3 innovative initiatives that demonstrate the benefits of multidisciplinary patient care

The acceleration of outpatient care in France

Initiated by the government in the context of the 2016¹Loi de modernisation de notre système de santé – Ministère du Travail, de la Santé, des Solidarités et des Familles. (2023, February 16). Ministère Du Travail, De La Santé, Des Solidarités Et Des Familles. https://sante.gouv.fr/archives/loi-de-modernisation-de-notre-systeme-de-sante-503/,  “Modernization of our healthcare system law,” the outpatient shift refers to the transfer of intrahospital activities to day hospitals and community-based care. This care model is both more efficient for the health system and smoother for the patient.

At the same time, the management of more complex conditions has undergone a revolution in recent years, with patient pathways increasingly shifting toward home or community-based care. The development of less invasive technologies for patients—such as subcutaneous administration or oral chemotherapies in immuno-oncology—has enabled the relocation of treatments that were previously administered in hospitals.

Finally, the multidisciplinary care approaches inherent to the outpatient shift show a positive impact, especially in chronic diseases, whose prevalence continues to rise. In the case of heart failure, for example, a multidisciplinary approach leads to a reduction in overall mortality (17%), all-cause hospitalizations (30%), and hospitalizations due to heart failure (43%)²De Labarre, R. M. (2020, January 27). Le parcours de soins du patient insuffisant cardiaque chronique entre deux hospitalisations pour décompensation aiguë: identification des difficultés de la prise en charge ambulatoire. https://dumas.ccsd.cnrs.fr/dumas-02531377.

There is thus a dual objective: to relocate care while expanding patient management. This requires coordination efforts among the different stakeholders involved. In this context, several initiatives have gradually emerged, offering real opportunities for patients in particularly high-risk situations (chronic diseases, geographical isolation, elderly populations, patients with multiple conditions, etc.).

Here, we highlight 3 initiatives that shed light on the benefits of a more comprehensive and coordinated approach to care.

Initiative n°1: Multi-professional health centers to broaden patient management and improve access to care

Introduced in 2007 to address disparities in healthcare provision across the country, multi-professional health centers (MSP) concentrate primary care activities within a single facility, helping to reduce care pathway disruptions for patients. Beyond ensuring access to care in medically underserved areas, MSPs enable more comprehensive disease management (psychology, rehabilitation, nursing care, and technical procedures) by bringing together several disciplines within the same structure.

Today, there are 2,501 multi-professional health centers across the country³Les maisons de santé – Ministère du Travail, de la Santé, des Solidarités et des Familles. (2024, August 9). Ministère Du Travail, De La Santé, Des Solidarités Et Des Familles. https://sante.gouv.fr/systeme-de-sante/structures-de-soins/article/les-maisons-de-sante-300889, a figure that has grown significantly (+1,300 between 2008 and 2020⁴Les maisons de santé – Ministère du Travail, de la Santé, des Solidarités et des Familles. (2024, August 9). Ministère Du Travail, De La Santé, Des Solidarités Et Des Familles. https://sante.gouv.fr/systeme-de-sante/structures-de-soins/article/les-maisons-de-sante-300889). This momentum represents a real opportunity to develop multidisciplinary care, as confirmed by the MSP 2027⁵Plan d’action 4 000 maisons de santé pluriprofessionnelles (2023), Ministère de la santé et de la prévention, https://sante.gouv.fr/IMG/pdf/dp_msp.pdf plan, which aims to reach 4,000 centers.

Initiative n°2: Multidisciplinary day hospital pathways for holistic care in hospital settings

To support the development of day hospitals (HDJ), the General Directorate for Healthcare Provision introduced in 2020 a new funding⁶INSTRUCTION N° DGOS/R1/DSS/1A/2020/52 du 10 septembre 2020 relative à la gradation des prises en charge ambulatoires | Fédération Hospitalière de France. (n.d.). https://www.fhf.fr/expertises/finances/finances-budget-eprd/instruction-ndeg-dgos/r1/dss/1a/2020/52-du-10-septembre-2020-relative-la-gradation-des-prises-en  framework allowing for the grouping of at least three interventions during a same-day hospitalization, within a multidisciplinary outpatient care pathway.

With holistic management addressing the multiple dimensions of disease (psychological, dietary, nutritional, etc.), this new organizational model emphasizes therapeutic education and patient adherence to treatment, with fully recognized coordination and interventions such as clinical pharmacy through medication reconciliation and reviews.

Comprehensive patient follow-up during a single day hospital admission has positive effects on treatment adherence, as well as on reducing adverse events and avoidable hospitalizations.⁷Zerbit J, Kroemer M, Fuchs B, et al. Pharmaceutical cancer care for haematology patients on oral anticancer drugs: Findings from an economic, clinical and organisational analysis. Eur J Cancer Care (Engl). 2022;31(6):e13753. doi:10.1111/ecc.13753

Learn how our team can support you in your care pathway projects >

Initiative n°3: Territorial professional health communities to structure local healthcare provision

Another key focus of the MaSanté2022 plan, the development of territorial professional health communities (CPTS), aims to address medical challenges at the local⁸Les communautés professionnelles territoriales de santé (CPTS), IRDES, 2024, https://www.irdes.fr/documentation/syntheses/les-communautes-professionnelles-territoriales-de-sante.pdf level, unlike health centers, which respond to needs identified within a specific patient base.

CPTS bring together all healthcare actors in a given area (healthcare, medical-social, social, community), whether working privately or not, in the community or in hospitals. Unlike primary care structures, CPTS do not provide care directly but rather address the issue of coordinating healthcare stakeholders and services locally. They fulfill six major missions, including the organization of multi-professional pathways around patients to prevent disruptions in care (e.g., hospital discharge, long-term illnesses, chronic conditions, etc.).

However, their structuring faces territorial challenges (medical deserts, uneven local networks), as described in the “Tour de France”⁹Rapport Tour de France des CPTS (2023), Marie-Hélène CERTAIN – Albert LAUTMAN – Hugo GILARDI, https://sante.gouv.fr/IMG/pdf/rapport_mission_tour_de_france_des_cpts_28062023_vf.2_2.pdf report on the status of CPTS dynamics in 2024. Initially planned to cover 100% of the population by the end of 2023, they currently cover only 55% of the territory, with 444 structures recorded (excluding unformalized projects) out of the 1,000 originally planned. Reported obstacles include a lack of human and financial resources (especially in “white zones”), and still-limited dialogue between community and hospital actors, hampering coordination.

Driven by the outpatient shift in the French healthcare system, multidisciplinary care pathways reflect a more holistic definition of care (e.g., disease follow-up, psychological well-being, therapeutic education). Their scope is no longer compartmentalized between community, hospital, or medical-social care, all now integrated into a unified medical logic. However, as shown by MSPs, HDJs, and CPTSs, involving a wide range of stakeholders brings numerous organizational challenges for the health system.

At Alcimed, we believe that effective collaboration among healthcare professionals will make it possible to meet these challenges, and we can support you in identifying the opportunities offered by these multidisciplinary approaches. Don’t hesitate to contact our team!

About the author
Pierre-Louis, Consultant in the Healthcare team at Alcimed in France.