Report. E-Health Patient Relationship Management. Prof.: Dr. Andreas Meier. Students: Mendimi Gabriella & Eva Stamm

Dimension: px
Commencer à balayer dès la page:

Download "Report. E-Health Patient Relationship Management. Prof.: Dr. Andreas Meier. Students: Mendimi Gabriella & Eva Stamm"

Transcription

1 Report E-Health Patient Relationship Management Prof.: Dr. Andreas Meier Students: Mendimi Gabriella & Eva Stamm 1

2 Table of contents 1. Introduction The establishment of the internet The empowerment of the patient The increase in chronical diseases Health reforms The Ljubljana Charter on reforming Health Care Patient relationship management as consequence What s Patient Relationship Management Development of research and current status CRM versus PRM Les différences entre PRM et CRM Les acteurs du système de santé PRM Méthodologies : a patient oriented approach Integration des données des patients Analyse des données des patients Outcomes management PRM Strategy Analysing phase Planning phase The executing phase The controlling phase Conclusion and future prospects Bibliography

3 1. Introduction Recent negative trends like the over aging of the society, the increase of the ozone and the steady work pressure lead to a bigger need of medical therapies and towards an overcharge of doctors and hospitals. Concepts of restructuring the health system are overdue. Progresses in technology and information technologies offer the chance to make the relationship between the patient and its providers more efficient. New management approaches recommend focusing on this relationship. This claim comes along with the following changes of the health system. 1.1 The establishment of the internet With the diffusion process of the internet, health knowledge has become accessible around the clock for everyone. Not only doctors are able to inspect the recent results of medical research also laymen can read and partially understand science reports. Patients regularly use the simplified access to medical information. They are able to acquire precisely the knowledge about the action of the doctor, recent developments in the medicine and they take care about preventive treatments. The internet offers also a wide range of contacts such as platforms of other concerned persons and of online doctors. The patient can not only get recommendation and chose a preferential treatment, he will see different prices and offers of doctors, hospitals and pharmaceuticals. For the practicing physician and the pharmaceutical industry this can be a chance to find new clients in a supraregional trading area but in equal measure it conceals the risk of loosing patients to cheaper or more trustworthy providers. Finally the impact of the internet on the transparency in health can be a chance or a threat to everyone. The patient needs help to evaluate and judge the sources, physicians have to accept the internet as assistance instead of denounce it as competitor and industries can either profit of the broad acceptance of their new communication and distribution channel or they will be challenged by those who do it. 1.2 The empowerment of the patient In the last decades the classical role allocation between patient and doctor changed dramatically. Mayer notices that up to the 19th century the relationship was predominantly paternalistic: The doctor made the decision based on the edge in experience while the patient had to follow the instructions. In a humanistic democratic society, where every human takes on responsibility for his own actions this principle becomes anachronistic. 1 A growing number of practitioners as a matter of fact support their patients to look after their health situation. The erstwhile prescription market evolves into a buyers market with mature decision makers. The patient s movement toward self-government is called the patient empowerment. He calls for co-determination over therapy decisions and enforces his influence on the prescription behaviour of the doctor. The capacity of the doctor or the pharmacist as an opinion leader loses ground. For care providers it remains the task of gaining the trust of the autonomous patient and of transmitting trustful information, but most notably doctors have to get used to take up the inputs of their patients in terms of communication, medication and treatment. 1 Mayer, J. Arzt-Patient-Beziehung im Wandel. In: Jähn, Karl; Nagel, E. (Hrsg.): E-health. Springer Verlag, Heidelberg Berlin New York 2004,

4 1.3 The increase in chronical diseases With the pollution of the environment, bronchial asthma and other chronic illnesses have increased. The World Health Organisation remarks the same development for other careintense diseases like diabetes or overweight - called adipositas in special languages. The world wide balance identifies chronical diseases as by far the leading cause of mortality, representing 60% of deaths. 2 The treatment of all those diseases is sumptuous and patients often relapse when medical attendance is reduced. The health system can not carry an increasing number of expensive therapies. Self-help of the patient might be a chance to reduce costs. 1.4 Health reforms The involvement of the patient in health care is partially required by law. From the contribution to costs arises the incentive of an efficient use of medical offers. Thus nut only the pattern of expenditure of the patient will be changed. Limits of financial resources of the public health system result in a dissonance between offer and demand of health care goods. Hahn writes that the European Governments struggle since the Eighties to contain the rising costs of health care. 3 For this increase especially the pharmaceutical industry has been denounced. Hence the pressure on the explorative concern grows. The cost-intensive employment of modern technology for the development of new pharmaceuticals, the shortened term of patents as well as the competition toughened, forces the pharmaceutical industry to ensure its existence through successful marketing of existing products. But, to base the marketing solely on the health professionals is not anymore a guarantee for success, instead DTC direct to the consumer marketing is utilized. But in health care the attempt of market the products directly to the patient is often not facilitated by law. The requirementof prescriptions for certain medicals is only one barrier to direct to patient marketing. Regulations of health insurances intensify this pressure. By far not every medical treatment or substance is accepted by them. This is for understandable reasons: They try to adapt to the new structures as well. The growth of patients due to the inverted age pyramid and to hyper sensibility leads to increased expenses. The insurances react with harder regulations and with the attempt of reducing the costs per head. Patients with chronic illnesses are thus financially not an attractive segment. The risk of discriminating them could be limited by a risk adjustment between the insurances. But this solution requires a transparent classification and central data storage. 1.5 The Ljubljana Charter on reforming Health Care The charter written in 1996 had the purpose of setting principles for the European Member States of the WHO. It strongly suggests integrating the patient in health decisions. Health care reforms must address citizens needs, taking into account, through the democratic process, their expectations about health and health care. They should ensure that the citizen s voice and choice decisively influence the way in which health services are designed and operate. Citizens must also share responsibility for their own health. 4 2 World Health Organization: Chronic Diseases and Health Promotion URL: 3 Hahn, Olaf Kilian: Patient Relationship Management. Ein CRM-Ansatz für die pharmazeutische Industrie. Mannheim 2005, p.1. 4 World Health Organization, Regional Office for Europe: The Ljubljana Charter on Reforming Health Care, URL: 4

5 1.6 Patient relationship management as consequence The empowerment of the patient, the enhanced concurrence between the pharmaceutical enterprises, the influence of the internet as information and distribution channel but also as driver of new group structures, and the development of the governmental health economy point at the same direction: Systematic orientation on the patients need. Care provider such as doctors, therapeutist, pharmacies, labours and hospitals, assurances and health care users namely the patients have to rethink their attitudes. The challenge is to manage the new developed autonomy of the patient in a positive manner. Patient Relationship Management can be a way to diagnose and anticipate threats and to recognize and seize chances systematically. To give an overview and to develop a strategy of Patient Relationship Management is the goal of this paper. 2. What s Patient Relationship Management Obviously when we are talking about PRM we are thinking of it as a form of management. The linguistic origin of the word management comes from Latin manus, hand, via the Italian maneggiare, which is the training of horses in the manege. Subsequently its meaning was extended to skilful handling in general, like of arms and musical instruments. However the word became associated with the French menage, household, as an equivalent of husbandry in its sense of the art of running a household. The theatre of present-day management contains elements of both manege, and different managers and cultures may use different accents. 5 Definitions of different cultures have in common that they concentrate more on the tasks of management today. Thommen writes in his introduction to management that: Management can be divided in four main elements: planning, deciding, delegation and control. 6 Those control functions are necessary to enable the core functions of the value chain. The listing of those differs slightly from author to author. Basically R&D, Ressources, Production and Marketing are mentioned. In all departments but remarkably strong in marketing the customer moved into the centre of the efforts. Consequently Customer Relationship Management became a corporate philosophy of adjusting every plan to the consumer needs on one hand and an instrument of marketing on the other hand. 7 Both orientations have in common that they want to tie the customers. Relationship Marketing focuses on long-term business relationships. This means that besides the usual goal of customer acquisition, customer retention and customer recovery is targeted. 8 5 Hofstede, Gert: Cultural constraints in management theories. In: Lane, Henry: International management behavior, Blackwell publishing 2002, reading 1, p. 75.) 6 Thommen, Jean-Paul: Betriebswirtschaft und Management. Gabler 2006, p Compare: Eggert, Andreas; Fassot, Georg: Elektronisches Kundenbeziehungsmanagement. Schäffer-Pöschel, p4. 8 Bruhn, Manfred: Relationship Marketing. Management of Customer Relationships.2003.p.13. 5

6 Through the orientation on the customers needs result qualitative advantages, additionally sales and lower costs. 9 This finally leads to a higher ROI. It s not a surprise that the health system finally wanted to partake in this growth. But here the concept of Relationship Management had to be adapted to the complexity of the system between the patient as customer in a broad sense, the care providers, the government and the assurances. Dr. Stefanie Hornung defines PRM in her book patientology. PRM is what emerges from the problem of the linkage between the modern patient conscience on one hand and the economical orientated world of the pharmaceutical industry on the other hand. 10 Most definitions set their focus on this relation. Besides PRM is relies more strongly on the assignment of technology. A definition of the Swiss ICT on the occasion of the user forum e-health thus phrased: Under the designation Patient Relationship Management, all efforts of maintaining the relationship between health professionals and patients including information and communication technologies can be subsumed 11 Out of the above-mentioned definitions we deduce a working definition: Patient Relationship management is the Systematic and skilful planning, decisioning, delegation and control of tasks, which serves to maintain the relationship between patients, hospitals, surgeries, pharmacies, insurances, public health care system and the pharmaceutical industry with the goal of the best possible supply of the patient and the efficient use of resources at the same time supported by information and communication technology. 3. Development of research and current status As we saw Patient Relationship Management emerged from Customer Relationship Marketing. Bruhn sees various origins of relationship marketing. 1. The beginning he finds in the mid-seventies. When marketing activities have been discovered as an exchange process between the seller and the buyer. 2. In the early eighties the question of how the relationships change over time aroused. 3. At the same time research in the field of service marketing has been called explicitly Relationship marketing. Upon the new conceptualisation three approaches have been remarked in literature: A tactical approach, which classified RM as marketing tool, a strategic approach, where time bond became more relevant and a philosophical approach, regarding RM as dogma for all corporate operations. 4. Followed by the centre stage of research about the customer retention. 9 Compare: Eberl, Markus; Zinnbauer, Markus: Measuring Customer Relationship Management Performance: A Consumer-Centric Approach. In: Journal of Marketing Channels, Vol.12, No.3, pp Hornung, Stefanie: Patientologie. Börm Bruckmeier Swiss ICT. Information and communication association. Programm for the Forum URL:

