Objectives : In the actual context of rapide changes in the health care environment, the need for efficient communications of medical data between the care providers became critical. Therefore, hospitals, general and specialised practitionners started dicussions throughout Belgium. These initiatives led to the constitution of non profit medical telematics associations (ASBL/VZW) which goals remain similar : the elaboration of medical networks after analysis of the needs and the implementation of exchange procedures. These associations will keep these medical networks under the responsibility and management of physicians who must assess the identification, authentication and certification of the potential users and guarantee the respect of the patients rights and privacy. The same discussions have started in Brussels. The goal is the implementation of a Brussels Medical Telematics Association. The name “ABruMeT” has been choosen to respect the utilisation of 3 languages : French (Association Bruxelloise Médicale de Télématique), Dutch (Associatie of Brusselse Medische Telematica), and English (Association of Brussels Medical Telematics).

Method : In 2003, delegates of general practitionners and hospitals started discussions. They defined what they want to do together and how, and summarised their willing in three issues. The first one is to get together, as far as possible, all the recognised associations of general pratitionners and all the hospitals situated in the Brussels area, and to avoid commercial or financial interests. Therefore, the ASBL/VZW formula was choosen. It implies the redaction of a juridical agreement, the implementation of a specific structure, and the respect of each members'sensibility. The second issue is the need for an active collaboration with the Telematics Commission of the Federal Ministry of Public Health. Finally, the third issue concerns the medodology which included three aspects detailled in the results: which informations do the health care providers need? Which are the technical needs and the available tools? How to work in accordance with the law defining the patients rights and privacy?

Results : The ASBL/VZW juridical agreement has been written, discussed and submitted to a lawyer. Some members participating to the working cessions of the Federal Telematics Commission, its projects and realisations have been immediatly integrated into the task list. The task list detailed the three aspects mentionned in the methodology. The needed informations have been described in the collaboration chart and include bilateral secured messages, protected access to a synthetised health care record for both partners, the bilateral alert concept and the access from outside to the inhospital patient record. Besides a minimal computer equipment and optimal securisation procedures for the data for both partners, we need secured channels and standardised codification and structure. Such standardisation is going on with the homologation of electronical health care records for general practitionners and the developpement of a common language : the KMEHR. Finally, the procedures must be implemented to permit the integration of the patients rights into a system with as final goal the quality and the continuity of care.