Accessible Protocols in Consultation

• Enhanced Quality and Safety: Strengthens the quality and safety of existing practices through formalization, harmonization, and securitization.
• Integration with Professional Software: Codified NPI can be integrated into healthcare management software.
• Digital Documentation: Access to documentation from computers, tablets, or smartphones for ease of use.
• Broad Validation: Extends validation to all relevant professionals in the region.
• Quick and Easy Access: Facilitates rapid access to information at critical decision-making moments for prevention and care.
• Simplicity in Tracking: Eases the follow-up and evolutionary process of best implementation practices (e.g., identifying barriers, professional leadership, availability of training and support).

Quality Control and Adherence to Protocols

• Traceability: Utilizes unique coded protocols for tracking.
• Strengthened Care Link: Enhances the relationship between care provision and patient support.
• Monitoring Relevant Indicators: Provides tools for tracking key performance indicators.
• Continuous Education Tool: Serves as a resource for ongoing professional development.
• Regular Updates: Incorporates regular updates based on user feedback.

Means of Valuation

• Response to Identified Multidisciplinary Issues: Addresses problems identified by healthcare teams in a specific territory.
• Extended Roles for Various Professionals: Expands the roles of many professionals, particularly non-physicians.
• Elimination of Ineffective Protocols: Phases out protocols that are ineffective, hazardous, or costly.
• Reduction in Meeting Time: Decreases the need for multiple meetings focused on intervention planning.
• Support for Innovation: Encourages professionals to experiment with new practices, boosting their confidence.
• Financial Valuation: Ensures appropriate financial and resource allocation for effective implementation.

Immaterial practices of prevention and care have existed since ancient times. However, the diversification of practices, the multiplication of professions at the intersection of prevention, care, and social assistance, and the globalization of information systems have leveled these services and obscured them at a time when medicine has made significant advances in the early detection and diagnosis of health issues. The interdisciplinary and multisectoral approach of the NPIS generates a value chain, from the design of practices to their implementation, regulation, and financing.

Innovative economic model initiatives are emerging worldwide, including fee-for-service, bundled payments, social economy provisions, offers promoting sustainable development, e-health economy, human innovation bundles, and long-term economy (World Economic Forum, 2024). The NPIS Prospective Pole, led by Michel Noguès, documents these initiatives in books (Noguès, 2022; Noguès, 2024). The NPIS Forums invite all innovators to share their experiences.

PSYCHOSOCIAL DOMINANCE

Psychotherapies:

• Cognitive Stimulation Therapy for memory strategies in Alzheimer’s disease in 14 sessions by a psychologist in a healthcare facility, health center, or private practice.
• Mindfulness Based Stress Reduction (MBSR-BC) program against anxiety during cancer treatments in 8 group sessions by a clinical psychologist, psychiatrist, or physician in an oncology department, a patient association, a private practice, a health center, or a healthcare facility.
• Acceptance and Commitment Therapy for chronic pain in 9 group sessions by a clinical psychologist or psychiatrist in a healthcare facility, health center, or private practice.
• Cognitive Behavioral Therapy for Insomnia (CBT-I) in 6-8 individual sessions, either remote or in-person, by a neuropsychologist, clinical psychologist, psychiatrist, or neurologist in a healthcare facility, health center, or private practice.
• Now I Can Do Heights program using virtual reality to treat acrophobia (fear of heights) by a clinical psychologist or psychiatrist in a private practice or health center.

Health Prevention Programs:

• Living Well with COPD therapeutic education program against symptoms and exacerbations of COPD over 2 months with 4 sessions, in-person or remote, by a nurse, physician, or pharmacist in a healthcare facility, health center, or private practice.
• CHESS Method (Chronic Headache Education and Self-management) for migraine self-management by a nurse or physician in a healthcare facility, health center, or private practice.
• MyFriend Youth Program for preventing anxiety and depression among students aged 12 to 15 years, 10 sessions by a school psychologist or school nurse in an educational institution.
• Spiegel Hypnotherapy Method specialized in smoking cessation in 3 sessions by a psychologist, nurse, physician, or hypnotherapist in a private practice, healthcare facility, health center, or private practice.
• Cognitive Behavioral Therapy for Depression (CBT-d) by a clinical psychologist or psychiatrist in a healthcare facility, health center, or private practice.

