PROSPECTIVE PAYMENT SYSTEMS AND EVOLUTION OF MANAGEMENT CONTROL IN FRENCH HOSPITALS: AN OVERVIEW

This analysis aims at contributing to the debate by exploring recent changes in French public hospitals. It will try to show how a new financing system can entail deep changes inside the management architecture. The structuring of the management control function is still in gestation. In most hospitals surveyed, this function is still at its early stages. There is still a long way for management control in acquiring a real legitimacy, especially from professionals. A key to success lies in the ability of institutions to recruit (and retain) a staff up to the current stakes, both able to overcome technical difficulties of the hospital management (including the T2A) and place themselves in intermediation between medical and management logics

Une nouvelle grille d'analyse pour le contrôle de gestion hospitalier : le contrôle intégré de Simons

International audienceThis paper aims to analyze the evolution of hospital management control in the current context of reforms (prospective payment system and clinical directorates). This evolution raises questions about the relevance of concepts recently highlighted in the literature and about the adaptability of the conceptual framework of Simons in the hospital context. This case study research compares field practices to Simons' model and shows that this approach can be of great interest in the hospital context.Cette communication a pour but d'analyser l'évolution du contrôle de gestion hospitalier dans le contexte actuel des réformes de la tarification à l'activité et de la nouvelle gouvernance. Cette évolution conduit à s'interroger sur la pertinence des concepts récemment mis en exergue dans la littérature et sur l'adaptabilité du cadre conceptuel de Simons au contexte hospitalier. Fondée sur une étude de cas, cette recherche confronte les pratiques de terrain au modèle de Simons et montre que cette approche peut présenter un grand intérêt dans le contexte des établissements de santé

L'externalisation dans le système de santé français : éléments d'explication d'un tabou

International audienceUsing an exploratory study, we try to understand why the outsourcing is little used among french hostpitals. We show that if the actors have nothing against the ousourcing process, it can be linked to the concept of sacrality. It can break their conception of the sacrality causing some difficult situations for the health professionals.A l'aide d'une étude exploratoire, nous cherchons à comprendre pourquoi l'externalisation hospitalière est peu utilisée. Nous montrons que les acteurs ne sont en majorité pas hostiles au principe d'externalisation. Toutefois, celui-ci peut causer une rupture dans la conception que les professionnels de santé se font de la sacralité entrainant des situations parfois difficiles pour les acteurs dans les organisations

Digital service innovation enabled by the blockchain use in healthcare: the case of the allergic patients ledger

International audienceBy combining the institutional approach and the rational model of digital innovation, there is increasingly a great interest in the implementation of blockchain solutions in healthcare but, until then concrete evidence for this type of project is missing. At the same time the healthcare sector, allergology in particular seems to face security (confidentiality, availability and integrity) issues and information audit trail weaknesses. For these reasons, our study focuses on the co-construction of a distributed ledger for patients allergies with healthcare professionals. The aim is to design and implement a reliable tool to deal with the availability , integrity and confidentiality of information about new allergies and distinguish between validated allergies and declarative allergies for the purpose of mitigating negative effects of unavailability of reliable information about patients allergies. This article defers the first step of our methodological cycle by explaining how collaboration is organized between Pikcio (blockchain technology provider) and allergists. As a result, we have first versions of some deliverables such as formal specifications, risk matrix document and a UML design (class diagram, use case diagram and sequence diagram) as the research project is iterative