ABSTRACT
Résumé Les Centres hospitaliers universitaires (CHU) ont une triple mission de soins, d'enseignement et de recherche. Cette dernière a une place prépondérante car elle permet d'offrir aux malades des soins de pointe adaptés à toutes les pathologies, et elle est la garantie d'une formation de haut niveau pour les futurs médecins et personnels soignants. L'évolution des bases scientifiques, technologiques, sociales, culturelles de la médecine justifient une refondation de la médecine universitaire dont la crise de la Covid-19 a révélé le besoin. Force est de constater que l'évolution des CHU s'est progressivement éloignée des principes fondateurs qui avaient montré leur efficacité en offrant aux malades une médecine de haut niveau. Face à ce constat, un colloque a réuni plus de cent personnalités du monde scientifique, économique et politique, des représentants des ministères, des parlementaires, avec pour objectifs de : faire un état des lieux de la recherche et de l'innovation en santé ;produire des recommandations sur la nécessaire refondation des CHU et leur place dans une organisation simplifiée de la recherche en biologie-santé ;et identifier les points qui devront faire l'objet d'une réflexion approfondie. Summary The University-hospitals have a triple mission of care, teaching and research. The latter has a preponderant place because it makes it possible to offer patients advanced care adapted to all diseases, and it is the guarantee of high-level training for future physicians and nursing staff. The evolution of the scientific, technological, social and cultural bases of medicine justify an overhaul of university medicine for which the Covid-19 crisis has revealed the need. Indeed, the evolution of the university-hospitals has gradually moved away from the founding principles that had shown their effectiveness by offering patients high-level care. Faced with this observation, a symposium brought together more than a hundred of decision makers from the scientific, economic and political world, representatives of ministries and members of the Parliament. The objectives of the symposium included making a state of research and innovation in health;producing recommendations on the necessary overhaul of university hospitals and their place in a simplified organization of research in biology and health;and identifying the points that will need in-depth analyses.
ABSTRACT
The COVID-19 pandemic occurred in the context of a dramatic decline in support for biological and health research in France. An analysis of resources allocated to this sector shows that the credits in 2020 correspond to only 17.2 % of the total credits allocated to research, the lowest ratio inat least 15 years. Another weakness in the system of support for hospital research is the way funds from the health insurance system are allocated. To bring it into line with international best practices, the task of allocating these funds should be entrusted to a "Hospital Research Orientation Council", which should also be involved in the implementation of national research programming. Another article deals with the organization of research. Recommendations are also made to improve the functioning of the research system at the local level, particularly in university hospitals, and at the national level.
ABSTRACT
Technological progress, including virtual clinics, web or smartphone-based applications, and assessment of fecal calprotectin (FC) at home has favored the implementation of treat to target strategies for patients with inflammatory bowel diseases (IBD). Although these innovations are promising and have been associated with a significant reduction in health costs, their application in clinical practice is limited. Here, we summarize the most recent literature on virtual clinics and available FC home tests. In addition, we report the experience of IBD patients monitored through the IBDoc® test at the Nancy University Hospital, focusing on usability testing and patient's satisfaction. This pilot experience shows that a virtual calprotectin clinic doubles adherence rate to FC in IBD patients. This finding is especially clinically relevant in the post-coronavirus disease 2019 (COVID-19) pandemic era, with an increasing use of e-health.