E-health: the Association of Midwives takes an active role

Points de vue | 15 Mar 2012
Points of view of  Marie-Josée Keller, President of the French Association of Midwives.

Simplification of administrative processes involves all professional association. The Association of Midwives, like other professional associations, has responded to the ethical and security challenges that this project has raised.

"E-health, in other words the set of projects that aim to modernize and centralize health information systems, is currently a key aspect of changes to our public health system, and has very ambitious aims. The DMP will be critical for care co-ordination and improving relationships between community health professionals and healthcare facilities. Telemedicine will also be a major advance in medical practice.

New health technologies are also an excellent way to provide access for patients to health education and to improve patient information, particularly about the quality of care that is provided.

However, the challenges of e-health go beyond these technical issues. In addition to questions regarding funding for our healthcare system in its current economic model, e-health raises issues concerning the roles and responsibilities of those involved in health, as well as ethical questions. These are challenges that need to be faced if we are to allay the fears that healthcare professionals and users have in respect to e-health.

The French Association of Midwives, along with the other national associations of health professions, has been providing input to these considerations of e-health for some time. Modernization and centralization of health information systems would appear to be essential if we are to improve the effectiveness and sustainability of our healthcare system, but these aims are pointless if they do not have a positive impact on the quality of patient management and reduce freedom of choice.

There is a definite expectation that e-health will adhere to the principles of security, confidentiality and traceability of data. We must exercise constant vigilance, to ensure that these expectations are met when modernizing information systems in the healthcare system in the current economic climate. The growing number of people involved in the patient management process, and the need to centralize and share health information, make the problem even more complex. This is why it is necessary to ensure a secure access procedure to health information, using a highly structured authentication and accreditation policy.

CPS cards are computerized professional identity documents, and these are rolled out via a national directory (the RPPS), and are an initial operational response to these challenges.

The RPPS, in addition to being a definitive directory, makes it easier and more reliable to share information between the various organizations that manage healthcare professionals. The association, which is responsible for entering midwives' data into the RPPS, is providing a tangible response to the challenges of modernizing health information systems.

Since 30 August 2010, the RPPS has provided a simplified administrative procedure for the midwifery profession, the aim of which is to simplify processes for registration and change of status, type of practice or location of practice. With significant investment from the Association of Midwives, administrative procedures for professionals have been made easier; our flagship institution has to ensure on behalf of other organizations that all data relating to midwives is collected.

E-health is therefore a response to the challenge of modernizing the healthcare system, and one that midwives, via their professional association, wish to support fully, for the benefit of the women and newborns in their care."


All midwives in France must belong to the Association of Midwives, regardless of how they practise. It is an organization governed by private law, and is responsible for guaranteeing the quality of care given to women and newborns. As such it upholds the principles of morality, probity, competence and dedication that are essential in the midwifery profession. It represents the profession in dealings with public authorities, and it also upholds the profession's independence.

The association contributes to a code of ethics, and regularly adapts this code in line with changes to society and to the healthcare system. It also ensures that all its members adhere to the professional duties and rules contained in this code. It plays a regulatory role, particularly in the registration of midwives and in examining midwives' contracts, and has a jurisdictional function via its disciplinary bodies.

The association is therefore an authoritative organization for its practitioner members, public authorities and its users, to whom it provides guarantees about the competence of its professionals, via its various duties.

Extract from the ASIP Santé's Annual Report 2011.