7 5. Around 1990 attributes of networking and interaction became the subject of further research. 6. In the mid-nineties RM has been related to consumer goods under the keyword brand relationships. 7. Additionally diverse constructs of RM such as commitment, trust and service quality shifted into the science agendas. 8. Nowadays research deals with mainly with the third stage of RM: The recovery or termination of customer relationships. 12 Health care showed its interest in Relationship Management around the turn of the millennium. There were approaches from medical practitioners of describing the doctorpatient relationship before, which implied implicit a systematic management. An example was the research of Dr. Dawson in the field of the therapy of borderline syndromes. 13 An attempt of describing the new role of the patient made later on Smith. He focussed on the communication between patient and doctor and interrogated the patients about their attitudes. 14 The year 2001 was a golden year of PRM research. Now, for the first time the concept of CRM was applied on Life science and Health Management. 15 Meanwhile the broad intersection of internet and health has been researched copiously. Possibilities of E-Health and the consequences of web based information on the patient behaviour have been two studies which emerged from that. 16 Recent research concentrates on specific questions of PRM. Hahn for example examined the influence of additional services on the retention of diabetics. The management approach he used is based on CRM and adopted to the requirements of chronic ill patients. 17 Hombug and Dreist conceived the first study on the subject of the patients majority. 18 Wetterman had a deeper look at case studies of realizing PRM and she tried to find out where the application in hospitals shipwrecked. 19 Other thesis such as the one of Holgrate Catherine focus on the effect of PRM on Pharmaceutical industry Compare Bruhn p.7,8. 13 Compare Dawson, David: Relationship Management of the borderline Patient. Brunner/Mazel Compare James Monroe Smith: Producing Patient Centered Health Care: Patient Perspective about health and illness and the Physican/ Patient Relationship. Auburn house Compare: - Badenhoop, Rolf: Patient Relationship Management: CRM in der Life Sciences Industrie. Gabler Leppi, Udo: Auf dem Weg zum individuellen Gesundheitsmanagement. Trends aus einer Studie. In: Pharma-Marketing Journal(PMJ). 25 Jg, Nr2, S Cap Gemini, Ernst and Young: Patient Relationship Management: Die Rolle des Patienten in der Life Sciences Industrie. Studie URL: - Ryf, Balz: Studie Patient Relationship Management: Res und Herausforderungen für die Zukunft Artikel in Badenhoop Compare: - Jähn, Karl; Nagel, Eckhard: E-Health Murray, E.; Burns, J.; Tai See, S.; Nazareth, I.: Interactive Health Communication Applications for people with chronic disease. The cochrace database of systematic reviews. Issue 4, Compare: Hahn, Olaf Kilian: PRM Compare: Hombug Christian; Dietz Beatrix: Patientenmündigkeit. Universität Mannheim Compare: Wettermann, Rebecca: Driving CRM value in healthcare: Deploying intuitive CRM options can produce greater ROI and enhanced patient and caregiver experience. Article in Health management Technology, Vol 28, Issue 9, S Sept Compare: Holgrate Catherine: Die Zukunft des deutschengesundheitsmarktes. PRM als strategische Option für die pharmazeutische Industrie. 7

8 The national institute for health care management collects studies about recent research in health care: pharmaceutical management issues amongst others. 21 Those examples are just a small part of the recent research achieved in the field of PRM. But still there is necessity of research especially in relation with strategies and management topics. 4. CRM versus PRM Le patient Relationship management (PRM) s inspire du Customer Relationship management (CRM) et s applique au domaine de la santé. De ce fait il y a beaucoup de points communs entre le CRM et le PRM mais également des différences : 4.1. Les similitudes entre PRM et CRM Le PRM et le CRM ont des similitudes en ce qui concerne les méthodologies de travail : Par exemple la collecte des données sur le patient ou le client et leur interprétation, la différence ici est que les données médicales sont plus sensibles que les données client dans le domaine du Customer Relationship Management. Les relations one-to-one mais le concept de la personnalisation des relations clients existe déjà dans le domaine de la santé avant l introduction du PRM. 4.2 Les différences entre PRM et CRM Les principales différences entre le PRM et CRM concernent les objectifs à atteindre : Le CRM essaie de fidéliser le client afin de l amener à dépenser le maximum d argent sur des produits ou des services vendus par l entreprise. Le PRM a pour objectifs de donner au patient toutes les informations dont il a besoin pour mieux choisir ses soins de santé et aussi réduire les coûts de santé. Avec le PRM, hôpitaux se focalisent sur leurs patients tandis que le CRM vise le marché entier. Dans le CRM et le PRM, les bénéfices sont les mêmes : meilleure anticipation des besoins des clients (patients), amélioration des canaux de communications entre les patients et les médecins pour le PRM, donner une information crédible au client (patient). L idée héritée du CRM est que «Lorsqu un besoin nait chez le patient, le médecin est là pour le satisfaire» 21 URL: 8

9 5. Les acteurs du système de santé Dans le domaine du PRM, il y a 3 acteurs principaux qui représentent une triade: Le patient C est un individu qui a une altération dans son état de santé (maladies, blessures ). Pour remédier à cette altération, il va généralement voir un médecin qui lui prodigue des soins. Le patient attend du médecin qu il lui qu il lui fournisse des informations exactes et complètes sur son état de santé et un traitement adéquat. Aujourd hui, les patients ne tolèrent pas la moindre erreur médicale de la part des médecins car ils supposent qu un médecin doit maitriser leur dossier avant de poser un diagnostic. Les médecins sont souvent attaqués en justice par des patients pour erreur médicale. Le patient est en général assuré contre certaines maladies chez un assureur à qui il verse une prime d assurance. Généralement les dépenses de santé ne sont pas prises en charge totalement par les compagnies d assurance. Le patient doit alors payer un complément de sa poche. Le médecin Un médecin est une personne qui a un diplôme de docteur en médecine. Il est un professionnel de la santé qui exerce la médecine en se chargeant de guérir et soigner les maladies, pathologies, et blessures de ses patients. Le médecin est souvent pris en tenaille entre les intérêts du patient pour qui il doit tout mettre en œuvre en vue de la guérison et ceux des assurances maladies qui font pression sur lui afin qu il réduise les coûts de traitement au minimum. Les assureurs Les assureurs sont des assurances publiques (France) ou privées (Suisse), en fonction du système de santé des pays. Ce sont les payeurs de cette triade. Ce sont eux qui remboursent tout ou partie des dépenses engagées pour soigner un patient. Ils offrent une assurance-maladie à leur client contre le versement par le client d une prime. Ainsi, Lorsqu un client est malade, ses dépenses de santé sont en partie ou totalement couvertes par cette assurance. Les assureurs exercent une pression à la fois sur les médecins et sur les patients pour réduire les dépenses de santé. Par exemple en France, l Etat qui gère la sécurité sociale a demandé aux médecins de préférer la prescription de médicaments dits génériques qui sont beaucoup moins chers que les médicaments brevetés. Ceci afin de réduire le déficit de la sécurité sociale. En Suisse les prescriptions des médecins sont également suivies de près par les assureurs (contrôle d économicité) : Les procédures d économicité ont avant tout un rôle préventif. Les fournisseurs de prestations (médecins, ) dont les coûts sont élevés sont invités à revoir leurs structures de coûts. Dans les pays d Europe, il existe en généralement deux façons de financer le système de santé: Le financement par l impôt ou assurance publique: c est le cas de la France et de l Allemagne. Mais voila, le système de santé en France est déficitaire, alors une manière de réduire se déficit est de réduire les dépenses de santé. Le financement par l assurance-maladie obligatoire : C est le cas de la Suisse. Son modèle est basé sur une assurance obligatoire gouvernée par le marché et assumée par des caisses travaillant en concurrence. Un catalogue de prestations minimales est imposé à tous les assurés. Dans les deux cas, les assureurs publics ou privés mettent en œuvre des stratégies pour réduire les dépenses de santé de leurs adhérents. 9

10 Dans les deux cas, le Patient Relationship Management (PRM) peut contribuer à réduire ces dépenses de santé. La figure 1 illustre les relations entre ces différents acteurs des systèmes de santé. INSURER PATIENT PROVIDER money flow service flow Figure 1: The medical triad 6. PRM Methodologies: a patient oriented approach Avant d être une technologie, le PRM doit etre une stratégie. Quelles sont ses méthodologies? 6.1 Intégration des données des patients D après des statistiques, un patient sur dix n est pas correctement identifié par l hôpital. Quand on parle d identification du patient, on ne parle seulement de savoir son nom, son prénom et son adresse. L identification est surtout son historique médicale : ses visites, ses maladies précédentes, tous les médecins qui l ont auscultés, les médicaments qui lui ont été prescrits, les opérations chirurgicales subies, ses allergies Le dossier médical complet du patient permet au médecin d avoir une bonne information sur le patient afin de poser un diagnostic fiable et de fournir au patient le traitement et les informations adéquates. Problème : Le plus souvent, le médecin a une vue partielle du dossier médical du patient parce que les informations se trouvent dans des systèmes hétérogènes. Exemple : Un patient qui lors de ses visites successives dans un hôpital consulte un généraliste, un cardiologue, un rhumatologue, un ORL, un gastro-entérologue. Souvent chaque médecin consigne les informations du patient dans un système qui lui est propre et n a accès qu aux informations qui concernent sont domaine. Le cardiologue prescrit un traitement au patient qui contient un certain produit. Or dans la partie du 10

