HESCULAEP

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HESCULAEP
Health Emergency National/Regional Programmes
For an improved Coordination in Pre-Hospital
Setting
Michel Baer, Anna Ozguler SAMU des Hauts-de-Seine
GARCHES FRANCE michel.baer_at_samu.org samu.hesculaep
_at_rpc.ap-hop-paris.fr
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SAMU des Hauts-de-Seine

• SAMU 92 is a public medical emergency call center
  (EMS) for the province of Hauts de Seine
• It is a service of AP/HP, first European hospital
  group (50 hospitals, 750 wards, 85,000 employees)
• Set up in 1974, 200 employees, including 50
  physicians
• Hauts-de-Seine 176 Km2, 1.4 million
  inhabitants, 36 districts

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SAMU des Hauts-de-Seine

• Out of hospital multi-tier emergency care
  provider
• Tel 15 European tel 112
• More than dispatch public/private call center
• Resource chosen according to degree of severity
  of patient, depending on the analysis of
  the incident by on line physicians
• Resources
• Medical advice, Information
• GP's, Specialized Physicians
• First aid vehicles, BLS ambulances, RC
• ALS resources, physicians manned
• Management of available beds

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SAMU is more than dispatch

• Home care provider (remote alarm for elderly)
• Emergency Forensic mobile doctors
• Training school for emergency care
• Psych. mobile unit
• Worldwide medevacs
• Contracting with Assistance/Insurances companies
• Mass disasters bio-toxic threats

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R D projects

• Health Research projects
• EU projects
• FP 4, 5, 6 Hector, Just, Amon, Hesculaep
• DG Health EED (EU Richmond VA)
• Agence Intergouvernementale de la Francophonie
• samu.org (EMS network Africa, North Africa)
• National (Health technology) TELEPAT
• WHO OHEMS

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Integrating and Strengthening the European
Research Area (ERA- NET scheme) FP6

• Objectives step up the cooperation and the
  coordination of research activities carried out
  at national or regional level in the MS through
• The networking of Research Activities
• The mutual opening of N/R research programmes
• Programmes should be understood as entire
  research and innovation programmes having the
  following characteristics
• be strategically planned
• be carried out at national or regional level
• either be financed and managed directly by
  national or regional public bodies, or by
  structures closely related to or mandated by
  public authorities (e.g. agencies).
• Creation of a European Internal market for
  Research to
• Avoid fragmentation
• Encourage cooperation and coordination
• Facilitate integration

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Setting up a consortium in the ERA-NET scheme

• Strong background EMS network
• Research programmes on EMS ?
• Research programmes on cancer, pain,
• Fragmentation of research programmes policies
• No coordination
• 3 actors
• State (National programmes policies)
• Region (Budget provider)
• EMS (Job Research)
• Two constraints
• Subsidiarity (Maastricht article 129, 130
  Amsterdam 157)
• Partners are programme owners such as ministries
  and research councils, in some cases programme
  management organizations or coordination bodies

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HESCULAEP

• 4 years project, starting 1st December 2003 in
  the frame of FP6 / ERA-NET as a Coordination
  Action
• Accepted and highly rated by the European
  Commission, with a budget of 2.3 M
• Objectives
• Develop a coherent and structured coordination of
  national/regional research programmes.
• Improve the overall management of medical
  emergencies in current and acceding E.U. member
  states in the pre-hospital field.

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Common architecture of EMS
Regional authorities Health, regional Councils
National authorities Ministries (Health,
Interior,..)
??
Public Health Agencies Evaluation, Regulation,..
Citizen call Acess to EMS
E M S
Provide answers - Daily life - Crisis
environment
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15 Institutions

• ARH Ile de France (France)
• AETSA (Andalusia, Spain)
• EPES (Andalusia, Spain)
• Centre of Emergency Medicine (Uppsala, Sweeden)
• County Council Uppsala (Sweeden)
• Regione Liguria (Italy)
• 118 San Martino Hl (Genoa, Italy)

• LAS- NHS (UK)
• Ministry of Health of Slovenia (Ljubljana)
• EMS Praha (Czech Republic)
• WHO (Copenhague, Denmark)
• EMS LANDSPITALI (Reykjavik, Iceland)

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A 4 Years / 4 Steps Project

1. Exchange of information EMS design
   architecture Collection of research programmes
2. Identification and analysis of EMS strategic
   activities Compare, Evaluate
3. Implementation of common EMS joint activities on
   a trans-national basis
4. Implementation of self-running coordinated
   trans-national long-term activities

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2
3
4
X X X X X
Dec 03
Dec 07
Mars 05
Avril 06
Mars 07
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EMS design architecture screening of
research programmes

• A comprehensive description of background and
  architecture of the 8 EMS.
• Screening and collecting research orientations in
  EMS field.
• Description of "background" legal, ethical,
  management, economy, evaluation of programmes
  administrative procedures.
• Conference on Strengthening and coordinating
  Emergency Medical Services toward a common
  policy ? (March 2005). PARIS

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M15
X X X X X
Dec 03
Dec 07
Mars 05
Avril 06
Mars 07
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Methodology

• Laws, ethical issues
• Economic regulations
• Channels networks
• Structures environment
• Personnel
• Equipment, tools (TM telecom)
• Patient care
• ..

• Call Access to EMS
• Dispatch
• Resources
• Optimal final care

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Main Milestones
M1
M15
M42
M48
M30
X X X X X
Dec 03
Dec 07
Mars 05
Juin 06
Juin 07
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Next critical steps

• Enlargement of the consortium (March 2005)
• New activities in the project
• Cooperation with MESA ?
• Setting up of joint proposals and long-term
  activities (WP4 and WP5)
• European Advisory Board on EMS