The challenge of adopting a collaborative information system for independent healthcare workers in France: a comprehensive study.

This study aimed to explore the perception of an underutilised collaborative information system through qualitative research, utilizing semi-structured, in-depth interviews with independent midwives and physician. PROSPERO, is a collaborative information system designed to bridge the communication gap between community-based healthcare workers and hospital-based care teams for parturients in Lyon, France. Through 27 semi-structured in-depth interviews with midwives, obstetricians, and general practitioners, we identified key themes related to the system's adoption: implementation challenges, utilisation barriers, interprofessional dynamics, and hidden variables affecting system use. Participants recognised the potential of PROSPERO to improve information sharing and care coordination but expressed concerns about the system's integration into existing workflows, time constraints, and the need for adequate training and technical support. Interprofessional dynamics revealed differing perspectives between hospital and independent practitioners, emphasising the importance of trust-building and professional recognition. Hidden variables, such as hierarchical influences and confidentiality concerns, further complicated the system's adoption. Despite the consensus on the benefits of a collaborative information system, its implementation was hindered by mistrust between healthcare workers (i.e. between independent practitioners and hospital staff). Our findings suggest that fostering trust and addressing the identified barriers are crucial steps towards successful system implementation. The study contributes to understanding the complex interplay of factors influencing the adoption of collaborative healthcare technologies and highlights the need for strategies that support effective interprofessional collaboration and communication.ClinicalTrials ID NCT02593292.

Abord de l'orientation sexuelle des patientes : représentations et pratiques des médecins généralistes.

INTRODUCTION: While more and more women say they are non-heterosexual, they feel that they benefit from poorer follow-up, both quantitative and qualitative, in general medicine than heterosexual women. Few studies focus on the experience of general practitioners with this audience. PURPOSE OF RESEARCH: To identify the medical practionners' representations and pratices in approaching the sexual orientation with female patients. METHOD: This is a qualitative study with data from 10 interviews with general practitioners selected as part of a theoretical sampling. Grounded theory-based analysis was used. RESULTS: General practioners deduced sexual orientation from one of its 3 components: attraction, practices and sexual identity. General practitioners described heteronormative behaviors but some operated a progressive distancing from it. In practice, this resulted in an inclusive approach of non-heterosexual people with an absence of presumption of heterosexuality. Whether or not to discuss sexual orientation depended on general practioners' perceptions of the usefulness and intrusiveness of this data. Social representations and stereotypes of the sexuality of non-heterosexual female patients could lead to discrimination in access to care. CONCLUSION: Identifying one's social representations and questioning one's heteronormativity allows for more inclusive care of non-heterosexual female patients. Supporting students and professionals in this process is one of the keys to better support for minority people.

Consultation de gynécologie à destination des personnes lesbiennes ou trans : retour d'expérience.

INTRODUCTION: Access to gynaecological care for lesbians and trans people is a public health issue. A free consultation has been experimented for this population in a community approach. METHODS: Feedback from the midwife responsible for this consultation through analysis of data from medical records and administrative reports. RESULTS: 100 consultations were conducted over the 30 months of the experiment. These consultations were for the benefit of lesbian cisgenre women in 76 cases and trans men in 17 cases. These consultations offered a time for attentive listening, anamnesis, clinical examination, screening tests, preventive treatment and orientation. Their duration varied from 50 minutes to 1.5 hours. The reasons for consulting are often multiple and thirty-eight percent of the people received said they had been victims of violence. CONCLUSIONS: Adjusting the consultation process could facilitate access to gynaecological care for lesbians and trans men. An institutional period of training, reflection and networking with the professionals and communities concerned seems essential to the success of this type of care.