11 dossier du patient vue par le généraliste et qui est enregistré dans un autre système informatique, il est marqué que le patient est justement allergique à ce médicament. La prescription du cardiologue peut mettre en danger la vie du patient et aboutir à une erreur médicale. Or si le cardiologue avait su que le patient était allergique à ce produit, tout cela aurait été évité. Dans ce cas on parle de fragmentation du système de santé. En langage informatique défragmenter veut dire réorganiser la disposition de l information sur un support de stockage afin de réduire les temps d accès et donc d augmenter les performances. Pour rendre le système de santé plus performant, il faut donc une intégration des données du client. Cette intégration consiste à combiner les données du patient stockées dans différentes répertoires, systèmes et mêmes différentes organisations de santé afin de fournir à l utilisateur qui est le médecin une vue homogène et complète de ces données du patient. Le problème est que ces données proviennent de sources hétérogènes qui n ont pas forcément le même schéma de données. Cela nécessite donc l utilisation d une application EII (Enterprise information integration) qui est une application qui permet l intégration de données provenant de sources hétérogènes dans une base de données centralisée et unique. Ainsi les médecins peuvent avoir une vue à 360 degrés des informations du patient quelque soit son point d entrée. 6.2 Analyse des données des patients Une fois les données du patient intégrées divers outils permettent de les analyser : La méthode de la modélisation prédictive - «predictive modeling» permet notamment de faire cette analyse. Un modèle prédictif permet la prévision d un événement futur à partir des éléments du passé. Le modèle est crée à partir de plusieurs facteurs ou prédicats (âge du patient, les maladies diagnostiquées, ) qui auront une influence sur le résultat. Une formule est ensuite créé utilisant des statistiques techniques, les prédictions sont calculées et le modèle résultant est testé et validé avec des données supplémentaires. Pour résumer, la modélisation prédictive permet de : a. Prédire quel patient présentant certaines conditions possède un risque élevé de développer une certaine maladie. Exemple : quel est le risque pour un patient avec une tension élevée (high blood pressure) de développer un Glaucome? b. Pour les patients déjà diagnostiqués quels sont ceux qui peuvent développer des complications? Exemple : quel est le risque pour un individu malade du diabète de développer une maladie du cœur. De cette façon, le médecin peut prescrire un traitement préventif au patient pour éviter les complications de la maladie qui pourraient entrainer une augmentation des dépenses de santé. Typiquement, une complication de la maladie du patient peut entrainer une opération chirurgicale lourde. Le «predictive modeling» a beaucoup d avantages, il permet: des interventions de prévention au lieu d un traitement couteux sur quelqu un qui est déjà malade. de découvrir des maladies plus tôt. En général plus une maladie est découverte tôt, plus facilement on la guérit. C est le cas pour beaucoup de cancers Une meilleure communication avec le patient. 11

12 Tout ceci contribue à baisser les couts de santé. 6.3 Outcomes management Une fois les prédictions faites, le médecin peut communiquer les résultats au patient, discuter avec celui-ci toutes les possibilités d intervention. Ainsi le patient qui est bien informé peut choisir le traitement qu il préfère. Le patient contribue avec le médecin à l amélioration de son état de santé. Le patient peut instantanément avoir toutes les informations concernant son état de santé notamment par l accès à une application web. Le médecin peut communiquer au patient ces informations à travers ses canaux de communication préférés : directement, par courrier, par , site web, téléphone, fax Un patient qui est bien informé sur son état de santé est un patient moins anxieux, qui suit mieux son traitement et qui a donc de meilleures chances de guérison. Car un autre facteur d augmentation des dépenses de santé vient des patients qui ne suivent pas les traitements jusqu au bout et qui donc des rechutes. Un médecin qui a une vue complète de toutes les données du patient, peut mieux diagnostiquer la maladie dont souffre le patient. Le médecin fait donc moins d erreurs médicales. Le résultat est une relation entre le patient et le médecin plus personnalisée et donc la diminution des erreurs médicales et la baisse des couts du système de santé. On voit donc qu avec ces méthodologies du PRM, le système de santé est moins fragmenté, le patient est complètement identifié avec son historique médicale, le médecin a une vue à 360 du patient et il peut mieux le soigner. Dans beaucoup d hôpitaux, les processus sont centrés sur l hôpital. Avec l introduction du PRM, l approche est plutôt orientée patient. Cette dernière approche a plus d efficacité. Voici quelques exemples qui illustrent les avantages des méthodologies du PRM : Exemple 1: Prévenir la douleur chez l enfant. Au Children Memorial Hospital à Chicago, le Docteur Eric Bremer qui est directeur de recherche sur les tumeurs du cerveau utilise une combinaison de modélisation prédictive et de datamining. Les tumeurs du cerveau possèdent un taux de mortalités très élevé. La clé du traitement est de savoir quel genre de tumeur le patient a et le stade d évolution de cette tumeur. Ainsi, on peut adapter son traitement car il est nécessaire de donner la bonne dose la chimiothérapie afin que non seulement le patient ne souffre pas beaucoup mais aussi qu il ait moins de dommages corporels. L utilisation de la modélisation prédictive et du datamining permet de déterminer le type de tumeur du cerveau que le patient a et son stade d évolution. Exemple 2 : améliorer le Chronic Desease Management (CDM) avec le PRM. En Ontario au Canada, le programme de recherche COMPETE qui associe le PRM et CDM contient des algorithmes individualisés pour chaque patient, basés sur le passé médical du patient, les médicaments qu il prend actuellement, ses allergies, ses risques vasculaires. L algorithme génère des objectifs adaptés à ce patient et des recommandations. 12

13 Exemple 3 : Informer les parents en temps réel sur les soins reçus par leur enfant. En 2005, le service de néo-natalité de la Royal Infirmary d Edinbourg en Ecosse a inauguré un site web qui permet aux parents de nouveau-nés, en particulier les prématurés de voir en temps réel l état de santé de l enfant et les traitements qui lui sont administrés. Le site permet également aux médecins de noter tous les médicaments administrés aux enfants. L hôpital entend ainsi améliorer la communication entre les médecins qui s occupent des enfants d une part et d autre part entre les médecins et les parents de nouveau-nés. Le site fournit en démonstration une application du même type mais destinée à tous les patients en général. Pour résumer cette partie, nous pouvons dire que Le Patient Relationship Management avant d être un ensemble de technologies mises ensemble est d abord une stratégie. C est la raison pour laquelle les processus au sein de l hôpital doivent également être adaptés. Sans cela en fait la technologie mise en place ne sera d aucune utilité. 7. PRM Strategy Strategies known from military or sport games are more or less plans designed to achieve particular goals. In our case it should be a help for relationship managers for the skilful handling of the tasks planning, deciding, delegation and control. Before planning a phase of analysis should be integrated in the concept. Whilst the steps deciding and delegation can be resumed in the phase execution. So far we have four steps of systematic patient relationship management: analysing, planning, execution and control. This order once more reminds of the customer relationship marketing process. But still it has to be adapted to the particularities of the health market and it is notably supported by ICT. We will exemplify the process for a gynaecologist trying to reform its patient relationship management. We are conscious, that PRM is nowadays most often used in pharmaceutical industry. But since the process there is more simular to the CRM except the specialities of the prescription market we chose the more uncommon example of the doctor adapting to the new behaviour of the patients. Special weight will be given to the analysing phase because we already heard about general planning of PRM methods and because analysing is a very important phase to the whole process. The steps of execution and control are very practically tasks and thus will be very roughly explained in this paper. 7.1 Analysing phase The analysing phase has the goal of giving an overview over the general situation of the health care institution. Its indispensable for solving patient relationship problems. It involves analysing the environmental influences such as the health market in general and the competitors. For this purpose we accomplish a SWOT-analysis. It can be divided in the categories: 1. External analysis of opportunities and threats for the patient relationship. 2. Internal analysis of strengths and weaknesses for the patient relationship. The external influences can not be influenced by the gynaecologist himself. The analysis should cover the following areas: Health market developments, Technologies, political and social environment, patients, suppliers of pharmaceuticals, suppliers of professional infrastructure, competitors. The gynaecologist discovers after analysing external data the following threats: 13

14 Society: Demographic Change and ageing: decline in birth rate Society: Income inequalities Competitors: Trend for group practices Environment: Ecological health threats such as pollution Politics: Limit of practitioners Patient: Rising patient expectations to the knowledge of the doctor Pharmaceutical industry: Direct to Patient Marketing Suppliers: Expensive Swiss quality products (Image price?) Competition: Many up-to date successors fresh from university Competition: Many female graduates often preferred by female patients And he discovers the following opportunities 22 : Internationalisation: Free movement of goods, services, labour Society: Technological developments: Society: Increase of medical know how and high investment in product development Society: 2 nd age of enlightenment: transparency on diseases such as aids, hepatitis et al., sexually education in school. Environment: Ecological health threats Politics: Limit of practitioners Market: Non-saturated market Patient: Empowerment of the patient Pharmaceutical industry: Generic products available Human Resources: qualified graduates as assistants available The findings highlight some possibilities in relationship marketing. In reality the analysis can be done for every unit of the medical offer and it should also be done very detailed. The analysis done here serves just as an idea of how it could work. An internal analysis helps to weigh which activities make sense to undertake for the gynaecologist and which chances are not relevant because he can not seize them. The gynaecologist thus thinks about: his financial situation, the quality of his personal and of his own service, practice marketing, communication, relationships to patients, location, premises and infrastructure. He finds out the following weaknesses: Unsatisfactory payment behaviour of young patients No quality certificate (e.g. Swiss pep) No advanced training Lack of marketing and management skills Lack of IT skills No systematic complaints management High rate of young patients loss Poor linkage with insurances Old fashioned equipment But he also knows about his strengths: Available capital Motivated medical assistant Loyalty of lifelong patients Trust of patients in family practice Good retention of older patients regular patients Wife and father are retired doctors High verbal feedback Amortised equipment Complete database back to the Seventies 24 hours emergency attendance 22 Some external factors may be a threat and a opportunity 14

