European Union of Private Hospitals

A pragmatic and inclusive approach to clinical research in rehabilitation

Interview with

Catherine Miffre, Administrator of the Health cooperation grouping – Cooperative innovation in the health care pathway (GCS CIPS, France)
Nelly Heraud (PhD), Director of Research (Clinical Research and Innovation Directorate)

Your organisation does private clinical research in the field of rehabilitation, what are its objectives?

Clinical research – which should not be confused with innovation or R&D – covers all scientific studies carried out on the human being. We are somewhat of a precursor in this activity since we started our first clinical research projects more than 30 years ago, on the one hand in the field of rehabilitation of the chronically ill, which was still little explored, and on the other hand in the private health sector. Our work focuses on the health pathway of the chronically ill and the frail.

We see clinical research as a driver of medical progress, as it contributes to the creation of new knowledge and the development of treatments and care protocols. Where appropriate, it can contribute to the rationalisation of health insurance expenditure by optimising care.

Among our objectives, we wish to encourage the development of new therapeutic and organisational practices, and to raise awareness and train therapeutic teams in the culture of clinical research in our member structures, which are low-capacity institutions. Indeed, the pooling of resources and results is the driving force behind our organisation. Each member clinic of the GCS, and more broadly our entire sector of activity, will benefit from innovations thanks to the investments made and the scientific valorisation of our work. We work closely with the academic world and the public hospital sector, while integrating the specificities of the private sector.

What is the particularity of your organisation?

The Health cooperation grouping (GCS CIPS), although mainly composed of Korian structures (medicine, mental health and rehabilitation), is open to all private establishments and more particularly to the structures of Medical Rehabilitation Care (French : SMR). This wide opening is a real specificity which favours access to clinical research for independent establishments with a low capacity and federates the scientific ambitions of the teams.

We have also taken the gamble of relying on the skills of graduate researchers (PhD) who are made available to the Health cooperation grouping by Korian and certain member establishments. This is one of the particularities of our organisation. Moreover, the authors of the publications include therapeutic teams, with very diverse profiles, and therefore not only doctors. Our approach is pragmatic and inclusive.

What difficulties do you encounter?

Funding is the key. It is a permanent battle to find the necessary resources because the clinical research system in France is designed and organised around the public sector, with the primary funding criteria based paradoxically on the quantity of publications, and less on the quality of the articles, which automatically puts us in a weak position. Our publications in indexed journals are nevertheless scientifically recognised at the international level, with 80% of publications in category A or B. Despite this, we have enormous difficulties in obtaining administrative support and access to the full range of funding.

Is there any European cooperation?

Our research work takes place in France but the scientific articles are published in international indexed journals with a high impact factor, after submission to reading committees.

The factors limiting international cooperation are the complexity of the organisation of health research in each European country, the relatively small size of our Health cooperation grouping, and its limited financial capacity. The integration of the Korian group, which has an international scope, into our grouping facilitates the dissemination of good practices beyond France.

Among the European experiences and perspectives, we are partners in a consortium (M Réhab) which has benefited from financial support from the Occitanie Pyrénées-Méditerranée region and the European Regional Development Fund (ERDF). The active involvement of the Korian group with a European scope, and, we hope, the support of the UEHP, should in many respects facilitate this desired opening.

Some figures

  • 69 establishments included in the Health cooperation grouping (GCS CIPS)
  • 25 studies in progress: 10 investigation disciplines; more than 50 professionals in the field; 8 institutional partnerships (research laboratories, universities, University hospitals (CHU), Korian Foundation…)
  • 850 patient volunteers included in research projects over the last 5 years
  • 80% of the projects include several establishments
  • For 80% of the studies, the promotion is totally supported by the Health cooperation grouping
  • 70% of the projects are on RIPH1 and RIPH2 type studies (research involving the human person)
  • 50 international scientific publications in the last 5 years
  • More than 100 communications at national and international scientific conferences