The type and amount of the current demand for unplanned healthcare is evolving. Tasks of emergency services moved towards chronic diseases complications, and towards the increasing amount of medico-social issues. For two years, a collaborative approach between community medicine and emergency medical communication center in the Yvelines (78) has been undertaken. The stakeholders are the Samu 78, the Versailles Hospital, the Yvelines Medical Board and the territorial coordination association. This approach aims at preventing inappropriate hospitalization, promoting home care, and redirecting patients to community medicine after a hospital stay, thanks to multidisciplinary coordination teamwork. The health crisis due to COVID-19 boosted and strengthened community medicine-emergency medical communication center cooperation with specific goals, with the help of dedicated digital tools (among other things). The leading workstreams were to handle the health crisis urgency through the set-up of secured health care provision over the Yvelines area, to manage the course of the precarious patients during the lockdown period and finally to support the lifting of the lockdown with a dedicated backup team, and the follow-up of COVID-19 patients and their close relatives. Solutions to the organizational issues and issues related to the acceptance of the new monitoring and coordination digital tools were found, thanks to a supportive institutional environment, and to the committed leaders interested in the innovative projects. This collaboration should be a model for the new access to healthcare system.
Cooperation between community medicine, emergency medical communication center and hospital, during the COVID-19 crisis, the Yvelines experience