1. Docteur ORTOLAN Congrès Equip- Novembre 2004 FRENCH EXPERIMENTATION OF MEDICAL PRACTICE ASSESSMENT (EPP) 2004, June 15th

2. Docteur ORTOLAN Congrès Equip- Novembre 2004 Context (1) Definition voluntary action, no sanction auto evaluation medical references ( linked to the Evidence Base Medicine ): medical files and clinical practice accompanied by practitioners entitled by ANAES

3. Docteur ORTOLAN Congrès Equip- Novembre 2004 Context (2) Union of liberal physicians (URML) of Ile de France in charge of the experimentation of the medical practice assessment (EPP) URML Ile de France has to evaluate this process : immediately and 6 months later A satisfaction questionnaire

4. Docteur ORTOLAN Congrès Equip- Novembre 2004 Context (3) Health quality research Since August, a law about the Social Security Reform has established the obligation of assessment for every French practitioner.

5. Docteur ORTOLAN Congrès Equip- Novembre 2004 Objectives In France, assessment is no traditionally considered as a way for the health quality improvement Could opinions change when assessment is achieved ? Does this kind of assessment have a real impact on the professional practice ?

6. Docteur ORTOLAN Congrès Equip- Novembre 2004 Method A satisfaction questionnaire has been send to forty doctors who have finished the medical practice assessment since more than 6 months. Questions about the valorisation, the representation of this particular assessment method, about consequences and benefits in their daily exercise especially in their medical files Analyse by URML Ile de France

7. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (1) 32 questionnaires were answered the answer rate reaches 80 per cent. half assessment had been carried out individually and the other half in groups 75% of respondents which realized their assessment in a group still keep contacts with members of the group

8. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (2) : Epp’s impact on the medical practice The most important change :medical files actualization more frequent 80% of respondents have changed their medical files’ content, 60% changed the presentation Benefits : patient’s follow up, medical files’ administration, improvement of disease detection

9. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (3) : Epp’s impact on the medical practice 80% of respondents feel like a change of their practice due to this assessment (improvement of their practice, a very good patients follow up) 84 % of respondents consider EPP as formative

10. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (4) : Evaluation of this assessment method 75 % have advised this assessment method Assessed practitioners do not increase the value of their successful assessment (patient, colleagues) wish to be allowed to stick up a certificate in their waiting room. 75% of respondents declare they had read all medical references available for the EPP

11. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (5) : Medical formation and other kind of evaluation 70% of respondents have take part in a medical formation since the end of their EPP Only 35% of assessed physicians have take part in another kind of medical assessment

12. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (6) : EPP by assessed practitioners - Representation Most of the respondents agree the idea of EPP as a way to start actions for health quality improvement. According to assessed practitioners, analyze the medical practice permits to obtain useful information for health quality

13. Docteur ORTOLAN Congrès Equip- Novembre 2004 Main results (7) :Prospect 75 % of respondents would like to continue this approach : new assessment, meetings with the group members

14. Docteur ORTOLAN Congrès Equip- Novembre 2004 The conclusions drawn Among physicians evaluated, a lot of them agree auto evaluation is formative. This result will be used for generalize this kind of medical formation. This kind of process could also be used as an efficient medical formation approach to ameliorate immediately physicians’ practices

15. Docteur ORTOLAN Congrès Equip- Novembre 2004 Conclusion Since the Law of Social Security Reform of august, more than 900 physicians registered at URML for EPP. So, in 2005, a larger evaluation of the process could be lead.