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Background and Objective: The increasing implementation and use of electronic health records over the last few decades has made a significant volume of clinical data being available. Over the past 20 years, hospitals have also adopted and implemented data warehouse technology to facilitate the reuse of administrative and clinical data for research. However, the implementation of clinical data warehouses encounters a set of barriers: ethical, legislative, technical, human and organizational. This paper proposes an overview of difficulties and barriers encountered during a clinical data warehouse (CDW) development and implementation project., Methods: We conducted a focus group at the 2023 Medical Informatics Europe Conference and invited professionals involved in the implementation of CDW. These experts described their CDW and the difficulties and barriers they encountered at each phase: (i) launching of the data warehouse project, (ii) implementing the data warehouse and (iii) using a data warehouse in routine operations. They were also asked to propose solutions they were able to implement to address the barriers previously reported., Results: After synthesis and consensus, a total of 26 barriers were identified, 10 pertained to tasks, 5 to tools and technologies, 4 to persons, 4 to organization, and 3 to the external environment. To address these challenges, a set of 15 practical recommendations was offered, covering essential aspects such as governance, stakeholder engagement, interdisciplinary collaboration, and external expertise utilization., Conclusions: These recommendations serve as a valuable resource for healthcare institutions seeking to establish and optimize CDWs, offering a roadmap for leveraging clinical data for research, quality enhancement, and improved patient care., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Basic epidemiological data are rare concerning the activity of specialized forensic psychiatric facilities in France. Here, we investigated the activity of the ten (640 beds) French "units for difficult patients" (unités pour malades difficiles [UMDs])., Method: We used the Programme de médicalisation des systèmes d'information (PMSI) database to describe the characteristics and evolution of psychiatric hospitalisations in UMDs between 2012 and 2021, as well as the age, sex, and principal diagnoses of the patients hospitalized in these facilities., Results: Between 2012 and 2021, 4857 patients were hospitalized in UMDs (6082 stays). Among them, 897 (18.5%) had more than one stay. The number of admissions ranged from a minimum of 434 to a maximum of 632 per year. The number of discharges ranged from a minimum of 473 to a maximum of 609 per year. The mean length of stay was 13.5 (SD: 22.64) months with a median of 7.3 months (IQR: 4.0-14.4). Among the 6082 stays, 5721 (94.1%) involved male patients. The median age was 33 (IQR: 26-41) years. The most frequent principal psychiatric diagnoses were psychotic disorders and personality disorders., Conclusion: The number of individuals hospitalized in specialized forensic psychiatric facilities has been stable for 10 years in France and remains lower than in most European countries., (Copyright © 2023 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)