15 Enough parking places Close bus station After having created the internal and external analysis a matrix can be made which links opportunities and threats with the most important weaknesses and strengths. E.g: Opportunity Threat Strength Patient empowerment Ageing High Feedback Old patient structure Weakn. New technologies& Expensive swiss know how Not updatet Old equipment equipment The finding of the Swot analysis form the basis for target planning within patient relationship management. Targets of patient relationship management for our case could be: o o o o o Improvement of management and marketing skills Receive a quality certificate Improvement of service quality through specialisation Improvement of average patient retention Stronger patient orientation: Collect patient satisfaction, patient history, patient suggestions data For each and every target a value can be defined and a time horizon can be set. As a next step a segmentation of customers can be made in terms of demographic criteria (e.g. age), frequency of consultation, socio-economic criteria (e.g. income level), consternation, health insurance company and so on. The segments are then described and finally the profitable relationships are identified. The gynaecologist could decide to focus on the segment of older patients for example spending may be more money in health. Besides: If he improves the relationship with his aged patients he seizes the chance of changing society structures and he uses his strength of having high retention of older patients. 7.2 Planning phase For the chosen segment(s) we can now begin to plan strategies for patient acquisition, patient retention and patient recovery. Those three strategies can also be seen as three options and it is not necessary to plan all of them contemporaneously. We will further shortly deal with all three options for our case. 1.) Acquisition strategy: The primary aim of patient acquisition strategy is to acquire new patients by having the practices direct its marketing activities accordingly. In our case the goals of improving marketing skills and service quality could be a reason to focus on acquisition. There are two kinds of strategies: The persuasive and the stimulating. The first possibility is to convince new patients f.e. through free trial consultations and through quality guarantees. The second wants to get the attention of the patients with help of advertisement, image and special offers. In our case a mixed strategy might be right. After deciding the strategy type instruments can be chosen. We can make use of the marketing mix. Price instruments: We can offer free starting consultations 15

16 Promotion: We can advertise in 55 plus and in Seniortip, the two leading internet magazines for seniors. And we might even help older people handle the computer. As a consequence we can introduce a patient forum integrated in an own homepage to enable patients discussions about our service. Product: We can offer product packages such as mobile attendance and psychological support for women in menopause. Place: We can provide home consultations of our medical assistant for seniors or bus schedules. 2.) Retention strategy: The key of patient retention strategy is to retain the maximum number of patients who are profitable. There are two possibilities how to reach a high retention. Solidarity strategies strive for patient retention by means of psychological determinants such as patient satisfaction. Dependence strategies in contrast set up barriers for the patient to switch to another doctor. In our case a mix of both themed To be an indispensable partner to the patient can be profitable. Solidarity elements: Patients are cared by a small intimate team of the gynaecologist and his assistant. Father and wife are the well-known voices who do call centre services. The family practice evokes a atmosphere of trust. Dependence elements: The complete database of the gynaecologist is an advantage since patient files are an element of dependence. However, if the patient switches nevertheless to another gynaecologist patient data must be committed to his new confidant. 3.) Recovery strategy: A recovery strategy includes regaining the trust of lost patients. This can be profitable because those patients might show a higher loyalty than before. The recovery can either make amends or improvements to address the problems. In our case as we have seen we have a high retention of older patients. That means automatically that there is no further need to invest in a recovery strategy for our current patients. Anyway, we can establish a complaint management just to make sure we have an instrument to find out where we lack of fulfilling the patients needs and then as long as they are controllable - try to change reasons for rotations. For the three options or phases of patient acquisition, retention and recovery strategy we developed very roughly some single inferior tasks. They mark just examples and not a complete management instruction. 7.3 The executing phase Any concept is worthless without implementation. To ensure that the patient relationship management succeeds all employees must be involved. Major changes may be required in internal operational processes. For the implementation it is necessary to first set down the implementation targets. The focus in bigger practices, in hospitals and pharmaceutical industries is on achieving acceptance and on informing involved persons. After instructing the employees the goal is to work out measures to improve the patient orientation and to fix specific responsibilities. For our gynaecologist this means he first has to sit together with his assistant and his involved family members to make the PRM concept understood. His goal must be to achieve a high level of enthusiasm. This first step is followed by the very important phase of adjusting the infrastructure to the new concept. Here its necessary to introduce the new databank for setting up the complaint management, for placing satisfaction questionnaires, for integrating the communication between the patients and for collecting the patient disease histories. While implementing the PRM strategy an eye has always to be kept on cost and time effects. One aspect for our gynaecologist could be the possible advantage of engaging an external consultant especially for IT implementation since cost advantage is bigger if every specialist works efficient in his domain. 16

17 Theoretically we can differ between a radical restructure of our health service and permanent small improvements. We will have to combine both elements since our major changes such as the web performance will be visible at once, but the small team has to start utilising the IT before and to make progresses in working with it in small steps. 7.4 The controlling phase A PRM strategy can only be successful if the impacts of the efforts on our goals are continuously controlled. Those impacts are either non-economic or economic variables, but in case of medical care providers the focus is on non economic criteria. Non-economic controls are aimed at verifying relationship managements non-economic targets. Thus it is necessary to conduct various construct measurements. These include the doctor-patient-relationship assessment (Relationship quality, quality of health service, perceived value of consultation), the psychological consequences (patient satisfaction, patient commitment) and the behaviour (patient retention). There are different ideas of how to measure non-economic variables. The gynaecologist choses to evaluate the quality of health service with the measurement of single attributes because he assumes that psychological and relationship constructs are the sum of specific estimates of different elements. He constructs a patient questionnaire to collect the data. In customer relationship marketing an instrument is used which can be easily transformed to patient relationship management: The Servqual questionnaire 23 in our case used to evaluate the quality of health service. According to this method service quality in PRM is measured on the basis of attributes in categories. Tangibles: Modern equipment, visually appealing facilities, professionalism of employees, visually appealing materials Reliability: Service as promised, dependability in terms of patients problems, performing service right the first time, providing health around the clock, maintaining error-free patient files. Responsiveness: keeping patient informed, no long time in waiting room, willingness to help begins at the reception of patient, readiness of doctor to respond to patients input. Assurance: employees instil confidence, feelings of safety, employees are courteous, employees answer to patients questions. Empathy: individual patient attention, dealing with patient in a caring way, having patients interest at heart, understanding of patients needs, convenient consulting hours. The patient can now either give grades or answer on a scale ranging from absolutely to non existent. - Doctor-patient relationship quality can be measured only by dimensions of familiarity and trust. Indicated by the variable groups personal understanding, personal awareness, professional awareness for the first dimension and harmony, acceptance and participation simplicity for the second. - Patient satisfaction measurement begins directly by verbally asking: How satisfied are you with your consultation? Afterwards more detailed question about the reasons for satisfaction or non-satisfaction can be asked. - Perceived value of the consultation can be found out be asking questions about the price such as: Treatment X is fairly priced, Treatment X has an unpayable value - Commitment of the patient is higher when then patient feels as a part of the medical institution: I am concerned about the long term existence of this practice, I am very loyal to this practice. - The patient retention can be measured by future patients behaviour in terms of: 1.) Likelihood of repeat consultations: I will repeat my consultation 2.) Intention of making use of other medical services: I will do my injections here 3.) Intention to make recommendations: I will introduce my children/ my friends to this practice. 23 Compare Bruhn p. 197 ff 17

18 For the final analyze the answers must be converted into absolut numbers and finally with the help of statistic programms such as PLS dependencies between the categories can be determined and total satisfaction or relationship quality can be found out. 8. Conclusion and future prospects As we have seen there are various reasons why changes in health are overdue. PRM is the way to generate a win-win situation out of the problem - or in other words - the chance of making profit of this necessity. There is an advantage for everyone using it. The patient profits from a better communication with the doctor, of an individualized offer and of a diminution of medical errors due to the integration of all medical facts (former consultations and treatments, allergies..) in one patient file and also due to the diminution of misapprehensions because of illegible files. The health care system profits of the commitment of the patient and of the application of PRM to fight chronic diseases. Finally the doctor profits not only in a empathic way namely of being able to be a bigger help to the patient. But he also profits in economic terms. With adapting his working processes to PRM all practice tasks can be made with the same software, data has to be collected just once and can be shared with other health providers. Money and time can be saved. Since the PRM approach is new there is just a small part of research done. Most of the research either concerns the economic side and leans thus strongly on CRM or it emphasizes more the advantages of PRM for the patient. Approaches which relate both perspectives are still rare. It has to be said that PRM is not just a technical system which can be bought and used immediately. Integrating a PRM system means to make major changes in the whole organization of medical providers. Instead of focussing ona smooth work flow the patient must be in centre. Since PRM handles with high confidential data, data protection will be an important subject to treat in future. More even than in other fields health care needs international regulations for handling data because it is often needed in urgent circumstances or even in life-threatening situations. Accomplish those claims is necessary to reduce the scepticism of the patients. A secure transmission, storage and administration is thanks to todays technic possibilities throughout feasible. 18

19 9. Bibliography Mayer J. : Arzt-Patient-Beziehung im Wandel. In: Jähn, Karl.; Nagel, Eckhard. (Hrsg.): E-health. Springer Verlag, Heidelberg Berlin New York World Health Organization: Chronic Diseases and Health Promotion. URL: ( ). Hahn, Olaf Kilian: Patient Relationship Management. Ein CRM-Ansatz für die pharmazeutische Industrie. Mannheim World Health Organization, Regional Office for Europe: The Ljubljana Charter on Reforming Health Care, URL: ( ). Hofstede, Gert: Cultural constraints in management theories. In: Lane, Henry: International management behavior, Blackwell publishing Thommen, Jean-Paul: Betriebswirtschaft und Management. Gabler 2006, p. 42. Eggert, Andreas; Fassot, Georg: Elektronisches Kundenbeziehungsmanagement. Schäffer-Pöschel, Bruhn, Manfred: Relationship Marketing. Management of Customer Relationships. Prentice Hall, Eberl, Markus; Zinnbauer, Markus: Measuring Customer Relationship Management Performance: A Consumer-Centric Approach. In: Journal of Marketing Channels, Vol.12, No.3. Hornung, Stefanie: Patientologie. Börm Bruckmeier Swiss ICT. Information and communication association. Programm for the Forum URL: ( ). Dawson, David: Relationship Management of the borderline Patient, Brunner/Mazel Smith, James Monroe: Producing Patient Centered Health Care: Patient Perspective about health and illness and the Physican/ Patient Relationship. Auburn house Badenhoop, Rolf: Patient Relationship Management: CRM in der Life Sciences Industrie. Gabler Leppi, Udo: Auf dem Weg zum individuellen Gesundheitsmanagement. Trends aus einer Studie. In: Pharma-Marketing Journal(PMJ). 25 Jg, Nr2, Cap Gemini, Ernst and Young: Patient Relationship Management: Die Rolle des Patienten in der Life Sciences Industrie. Studie URL: d=72&id=349. ( ) Ryf, Balz: Studie Patient Relationship Management: Res und Herausforderungen für die Zukunft Artikel in Badenhoop 2001 (see above). Murray, E.; Burns, J.; Tai See, S.; Nazareth, I.: Interactive Health Communication Applications for people with chronic disease. The cochrace database of systematic reviews. Issue 4, Hombug, Christian; Dietz, Beatrix: Patientenmündigkeit. Universität Mannheim Wettermann, Rebecca: Driving CRM value in healthcare: Deploying intuitive CRM options can produce greater ROI and enhanced patient and caregiver experience. Article in: Health management Technology, Vol 28, Issue 9, S Sept Holgrate, Catherine: Die Zukunft des deutschen Gesundheitsmarktes. PRM als strategische Option für die pharmazeutische Industrie. URL: ( ) Website demonstrations: https://www.patientsite.org 19