CORPOREAL DOMINANCE

Physiotherapy Protocols:

• McKenzie Method for back pain by a physiotherapist in a healthcare facility, health center, or private practice.
• Pelvic Floor Muscle Training (PFMT) program by a midwife or physiotherapist in a health center or private practice.
• Rehabilitation program following hip prosthesis in 6 to 10 sessions by a physiotherapist in a healthcare facility, health center, or private practice.

Adapted Physical Activity Programs:

• Dance Therapy for Parkinson’s Disease addressing psychological symptoms of Parkinson’s by a physical activity instructor in a healthcare facility, health center, or private practice.
• Re-exercise program at ventilatory threshold against dyspnea caused by COPD by a physical activity instructor or physiotherapist in a healthcare facility, health center, or private practice.
• Anti-fatigue APA program during treatments for breast, prostate, or colon cancer by a physical activity instructor in a healthcare facility, health center, or private practice.

Thermal Treatments:

• Specialized thermal cure for gonarthrosis by a physiotherapist or thermal agent in a thermal facility.

NUTRITIONAL DOMINANCE

• Gluten-free diet for celiac disease by a dietitian in a healthcare facility, health center, or private practice.
• FODMAP diet for gastrointestinal disorders by a dietitian in a healthcare facility, health center, or private practice.

As of April 2019, there were 46 evaluation models for NPI in the scientific literature (Carbonnel and Ninot, 2019). These models were constructed by researchers for researchers, often from a monodisciplinary perspective and rarely from a patient-centered approach. This led to significant heterogeneity in study protocols and the way NPI were conceived (approach, method, technique, or materials). The results were scattered, debatable, poorly transferable, and rarely reproducible. Consequently, these practices were not widely recognized outside the study context (dependent on the establishment and/or practitioner). This situation raised doubts about their effectiveness (e.g., efficacy, safety, relevance, utility, cost-effectiveness), their content (e.g., heterogeneity in doses, procedures, ingredients, techniques, contexts, target populations), their approval (e.g., ethics committees), their dissemination (e.g., conflicting reviewer opinions), their teaching (e.g., protocols, best practices), and their recognition (e.g., authorization, integration into official classifications, reimbursement). This lack of a consensual evaluation model for NPI suggested that each professional had to reinvent their program for every new patient, given the wide or contradictory recommendations from authorities, agencies, and scientific societies. It also implied that only the patient-provider relationship mattered in the health effects induced (Ninot, 2020). Moreover, it left the door open for pseudoscientific practices and, more broadly, parallel medicine, along with all the obscurantist, health-related, sectarian, political, and judicial issues that are known in France (Miviludes, 2022; CNOI, 2023; CNOM, 2023) and around the world (Ernst and Smith, 2018). This idea was also gaining traction in the United States in the field of oncology, aiming to juxtapose two medical offerings: one based on experimental science, primarily focused on surgery, medication, radiotherapy, and medical devices, and the other described as "complementary, integrative, or traditional," based on individual experience, opinions, and traditions (Mao et al., 2022). This second offering claimed exclusivity in the domains of prevention and care, emphasizing care for the person versus cure for the disease. Thus, the NPIS Model was co-constructed with the idea that experimental science could demonstrate the existence of effective, safe, and reproducible prevention and care protocols. This work was supported by seed funding for participatory research from INSERM and involved over 1,000 participants under the guidance of a committee of 22 multidisciplinary experts, including two user representatives. This transdisciplinary innovation is currently supported by 30 French scientific societies, the National Center for Palliative Care and End of Life, INCa, and the French Platform for Clinical Research Networks.