Digital Health Education for the Future: The SaNuRN (Santé Numérique Rouen-Nice) Consortium’s Journey

Abstract Santé Numérique Rouen-Nice (SaNuRN; “Digital Health Rouen-Nice” in English) is a 5-year project by the University of Rouen Normandy (URN) and Côte d’Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is aimed at educating and training health and paramedical students in digital health. The project is a cooperative effort between URN and CAU, covering 4 French departments. It is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20-30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a 2-tier system involving facilitators who will enable the efficient expansion of the project’s educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for health care professionals in clinical practice. The SaNuRN team introduced new ways of evaluating health care professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, SaNuRN represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. SaNuRN provides a comprehensive, personalized, 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The project is enhanced using artificial intelligence and natural language processing to create virtual patients and professionals for digital health care simulation. SaNuRN teaching materials are open access. It collaborates with academic institutions worldwide to develop educational material on digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements.

1.3 Accessing health data in compliance with professional and legal requirements 1.3.1 Identifying criteria for accessing user data: understanding the regulatory framework and the concept of a care team 1.3.2Knowing the specifics of health data storage [National Health Data System (SNDS) and health data warehouses] 1.3.3Knowing what a cloud, a host, and the Health Data Hub (HDH) are 1.3.4Knowing the criminal and civil liabilities incurred 1.3.5 Respecting professional secrecy applied to medical and healthcare professions, the protection of professionals and users, and shared medical confidentiality 1.3.6Respecting the rights of users and obligations related to patient information: knowing how to behave and knowing how to do 1.

4. 3
Using suitable foundational tools and services and identifying their articulation with other shared records 4.3.1 Knowing the technical doctrine of digital health 4.3.2Using services associated with the Shared Medical Record (DMP) and My Health Space (MES) 4.3.3Knowing the various shared records [pharmaceutical record (DP), the Computerized Patient Record (DPI), and the Computerized User Record (DUI), ...] 4.3.4Knowing and implementing the guidelines for proper use of e-Prescription 4.3.5Using digital services for coordination and orientation (e-Parcours, Via trajectory) 4.4 Seeking evidence-based health information 4.4.1 Knowing reliable reference sites and recognizing fraudulent ones 4.4.2Conducting online research (defining the research and the search equation, ...) 4.4.3Identifying and evaluating the source of information 4.4.4Identifying disinformation content 4.4.5 Being able to provide users with the right resources (MES) regulation and best practices in telehealth 5.1.1Knowing the legal, regulatory, and conventional framework of telehealth 5.1.2Knowing the roles and differentiating the responsibilities of different actors in a care process (privacy protection and respect for medical confidentiality, ...) 5.1.3Being able to differentiate teleconsultation, teleassistance, telesurveillance, teleexpertise, and telecare 5.1.4Identifying inherent risks in telehealth practice 5.1.5Identifying ethical and deontological issues 5.2 Practicing telehealth in connection with the care team and in compliance with best practices 5.2.1 Implementing best practices to ensure the quality and safety of care 5.2.2 Personalizing and leading a telehealth medical or care project (design, implementation, evaluation) 5.2.3 Choosing telehealth tools suitable for practice and according to the preferences of patients and users 5.2.4 Informing and supporting the patient and their caregivers effectively

2. Cybersecurity 2.1 Designing and maintaining a secure digital work environment
Configuring workstations and mobile phones (managing antivirus and updates, data encryption and backup, using software compliant with security and confidentiality rules) 2.1.4Managing removable devices and nomadic use of equipment 2.1.5Knowing different authentication principles, the importance of strong and twofactor authentication, and managing strong passwords 2.1.6Securing email and following best practices for sending and receiving emails 2.1.7Understanding the challenges of electronic identification applied to the health sector 2.1.8Implementing best practices to secure digital environment

Interacting adequately among professionals, with the user, with caregivers and companions, and with institutions and administrations
3.2.1 Knowing the governance and actors of digital health in France (DNS, ANS, GRADeS,

Interacting on the internet while managing one's digital identity
Being aware of the e-health market and major digital French transformation programs digital (e.g.digital Segur, Hop'en, digital ESMS, ...) 4.1.4Knowing the responsibility associated with medical decisions 4.1.5Navigating through legal notices, property rights, and user rights 4.1.6Identifying functionalities and tools necessary for practice (interoperability, security, health data exchange, backup, storage, signature, SaaS or On-Premise)

Using a connected device or a mobile application and analyzing their reliability
4.2.1 Knowing the different categories of connected objects and health applications [ Higher Health Authority (HAS) frameworks, categorization, ...] 4.2.2Identifying digital tools tailored to the expectations and healthcare needs of users, as well as the associated risks 4.2.3Evaluating the reliability of a connected object or a mobile application 4.2.4Using and configuring connected objects and health applications