClCinformatique de Surveillance et d'hformation sur les Maladies Transmissiblcs (RNTMT)]. During these years, the concepts on which the project was based and which concerned data gathering, data management and analysis, information distribution and communication, have been tested. These concepts have evolved from the realm of theory to concrete applications and have been proved feasible; they have led to significant results which are described in detail in this paper. However, because of