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L'insuffisance renale terminale (IRT) est l'un des domaines de la medecine ou les entrepots de donnees ont un role important a jouer. En effet, la prevalence de l'IRT en France n'est pas connue de facon precise. En consequence, l'offre de soins est inadaptee a la demande. Afin d'ameliorer la connaissance medicale, epidemiologique et organisationnelle de l'IRT, un systeme d'information multisource a ete mis en place a des fins de meilleure apprehension de la situation, a la fois particuliere (suivi du patient) et globale (aux niveaux regional et national), avec une finalite d'aide a la decision sanitaire. Ce systeme est centre patient, fonde sur une organisation regionale, avec un identifiant unique. Il s'appuie sur une architecture de type n-tier et integre un entrepot de donnees. Ce travail est realise dans le cadre du REIN (reseau epidemiologie et information en nephrologie).

In France, the prevalence of End-Stage Renal Disease (ESRD) is not precisely known. The sources of information are scattered and not coordinated. Consequently, care is ill adapted to meet the demand. The Multi-Source Information System is the basis of the Renal Epidemiology and Information Network (REIN). It is dedicated to improve and organise our medical and epidemiological knowledge of ESRD and to aid public health decision-making in this area. The proposed approach is based on the datawarehouses. This model allows a unified vision of scattered data into distinct databases, for a better management, be it particular (patient follow-up) or global (regional follow-up), with a finality of aid in decision-making. Several categories of problems were considered: the global conception of the information system, the organisation of the datawarehouse, which offers different viewpoints of the data, the integration of heterogeneous data coming from different sources, data exchange and definition of a specific ontology.

A Multi-Source Information System (MSIS), has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease (ESRD). MSIS aims at providing reliable follow-up data for ESRD patients. It is based on an n-tier architecture, made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. MSIS is operational since 2002 and progressively deployed in 9 regions in France. It includes 11,500 patients. MSIS facilitates documenting medical events which occur during the course of ESRD patient' health care and provides means to control the quality of each patient's record and reconstruct the patient trajectory of care. Consolidated data are made available to a data warehouse and to a geographic information system for analysis and data representation in support of public-health decision making.

Most countries face today a growing burden of chronical diseases. In France the multi-source information system MSIS/spl I.bar/REIN has been built to collect and analyse epidemiological data about end-stage renal diseases, dialysis and kidney transplant. It enables a better knowledge of the demand and of the needs for care. This system is patient-centred and based on a regional organization. With the support of the European Commission, the actors of the French experiment are setting up a similar system in Shanghai, albeit fully adapted to Chinese medical needs and administrative context. The design and the implementation of the system, named Gennere, have put emphasis on its genericity in order to enable the system to be easily adapted to other chronic diseases and/or other countries. The first experiment deals with two fields: nephrology and rheumatology.

GENNERE is a networked information system designed to answer epidemiological needs. Based on a French experiment in the field of End-Stage Renal Diseases (ESRD), it has been thought of so as to be adapted to Chinese medical needs and administrative rules. It has been implemented for nephrology and rheumatology at the Rui Jin hospital in Shanghai, but its design and implementation have been guided by genericity in order to make easier its adaptation and extension to other diseases and other countries. The genericity aspects have been considered at the levels of events design, database design and production, and software design. This first experiment in China leads to some conclusions about the adaptability of the system to several diseases and the multilinguality of the interface and in medical terminologies.

A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease. Interoperability has been considered at 4 levels: semantics, network, formats and contents. An n-tier architecture has been chosen at the network level. It is made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. The MSIS is patient-oriented, based on a regional organization. Its implementation in the context of a regional experimentation is presented with insights on the design and underlying technologies. The n-tier architecture is a robust model and flexible enough to aggregate multiple information sources and integrate modular developments. The data warehouse is dedicated to support health care decision-making.

In France, the prevalence of End-Stage Renal Disease (ESRD) is not precisely known. The sources of information are scattered and not coordinated. Consequently, care is ill adapted to meet the demand. The Multi-Source Information System is the basis of the Renal Epidemiology and Information Network (REIN). It is dedicated to improve and organise our medical and epidemiological knowledge of ESRD and to aid public health decision-making in this area. The proposed approach is based on the datawarehouses. This model allows a unified vision of scattered data into distinct databases, for a better management, be it particular (patient follow-up) or global (regional follow-up), with a finality of aid in decision-making. Several categories of problems were considered: the global conception of the information system, the organisation of the datawarehouse, which offers different viewpoints of the data, the integration of heterogeneous data coming from different sources, data exchange and definition of a specific ontology.