ICH Q8, Q9 and Q10. Krishnan R. Tirunellai, Ph. D. Bureau of Pharmaceutical Sciences Therapeutic Products Directorate Health Canada December 4, 2008

ICH Q8, Q9 and Q10. Krishnan R. Tirunellai, Ph. D. Bureau of Pharmaceutical Sciences Therapeutic Products Directorate Health Canada December 4, 2008 ICH Q8, Q9 and Q10 An Opportunity to Build Quality into Product Krishnan R. Tirunellai, Ph. D. Bureau of Pharmaceutical Sciences Therapeutic Products Directorate Health Canada December 4, 2008 Sequence

Plus en détail

Girls and Boys, Women and Men - Filles et garçons, femmes et hommes - respecting differences, promoting equality and sharing responsibility

Girls and Boys, Women and Men - Filles et garçons, femmes et hommes - respecting differences, promoting equality and sharing responsibility Girls and Boys, Women and Men - respecting differences, promoting equality and sharing responsibility Filles et garçons, femmes et hommes - respecter les différences, promouvoir l égalité et partager les

Plus en détail

IS/07/TOI/164004. http://www.adam-europe.eu/adam/project/view.htm?prj=6140

IS/07/TOI/164004. http://www.adam-europe.eu/adam/project/view.htm?prj=6140 La vente au détail - RetAiL est un cours fondé sur la technologie de l information, un IS/07/TOI/164004 1 Information sur le projet La vente au détail - RetAiL est un cours fondé sur la technologie de

Plus en détail

Design and creativity in French national and regional policies

Design and creativity in French national and regional policies Design and creativity in French national and regional policies p.01 15-06-09 French Innovation policy Distinction between technological innovation and non-technological innovation (including design) French

Plus en détail

eid Trends in french egovernment Liberty Alliance Workshop April, 20th 2007 French Ministry of Finance, DGME

eid Trends in french egovernment Liberty Alliance Workshop April, 20th 2007 French Ministry of Finance, DGME eid Trends in french egovernment Liberty Alliance Workshop April, 20th 2007 French Ministry of Finance, DGME Agenda What do we have today? What are our plans? What needs to be solved! What do we have today?

Plus en détail

The evolution and consequences of the EU Emissions Trading System (EU ETS)

The evolution and consequences of the EU Emissions Trading System (EU ETS) The evolution and consequences of the EU Emissions Trading System (EU ETS) Jon Birger Skjærseth Montreal 27.10.08 reproduction doivent être acheminées à Copibec (reproduction papier) Introduction What

Plus en détail

Forthcoming Database

Forthcoming Database DISS.ETH NO. 15802 Forthcoming Database A Framework Approach for Data Visualization Applications A dissertation submitted to the SWISS FEDERAL INSTITUTE OF TECHNOLOGY ZURICH for the degree of Doctor of

Plus en détail

AWICO instrument pour le bilan de compétences élargie

AWICO instrument pour le bilan de compétences élargie AWICO instrument pour le bilan de compétences élargie No. 2009 LLP-LdV-TOI-2009-164.603 1 Information sur le projet Titre: Code Projet: Année: 2009 Type de Projet: Statut: Accroche marketing: Résumé: Description:

Plus en détail

Transfert des expérimentales et innovantes méthodes d enseignement pour l education de management

Transfert des expérimentales et innovantes méthodes d enseignement pour l education de management l education de management 2010-1-PL1-LEO01-11462 1 Information sur le projet Titre: Code Projet: Année: 2010 Type de Projet: Statut: Accroche marketing: Résumé: Transfert des expérimentales et innovantes

Plus en détail

SGR Services de gestion des risques

SGR Services de gestion des risques Title: Safety Achievement Financial Incentive System (SAFIS) Titre : Système d incitation financière à la sécurité DIRECTIVE Effective / En vigueur: 01/05/2008 Release / Diffusion No. 003 Page 1 of / de

Plus en détail

MAT 2377 Solutions to the Mi-term

MAT 2377 Solutions to the Mi-term MAT 2377 Solutions to the Mi-term Tuesday June 16 15 Time: 70 minutes Student Number: Name: Professor M. Alvo This is an open book exam. Standard calculators are permitted. Answer all questions. Place

Plus en détail

IT & E - Integrated Training & emploi des personnes handicapées en dessin assisté par ordinateur, les détails et graphiques

IT & E - Integrated Training & emploi des personnes handicapées en dessin assisté par ordinateur, les détails et graphiques IT & E - Integrated Training & emploi des personnes handicapées en dessin assisté par ordinateur, les détails et graphiques TR/06/B/P/PP/178009 1 Information sur le projet Titre: Code Projet: Année: 2006

Plus en détail

GCSE Bitesize Controlled Assessment

GCSE Bitesize Controlled Assessment GCSE Bitesize Controlled Assessment Model 2 (for A/A* grade) Question 3 Subject: Topic: French Writing In this document you will find practical help on how to improve your grade. Before you start working

Plus en détail

The managing Information system (S.I.D.) of the Civil Servants Health Insurance. Mutualité Fonction Publique - Direction des Systèmes d Information

The managing Information system (S.I.D.) of the Civil Servants Health Insurance. Mutualité Fonction Publique - Direction des Systèmes d Information The managing Information system (S.I.D.) of the Civil Servants Health Insurance Mutualité Fonction Publique - Direction des Systèmes d Information Joseph GARACOITS - Isabelle RICHARD France Intervention

Plus en détail

Section B: Receiving and Reviewing the Technician Inspection Report & Claims Decision Process

Section B: Receiving and Reviewing the Technician Inspection Report & Claims Decision Process Phoenix A.M.D. International Inc. - Claim Procedures, Timelines & Expectations Timelines & Expectations 1. All telephone messages and e-mail correspondence is to be handled and responded back to you within

Plus en détail

Autres termes clés (Other key terms)

Autres termes clés (Other key terms) Carve-out method Autres termes clés (Other key terms) Norme Rapports d assurance sur les contrôles d une société de services extérieurs (, Assurance Reports on Controls at a Third Party Service Organization)

Plus en détail

Assoumta Djimrangaye Coordonnatrice de soutien au développement des affaires Business development support coordinator

Assoumta Djimrangaye Coordonnatrice de soutien au développement des affaires Business development support coordinator 2008-01-28 From: [] Sent: Monday, January 21, 2008 6:58 AM To: Web Administrator BCUC:EX Cc: 'Jean Paquin' Subject: RE: Request for Late Intervenorship - BCHydro Standing Offer C22-1 Dear Bonnie, Please

Plus en détail

C est quoi, Facebook?

C est quoi, Facebook? C est quoi, Facebook? aujourd hui l un des sites Internet les plus visités au monde. Si tu as plus de 13 ans, tu fais peut-être partie des 750 millions de personnes dans le monde qui ont une page Facebook?

Plus en détail

2 players Ages 8+ Note: Please keep these instructions for future reference. WARNING. CHOKING HAZARD. Small parts. Not for children under 3 years.

2 players Ages 8+ Note: Please keep these instructions for future reference. WARNING. CHOKING HAZARD. Small parts. Not for children under 3 years. Linja Game Rules 2 players Ages 8+ Published under license from FoxMind Games NV, by: FoxMind Games BV Stadhouderskade 125hs Amsterdam, The Netherlands Distribution in North America: FoxMind USA 2710 Thomes

Plus en détail

French 2208A. French for Healthcare Le français de la santé

French 2208A. French for Healthcare Le français de la santé French 2208A French for Healthcare Le français de la santé Professeur : Heures de bureau : Olga Kharytonava disponible tous les jours par courriel, sauf le week-end. Préalable - Fr 1900 E ou Fr 1910, ou

Plus en détail

Experiences TCM QUALITY MARK. Project management Management systems ISO 9001 ISO 14001 ISO 22000

Experiences TCM QUALITY MARK. Project management Management systems ISO 9001 ISO 14001 ISO 22000 TCM QUALITY MARK Jean-Marc Bachelet Tocema Europe workshop 4 Project management Management systems ISO 9001 ISO 14001 ISO 22000 + lead auditors for certification bodies Experiences Private and state companies,

Plus en détail

236. 2. 7 mai. 9 mai. Final paper. Final paper dû le 12 Mai

236. 2. 7 mai. 9 mai. Final paper. Final paper dû le 12 Mai 236. 2 17ème 5 mai 7 mai 9 mai dû le 12 Mai objectifs pp.76 78 pp.78 7Turn in p. 83. I L Europe pp. 80 81 8ème 3 mars 5 mars 7 mars Révision Examen 2 La famille pp. 134 137 9ème 10 mars 12 mars 14 mars

Plus en détail

companies FEDERAL BILINGUAL VET DIPLOMA IN COMMERCE May 30th, 2013 Département de la solidarité et de l'emploi

companies FEDERAL BILINGUAL VET DIPLOMA IN COMMERCE May 30th, 2013 Département de la solidarité et de l'emploi FEDERAL BILINGUAL VET DIPLOMA IN COMMERCE A new offer adapted to English speaking companies May 30th, 2013 19.06.2013 - Page 1 SWISS PILOT PROJECT DEVELOPED IN GENEVE Project from the Swiss Confederation

Plus en détail

Florida International University. Department of Modern Languages. FRENCH I Summer A Term 2014 FRE 1130 - U01A

Florida International University. Department of Modern Languages. FRENCH I Summer A Term 2014 FRE 1130 - U01A Florida International University Department of Modern Languages FRENCH I Summer A Term 2014 FRE 1130 - U01A Class time: Monday, Tuesday, Wednesday, Thursday; 6:20 P.M. - 9:00 P.M. Instructors: Prof. Jean-Robert

Plus en détail

The new consumables catalogue from Medisoft is now updated. Please discover this full overview of all our consumables available to you.

