Gestion décentralisée des documents médicaux des patients. Un système de recherche et d'accès aux données

Depuis plus de 20 ans, plusieurs pays ont essaye de mettre en place un dossier medical standardise centralise (au niveau regional ou national). La plupart de ces tentatives ont echoue, principalement pour deux raisons liees aux difficultes de mise en place d'un identifiant unique pour le patient et a l'absence de standardisation des dossiers medicaux. Dans cet article nous discutons l'interet d'une solution pragmatique reposant sur l'acces aux donnees deja collectees et stockees de facon decentralisee, grâce a la mise en place d'un systeme de recherche et d'acces aux donnees reparties du patient. L'originalite de cette procedure repose sur des avancees technologiques, notamment les techniques de grille et de tatouage. Les donnees deja standardisees pourraient beneficier d'une gestion centralisee. Ceci conduirait a mettre en place un systeme mixte (decentralise pour les donnees standardisees et centralise pour les donnees deja standardisees).

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