Joint surveillance in primary care

In mainland France, epidemiological surveillance in primary care (general practice and paediatric) currently relies on two main data sources, the Sentinelles network (Inserm - Sorbonne University) and SOS Médecins. However, other data sources do exist, such as the EMR data warehouse (Electronic Medical Records) developed by IQVIA, or the P4DP data warehouse (Platform for Data in Primary Care) being developed by the Collège National des Généralistes Enseignants (CNGE).

In the wake of the Covid-19 pandemic, it became essential to step up surveillance in primary care in order to obtain reliable data from general practitioners and paediatricians at regional and even departmental level.

In order to meet these objectives, Santé publique France wanted to bring together the various existing networks or those under construction to set up joint monitoring of health indicators in primary care.

This objective is gradually being achieved thanks to a number of collaborations between the ‘Surveillance et Modélisation des maladies transmissibles’ (SUMO) team at the Institut Pierre Louis d'Epidémiologie et de Santé Publique (Iplesp), which includes the Sentinelles network, and:

• IQVIA: Over the last twenty years, the Sentinelles network has carried out several research projects in collaboration with IQVIA, as part of a scientific partnership (see ‘Partnership between the Sentinelles network and IQVIA’). Recent work has been carried out to jointly analyse the data transmitted by Sentinelles GPs and that of GPs in the EMR-IQVIA warehouse (derived from automatic extractions from their medical software). This now makes it possible to estimate a common incidence of cases seen in general practice consultations for different health indicators (acute respiratory infections, bronchiolitis, pneumopathies, acute diarrhea, shingles and chickenpox), thereby improving accuracy.

• CNGE: A scientific partnership has been set up to carry out joint work between the Sentinelles network and the P4DP data warehouse currently under construction. Initially, general practitioners working with the general practice departments of the University of Rouen Normandie (DUMG) and the University of Côte d'Azur (DERMG) will be involved in virological surveillance of respiratory infections. A second stage will involve analysing data from the P4DP warehouse in conjunction with data from the Sentinelles network and the EMR-IQVIA warehouse, when they become available.

• SOS Médecins: A partnership has been set up to carry out joint virological surveillance of acute respiratory infections with GPs from the Sentinelles network and the general practice departments of the Universities of Rouen Normandie and Côte d'Azur. For the 2024/2025 winter season, six SOS Médecins associations (Ajaccio, Dijon, Limoges, Nantes, Orléans and Saint-Quentin) are taking part in this surveillance. In a second phase, a review will be carried out to extend the collaboration.

The strengthening of these partnerships will also continue in the coming years as part of the SISP&EAU project, led by Iplesp and financed by the ‘Emerging infectious diseases priority research programme and equipment (PEPR MIE) of France 2030’, managed by the ANRS. The Sentinelles network (Iplesp), IQVIA (EMR warehouse) and the CNGE (P4DP warehouse) will all be involved in this project.