The new consumables catalogue from Medisoft is now updated. Please discover this full overview of all our consumables available to you. General information 120426_CCD_EN_FR Dear Partner, The new consumables catalogue from Medisoft is now updated. Please discover this full overview of all our consumables available to you. To assist navigation

Plus en détail

Programme Intégré de Formation des Formateurs (PRIFF) Appel à candidature. Formation des enseignants PES- d anglais

Programme Intégré de Formation des Formateurs (PRIFF) Appel à candidature. Formation des enseignants PES- d anglais REPUBLIQUE TUNISIENNE Ministère de l Enseignement Supérieur et de la Recherche Scientifique Programme Intégré de Formation des Formateurs (PRIFF) Appel à candidature Formation des enseignants PES- d anglais

Plus en détail

Un ACTIF InConToURnABLE PoUR DEs PARTEnARIATs significatifs. social. An ASSeT To meaningful PARTneRSHIPS

Un ACTIF InConToURnABLE PoUR DEs PARTEnARIATs significatifs. social. An ASSeT To meaningful PARTneRSHIPS Le capital Un ACTIF InConToURnABLE PoUR DEs PARTEnARIATs significatifs social capital An ASSeT To meaningful PARTneRSHIPS Présentation des participants participants presentation Fondation Dufresne et Gauthier

Plus en détail

FORMATION CONTINUE en Français Langue Étrangère

FORMATION CONTINUE en Français Langue Étrangère Francés y inglés / Francese e inglese / Französisch und englischem FORMATION CONTINUE en Français Langue Étrangère L EFI, située au cœur de Paris, dans le Marais, est à proximité des principales lignes

Plus en détail

Application Form/ Formulaire de demande

Application Form/ Formulaire de demande Application Form/ Formulaire de demande Ecosystem Approaches to Health: Summer Workshop and Field school Approches écosystémiques de la santé: Atelier intensif et stage d été Please submit your application

Plus en détail

AccessLearn Community Group: Introductory Survey. Groupe communautaire AccessLearn : étude introductive. Introduction.

AccessLearn Community Group: Introductory Survey. Groupe communautaire AccessLearn : étude introductive. Introduction. AccessLearn Community Group: Introductory Survey Introduction The W3C Accessible Online Learning Community Group (aka AccessLearn) is a place to discuss issues relating to accessibility and online learning,

Plus en détail

PROJET DE LOI C- BILL C- SECRET SECRET HOUSE OF COMMONS OF CANADA CHAMBRE DES COMMUNES DU CANADA

PROJET DE LOI C- BILL C- SECRET SECRET HOUSE OF COMMONS OF CANADA CHAMBRE DES COMMUNES DU CANADA SECRET C- SECRET C- First Session, Forty-first Parliament, Première session, quarante et unième législature, HOUSE OF COMMONS OF CANADA CHAMBRE DES COMMUNES DU CANADA BILL C- PROJET DE LOI C- An Act to

Plus en détail

APPLICATION DOMAIN: Choose a domain

APPLICATION DOMAIN: Choose a domain APPLICATION DOMAIN: Choose a domain PERSONAL DATA DONNEES PERSONNELLES 1. SURNAME NOM DE FAMILLE: 2. FORENAME(S) PRENOM(S): 3. PERMANENT ADDRESS RESIDENCE PERMANENTE: 4. EMAIL - MÉL: 5. PRIVATE TELEPHONE

Plus en détail

When you are told to do so, open your paper and write your answers in English in the spaces provided.

When you are told to do so, open your paper and write your answers in English in the spaces provided. FOR OFFICIAL USE C 000/403 NATIONAL QUALIFICATIONS 008 TUESDAY, 3 MAY.0 AM.0 PM Total FRENCH STANDARD GRADE Credit Level Reading Fill in these boxes and read what is printed below. Full name of centre

Plus en détail

Conférence «Accords transnationaux d entreprise» «Transnational Company Agreements» Conference

Conférence «Accords transnationaux d entreprise» «Transnational Company Agreements» Conference Conférence «Accords transnationaux d entreprise» «Transnational Company Agreements» Conference 13-14 novembre 2008-13th -14th Novembre 2008 Centre des Congrès, Lyon Le rôle des accords d entreprise transnationaux

Plus en détail

POSTING APPLICATION OF THE PAY EQUITY ACT (SECTIONS 76.3 AND 76.4) PAY EQUITY AUDIT WITHIN THE PAY EQUITY PLAN OF THE CONSEIL DU TRÉSOR

POSTING APPLICATION OF THE PAY EQUITY ACT (SECTIONS 76.3 AND 76.4) PAY EQUITY AUDIT WITHIN THE PAY EQUITY PLAN OF THE CONSEIL DU TRÉSOR Version officielle en français disponible ici POSTING APPLICATION OF THE PAY EQUITY ACT (SECTIONS 76.3 AND 76.4) PAY EQUITY AUDIT WITHIN THE PAY EQUITY PLAN OF THE CONSEIL DU TRÉSOR FOR ALL EMPLOYEES IN

Plus en détail

1. Subject 1. Objet. 2. Issue 2. Enjeu. 905-1-IPG-070 October 2014 octobre 2014

1. Subject 1. Objet. 2. Issue 2. Enjeu. 905-1-IPG-070 October 2014 octobre 2014 905-1-IPG-070 October 2014 octobre 2014 (New) Danger as a Normal Condition of Employment 905-1-IPG-070 (Nouveau) Danger constituant une Condition normale de l emploi 905-1-IPG-070 1. Subject 1. Objet Clarification

Plus en détail

GREDOR Gestion des Réseaux Electriques de Distribution Ouverts aux Renouvelables

GREDOR Gestion des Réseaux Electriques de Distribution Ouverts aux Renouvelables GREDOR Gestion des Réseaux Electriques de Distribution Ouverts aux Renouvelables Can operational planning decrease distribution costs? - La gestion prévisionnelle pour diminuer les coûts de distribution?

Plus en détail

6. Les désastres environnementaux sont plus fréquents. 7. On ne recycle pas ses déchets ménagers. 8. Il faut prendre une douche au lieu d un bain.

6. Les désastres environnementaux sont plus fréquents. 7. On ne recycle pas ses déchets ménagers. 8. Il faut prendre une douche au lieu d un bain. 1. Notre planète est menacée! 2. Il faut faire quelque chose! 3. On devrait faire quelque chose. 4. Il y a trop de circulation en ville. 5. L air est pollué. 6. Les désastres environnementaux sont plus

Plus en détail

Editing and managing Systems engineering processes at Snecma

Editing and managing Systems engineering processes at Snecma Editing and managing Systems engineering processes at Snecma Atego workshop 2014-04-03 Ce document et les informations qu il contient sont la propriété de Ils ne doivent pas être copiés ni communiqués

Plus en détail

WEDNESDAY, 11 MAY 1.30 PM 2.30 PM. Date of birth Day Month Year Scottish candidate number

WEDNESDAY, 11 MAY 1.30 PM 2.30 PM. Date of birth Day Month Year Scottish candidate number FOR OFFICIAL USE C Total 000/403 NATIONAL QUALIFICATIONS 0 WEDNESDAY, MAY.30 PM.30 PM FRENCH STANDARD GRADE Credit Level Reading Fill in these boxes and read what is printed below. Full name of centre

Plus en détail

French 2208A. French for Healthcare Le français de la santé

French 2208A. French for Healthcare Le français de la santé French 2208A French for Healthcare Le français de la santé Professeur : Heures de bureau : Iryna Punko disponible tous les jours par courriel, sauf le week-end. Préalable - Fr 1900 E ou Fr 1910, ou permission

Plus en détail

Date: 09/11/15 www.crmconsult.com Version: 2.0

Date: 09/11/15 www.crmconsult.com Version: 2.0 Date: 9/11/2015 contact@crmconsult.fr Page 1 / 10 Table des matières 1 SUGARPSHOP : SCHEMA... 3 2 PRESENTATION... 4 3 SHOPFORCE WITH SCREENSHOTS... 5 3.1 CLIENTS... 5 3.2 ORDERS... 6 4 INSTALLATION...

Plus en détail

How to Manage My Own Skills

How to Manage My Own Skills How to Manage My Own Skills BG/06/B/F/PP - 166001 http://www.adam-europe.eu/adam/project/view.htm?prj=3541 1 Information sur le projet Titre: How to Manage My Own Skills Code Projet: BG/06/B/F/PP - 166001

Plus en détail

ICM STUDENT MANUAL French 1 JIC-FRE1.2V-12 Module: Marketing Communication and Media Relations Study Year 2. 1. Course overview. Learning objectives:

ICM STUDENT MANUAL French 1 JIC-FRE1.2V-12 Module: Marketing Communication and Media Relations Study Year 2. 1. Course overview. Learning objectives: ICM STUDENT MANUAL French 1 JIC-FRE1.2V-12 Module: Marketing Communication and Media Relations Study Year 2 1. Course overview Books: Français.com, niveau intermédiaire, livre d élève+ dvd- rom, 2ième

Plus en détail

Les licences Creative Commons expliquées aux élèves

Les licences Creative Commons expliquées aux élèves Les licences Creative Commons expliquées aux élèves Source du document : http://framablog.org/index.php/post/2008/03/11/education-b2i-creative-commons Diapo 1 Creative Commons presents : Sharing Creative

Plus en détail

Haslingden High School French Y8 Block C Set 1 HOMEWORK BOOKLET

Haslingden High School French Y8 Block C Set 1 HOMEWORK BOOKLET Haslingden High School French Y8 Block C Set 1 HOMEWORK BOOKLET Name: Form: Subject Teacher: Date Given: Date to Hand in: Level: Effort: House Points: Comment: Target: Parent / Guardian Comment: Complete

Plus en détail

We Generate. You Lead.

We Generate. You Lead. www.contact-2-lead.com We Generate. You Lead. PROMOTE CONTACT 2 LEAD 1, Place de la Libération, 73000 Chambéry, France. 17/F i3 Building Asiatown, IT Park, Apas, Cebu City 6000, Philippines. HOW WE CAN

Plus en détail

MODERN LANGUAGES DEPARTMENT

MODERN LANGUAGES DEPARTMENT MODERN LANGUAGES DEPARTMENT Common Assessment Task 2 YEAR 9 Je m appelle Ma classe Mark 20 10 19 23 13 15 Total Effort Instructions For this extended piece of homework, you are going to write about the

Plus en détail

Retired Rock Star Presents Programme for Schools

Retired Rock Star Presents Programme for Schools Séquence 12 Public cible 2 de, 1 e / Écouter : B1+ ; Écrire : B1 Retired Rock Star Presents Programme for Schools Le célèbre musicien du groupe Pink Floyd, Roger Waters, présente son programme pour les

Plus en détail

LA PERSONNE SPÉCIALE

LA PERSONNE SPÉCIALE LA PERSONNE SPÉCIALE These first questions give us some basic information about you. They set the stage and help us to begin to get to know you. 1. Comment tu t appelles? What is your name? Je m appelle

Plus en détail

GLOBAL COMPACT EXAMPLE

GLOBAL COMPACT EXAMPLE GLOBAL COMPACT EXAMPLE Global Compact Good Practice GROUPE SEB 2004-2005 1/4 FIRM: GROUPE SEB TITLE: GROUPE SEB Purchasing Policy contributing to sustainable development GC PRINCIPLES taken into account:

Plus en détail

Sujet de TPE PROPOSITION

Sujet de TPE PROPOSITION Single photon source made of single nanodiamonds This project will consist in studying nanodiamonds as single photon sources. The student will study the emission properties of such systems and will show

Plus en détail

David Marsden Labour market segmentation in Britain: the decline of occupational labour markets and the spread of entry tournaments

David Marsden Labour market segmentation in Britain: the decline of occupational labour markets and the spread of entry tournaments David Marsden Labour market segmentation in Britain: the decline of occupational labour markets and the spread of entry tournaments Article (Accepted version) (Refereed) Original citation: Marsden, David

Plus en détail

L intégration socioscolaire des jeunes Québécois d origine chinoise : le rôle des écoles ethniques complémentaires

L intégration socioscolaire des jeunes Québécois d origine chinoise : le rôle des écoles ethniques complémentaires L intégration socioscolaire des jeunes Québécois d origine chinoise : le rôle des écoles ethniques complémentaires Ming Sun Université de Montréal Haï Thach École Chinoise (Mandarin) de Montréal Introduction

Plus en détail

Formation en conduite et gestion de projets. Renforcer les capacités des syndicats en Europe

Formation en conduite et gestion de projets. Renforcer les capacités des syndicats en Europe Formation en conduite et gestion de projets Renforcer les capacités des syndicats en Europe Pourquoi la gestion de projets? Le département Formation de l Institut syndical européen (ETUI, European Trade

Plus en détail

Réjean Gascon Directeur CFP de Waswanipi. rgascon@cscree.qc.ca

Réjean Gascon Directeur CFP de Waswanipi. rgascon@cscree.qc.ca Réjean Gascon Directeur CFP de Waswanipi rgascon@cscree.qc.ca Présentation Centre régional de formation professionnelle de Waswanipi Offre de services 2014-2015 au CFP de Waswanipi Programmes en foresterie

Plus en détail

Instructions Mozilla Thunderbird Page 1

Instructions Mozilla Thunderbird Page 1 Instructions Mozilla Thunderbird Page 1 Instructions Mozilla Thunderbird Ce manuel est écrit pour les utilisateurs qui font déjà configurer un compte de courrier électronique dans Mozilla Thunderbird et

Plus en détail

BNP Paribas Personal Finance

BNP Paribas Personal Finance BNP Paribas Personal Finance Financially fragile loan holder prevention program CUSTOMERS IN DIFFICULTY: QUICKER IDENTIFICATION MEANS BETTER SUPPORT Brussels, December 12th 2014 Why BNPP PF has developed

Plus en détail

GCSE Bitesize Controlled Assessment

GCSE Bitesize Controlled Assessment GCSE Bitesize Controlled Assessment Model 1 (for C/C+ grade) Question 2 Subject: Topic: French Speaking In this document you will find practical help on how to improve your grade. Before you start working

Plus en détail

LA FORMATION SYNDICALE DE L AFPC DANS LA RÉGION DE LA CAPITALE NATIONALE

LA FORMATION SYNDICALE DE L AFPC DANS LA RÉGION DE LA CAPITALE NATIONALE LA FORMATION SYNDICALE DE L AFPC DANS LA RÉGION DE LA CAPITALE NATIONALE Descriptifs des cours offerts à l hiver 2015 L ABC du syndicat (cours de deux jours) Ce cours est la pierre angulaire du programme

Plus en détail

Organisation de Coopération et de Développement Economiques Organisation for Economic Co-operation and Development. Bil.

Organisation de Coopération et de Développement Economiques Organisation for Economic Co-operation and Development. Bil. A usage officiel/for Official Use C(2006)34 C(2006)34 A usage officiel/for Official Use Organisation de Coopération et de Développement Economiques Organisation for Economic Co-operation and Development

Plus en détail

Managing Electricity Sourcing in Europe's Energy Intensive Industry - A Methodology to Develop an Electricity Sourcing Strategy

Managing Electricity Sourcing in Europe's Energy Intensive Industry - A Methodology to Develop an Electricity Sourcing Strategy Managing Electricity Sourcing in Europe's Energy Intensive Industry - A Methodology to Develop an Electricity Sourcing Strategy THÈSE N O 5124 (2011) PRÉSENTÉE le 22 septembre 2011 À LA FACULTÉ MANAGEMENT

Plus en détail

Autres termes clés (Other key terms)

Autres termes clés (Other key terms) Autres termes clés (Other key terms) Norme Contrôle qualité des cabinets réalisant des missions d audit ou d examen d états financiers et d autres missions d assurance et de services connexes ( Quality

Plus en détail

EN UNE PAGE PLAN STRATÉGIQUE

EN UNE PAGE PLAN STRATÉGIQUE EN UNE PAGE PLAN STRATÉGIQUE PLAN STRATÉGIQUE EN UNE PAGE Nom de l entreprise Votre nom Date VALEUR PRINCIPALES/CROYANCES (Devrait/Devrait pas) RAISON (Pourquoi) OBJECTIFS (- AN) (Où) BUT ( AN) (Quoi)

Plus en détail

National Director, Engineering and Maintenance East (Montreal, QC)

National Director, Engineering and Maintenance East (Montreal, QC) National Director, Engineering and Maintenance East (Montreal, QC) Reporting to the General Manager, Engineering and Maintenance, you will provide strategic direction on the support and maintenance of

Plus en détail

Préconisations pour une gouvernance efficace de la Manche. Pathways for effective governance of the English Channel

Préconisations pour une gouvernance efficace de la Manche. Pathways for effective governance of the English Channel Préconisations pour une gouvernance efficace de la Manche Pathways for effective governance of the English Channel Prochaines étapes vers une gouvernance efficace de la Manche Next steps for effective

Plus en détail

2002 Maritime Mathematics Competition Concours de Mathématiques des Maritimes 2002

2002 Maritime Mathematics Competition Concours de Mathématiques des Maritimes 2002 2002 Maritime Mathematics Competition Concours de Mathématiques des Maritimes 2002 Instructions: Directives : 1 Provide the information requested below Veuillez fournir les renseignements demandés ci-dessous

Plus en détail

RESULTING FROM THE ANTI-SEMITIC LEGISLATION IN FORCE DURING THE OCCUPATION. (Decree 99-778 of September 10, 1999) QUESTIONNAIRE. Family Name...

RESULTING FROM THE ANTI-SEMITIC LEGISLATION IN FORCE DURING THE OCCUPATION. (Decree 99-778 of September 10, 1999) QUESTIONNAIRE. Family Name... COMMISSION FOR THE COMPENSATION OF VICTIMS OF SPOLIATION RESULTING FROM THE ANTI-SEMITIC LEGISLATION IN FORCE DURING THE OCCUPATION (Decree 99-778 of September 10, 1999) Case Number : (to remind in all

Plus en détail

Animation de la démarche Santé et Sécurité au Travail pour Les Crudettes SAS

Animation de la démarche Santé et Sécurité au Travail pour Les Crudettes SAS MINISTERE DE L AGRICULTURE LES CRUDETTES SAS www.lescrudettes.com MÉMOIRE DE FIN D ÉTUDES présenté pour l obtention du diplôme d ingénieur agronome spécialisation : Agro-alimentaire option : QUALI-RISQUES

Plus en détail

GCSE Bitesize Controlled Assessment

GCSE Bitesize Controlled Assessment GCSE Bitesize Controlled Assessment Model 2 (for A/A* grade) Question 4 Subject: Topic: French Speaking In this document you will find practical help on how to improve your grade. Before you start working

Plus en détail

Construire son projet : Rédiger la partie impacts (2/4) Service Europe Direction des Programmes et de la Formation pour le Sud

Construire son projet : Rédiger la partie impacts (2/4) Service Europe Direction des Programmes et de la Formation pour le Sud Construire son projet : Rédiger la partie impacts (2/4) Service Europe Direction des Programmes et de la Formation pour le Sud Sommaire Construire son projet : Rédiger la partie impacts (2/4) Comment définir

Plus en détail

iqtool - Outil e-learning innovateur pour enseigner la Gestion de Qualité au niveau BAC+2

iqtool - Outil e-learning innovateur pour enseigner la Gestion de Qualité au niveau BAC+2 iqtool - Outil e-learning innovateur pour enseigner la Gestion de Qualité au niveau BAC+2 134712-LLP-2007-HU-LEONARDO-LMP 1 Information sur le projet iqtool - Outil e-learning innovateur pour enseigner

Plus en détail

The ISIA Minimum Standard. Why, What, How

The ISIA Minimum Standard. Why, What, How The ISIA Minimum Standard Why, What, How Budapest 10-11 October 2011 Vittorio CAFFI 1 Questions to address Why a Minimum Standard? Who is concerned? When has to be implemented? What is it? How can it be

Plus en détail

Institut d Acclimatation et de Management interculturels Institute of Intercultural Management and Acclimatisation

Institut d Acclimatation et de Management interculturels Institute of Intercultural Management and Acclimatisation Institut d Acclimatation et de Management interculturels Institute of Intercultural Management and Acclimatisation www.terresneuves.com Institut d Acclimatation et de Management interculturels Dans un

Plus en détail

BA (Hons) French with Translation Studies F/T SH 322F

BA (Hons) French with Translation Studies F/T SH 322F BA (Hons) French with Translation Studies F/T SH 322F 1. Rationale With the advent of globalization, translation studies have become an imperative field to be taken on-board by department of languages.

Plus en détail

SENEGAL DIAGNOSTICS DE LA GOUVERNANCE TRANSPORTS ET TRAVAUX PUBLICS

SENEGAL DIAGNOSTICS DE LA GOUVERNANCE TRANSPORTS ET TRAVAUX PUBLICS SENEGAL DIAGNOSTICS DE LA GOUVERNANCE TRANSPORTS ET TRAVAUX PUBLICS FOCUS GROUPE: Sociétés Privées qui Utilisent Services de Transport Terrestre et/ou PAD Groupe A Routes et Port Les questions de Sections

Plus en détail

90558-CDT-06-L3French page 1 of 10. 90558: Listen to and understand complex spoken French in less familiar contexts

90558-CDT-06-L3French page 1 of 10. 90558: Listen to and understand complex spoken French in less familiar contexts 90558-CDT-06-L3French page 1 of 10 NCEA LEVEL 3: FRENCH CD TRANSCRIPT 2006 90558: Listen to and understand complex spoken French in less familiar contexts New Zealand Qualifications Authority: NCEA French

Plus en détail

Predisposing factors of burn out among Parisian General Practitioners Trainees. A longitudinal study

Predisposing factors of burn out among Parisian General Practitioners Trainees. A longitudinal study Predisposing factors of burn out among Parisian General Practitioners Trainees. A longitudinal study Pr Eric GALAM ; Dr Camille VAULOUP-SOUPAULT EAPH Barcelona April 21th, 2015 egalam@hotmail.com 1 Burn

Plus en détail

20 ans. Votre partenaire pour le changement. Your Partner for Change. Your Partner for Change

20 ans. Votre partenaire pour le changement. Your Partner for Change. Your Partner for Change 100 C 70 M 10 K 55 M 100 Y Offset Your Partner for Change 20 ans Votre partenaire pour le changement Your Partner for Change Basel Bern Buchs Genève Luzern Lugano Schindellegi Zürich 20 ans au service

Plus en détail

GEIDE MSS /IGSS. The electronic document management system shared by the Luxembourg

GEIDE MSS /IGSS. The electronic document management system shared by the Luxembourg GEIDE MSS /IGSS The electronic document management system shared by the Luxembourg Social Security Ministry and IGSS Introduction: The administrative context IGSS missions Legal and international affairs

Plus en détail

Natixis Asset Management Response to the European Commission Green Paper on shadow banking

Natixis Asset Management Response to the European Commission Green Paper on shadow banking European Commission DG MARKT Unit 02 Rue de Spa, 2 1049 Brussels Belgium markt-consultation-shadow-banking@ec.europa.eu 14 th June 2012 Natixis Asset Management Response to the European Commission Green

Plus en détail

How to be a global leader in innovation?

How to be a global leader in innovation? How to be a global leader in innovation? 2014-03-17 / Rybinsk Marc Sorel Safran Country delegate /01/ Innovation : a leverage to create value 1 / 2014-01-30/ Moscou / Kondratieff A REAL NEED FOR INNOVATION

Plus en détail

Lean approach on production lines Oct 9, 2014

Lean approach on production lines Oct 9, 2014 Oct 9, 2014 Dassault Mérignac 1 Emmanuel Théret Since sept. 2013 : Falcon 5X FAL production engineer 2011-2013 : chief project of 1st lean integration in Merignac plant 2010 : Falcon 7X FAL production

Plus en détail

CMBEC 32 May 22, 2009

CMBEC 32 May 22, 2009 MEDICAL DEVICE REGULATIONS OVERVIEW CMBEC 32 May 22, 2009 Sarah Chandler A/Head, Regulatory and Scientific Section Medical Devices Bureau (MDB) Therapeutic Products Directorate (TPD) 613-954-0285 sarah_chandler@hc-sc.gc.ca

Plus en détail

Génie Logiciel et Gestion de Projets

Génie Logiciel et Gestion de Projets Génie Logiciel et Gestion de Projets INFO-F-407 Ragnhild Van Der Straeten 2008-2009 ULB 1 Génie Logiciel et Gestion de Projets Organisation 2 Ragnhild Van Der Straeten VUB, 4K209 Campus Etterbeek rvdstrae@vub.ac.be

Plus en détail

Récapitulatif du budget et du plan de financement (en milliers de dollars des États-Unis) Catégorie de dépenses FIDA Cofinancement 1 Gestion des projets 270 000 110 000 Consultants recrutés pour de courtes

Plus en détail

C est quoi, Facebook?

C est quoi, Facebook? C est quoi, Facebook? Si tu as plus de 13 ans, tu fais peut-être partie des 750 millions de personnes dans le monde qui ont un compte Facebook? Et si tu es plus jeune, tu as dû entendre parler autour de

Plus en détail

Developpement & Formation. Serge Dubois, BP Algeria Communications Manager

Developpement & Formation. Serge Dubois, BP Algeria Communications Manager Developpement & Formation Serge Dubois, BP Algeria Communications Manager Building capability «BP Strategy, Safety People Performance» Tony Hayward, CEO BP Octobre 2007 Human resources are the most invaluable

Plus en détail

Please find attached a revised amendment letter, extending the contract until 31 st December 2011.

Please find attached a revised amendment letter, extending the contract until 31 st December 2011. Sent: 11 May 2011 10:53 Subject: Please find attached a revised amendment letter, extending the contract until 31 st December 2011. I look forward to receiving two signed copies of this letter. Sent: 10

Plus en détail

Tier 1 / Tier 2 relations: Are the roles changing?

Tier 1 / Tier 2 relations: Are the roles changing? Tier 1 / Tier 2 relations: Are the roles changing? Alexandre Loire A.L.F.A Project Manager July, 5th 2007 1. Changes to roles in customer/supplier relations a - Distribution Channels Activities End customer

Plus en détail

Sustainability Monitoring and Reporting: Tracking Your Community s Sustainability Performance

Sustainability Monitoring and Reporting: Tracking Your Community s Sustainability Performance Sustainability Monitoring and Reporting: Tracking Your Community s Sustainability Performance Thursday, February 11 th, 2011 FCM Sustainable Communities Conference, Victoria, BC The Agenda 1. Welcome and

Plus en détail

The potential of the building sector in sustainable and lowcarbon

The potential of the building sector in sustainable and lowcarbon The potential of the building sector in sustainable and lowcarbon strategies Arab Hoballah, UNEP SUSTAINABLE AND COMPETITIVE HOTELS THROUGH ENERGY INNOVATION - NEZEH 2015 L'INNOVATION ÉNERGÉTIQUE AU SERVICE

Plus en détail

MOVILISE-Le cours en anglais pour les hommes de sport sportsman par l usage des methodes nouvelles

MOVILISE-Le cours en anglais pour les hommes de sport sportsman par l usage des methodes nouvelles MOVILISE-Le cours en anglais pour les hommes de sport sportsman par l usage des methodes nouvelles 2009-1-TR1-LEO05-08709 1 Information sur le projet Titre: Code Projet: Année: 2009 Type de Projet: Statut:

Plus en détail

HYDRODYNAMIQUE PHYSIQUE. PROBLèMES RéSOLUS AVEC RAPPELS DE COURS BY MARC FERMIGIER

HYDRODYNAMIQUE PHYSIQUE. PROBLèMES RéSOLUS AVEC RAPPELS DE COURS BY MARC FERMIGIER Read Online and Download Ebook HYDRODYNAMIQUE PHYSIQUE. PROBLèMES RéSOLUS AVEC RAPPELS DE COURS BY MARC FERMIGIER DOWNLOAD EBOOK : HYDRODYNAMIQUE PHYSIQUE. PROBLèMES RéSOLUS Click link bellow and free

Plus en détail

Génie Logiciel et Gestion de Projets

Génie Logiciel et Gestion de Projets Génie Logiciel et Gestion de Projets INFO-F-407 Ragnhild Van Der Straeten 2007-2008 ULB 1 1 Génie Logiciel et Gestion de Projets Organisation 2 2 Ragnhild Van Der Straeten VUB, 4K209 Campus Etterbeek rvdstrae@vub.ac.be

Plus en détail

Improving the breakdown of the Central Credit Register data by category of enterprises

Improving the breakdown of the Central Credit Register data by category of enterprises Improving the breakdown of the Central Credit Register data by category of enterprises Workshop on Integrated management of micro-databases Deepening business intelligence within central banks statistical

Plus en détail

GESTION DE PROJETS AGILE

GESTION DE PROJETS AGILE GESTION DE PROJETS AGILE Jean-Louis Lefèvre jean-louis.lefevre@univ-lyon1.fr 2014 AGILE & Project Management Polytech 5A JL Lefèvre P 1 QUATRE (GROS) PROBLÈMES EN GESTION DE PROJETS Classiquement, pour

Plus en détail

DICTIONNAIRE DE SPIRITUALITé ASCéTIQUE ET MYSTIQUE : DOCTRINE ET HISTOIRE...

DICTIONNAIRE DE SPIRITUALITé ASCéTIQUE ET MYSTIQUE : DOCTRINE ET HISTOIRE... Read Online and Download Ebook DICTIONNAIRE DE SPIRITUALITé ASCéTIQUE ET MYSTIQUE : DOCTRINE ET HISTOIRE... DOWNLOAD EBOOK : DICTIONNAIRE DE SPIRITUALITé ASCéTIQUE ET Click link bellow and free register

Plus en détail

GRAPHIC STANDARDS MANUAL

GRAPHIC STANDARDS MANUAL GRAPHIC STANDARDS MANUAL CHARTE GRAPHIQUE This Graphic Standards Manual is aimed at the relays of the Europe Direct information network. They are members of a single family dedicated to the same aim: the

Plus en détail

Présentation de la Boîte à Outiles du IOMC pour la Prise de Décisions sur la Gestion de produits Chimiques

Présentation de la Boîte à Outiles du IOMC pour la Prise de Décisions sur la Gestion de produits Chimiques Le projet est Présentation de la Boîte à Outiles du IOMC pour la Prise de Décisions sur la Gestion de produits Chimiques Mars 2015 Programme inter-organisations pour la gestion rationnelle des produits

Plus en détail