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.

In France, the term "professional" is broader than the term "practitioner," which is limited to the 24 healthcare professionals defined in the Public Health Code (CSP). For example, a clinical psychologist and a teacher in adapted physical activity (APA) are professionals who work for the health of individuals by offering NPI for preventive or therapeutic purposes, but they are not considered "health professionals" in the strict sense of the CSP. Some professions fall under the Social Action and Families Code (e.g., specialized educator) or the Sports Code. In Europe and worldwide, the issue becomes more complex because health-related professions do not share the same designations. For instance, "masseur-kinésithérapeute" in France is referred to as "physiotherapist" in most other countries. NPI can serve as common denominators across countries, as they will have a unique code and specification sheet.

Each NPI file in the NPI Registry has been submitted by a practitioner or researcher through the dedicated platform hosted by the NPIS. Each file undergoes review by an independent and integrated scientific committee. This committee invites relevant scientific societies and health authorities to validate the NPI files and/or to oversee the decisions made. Each validated file is then reviewed by a committee of users and professionals. Once labeled NPIS©, the file is translated into at least English and French and integrated into the NPI Registry.

The file contains standardized content supported by scientific studies that align with the NPIS definition of NPI, the expected specifications (Table 2), and the consensual evaluation framework for NPI, known as the NPIS Model. It includes a manual for professionals, an information notice for users, a section on funding options, and an area for anonymous user feedback. This ensures the file remains dynamic and part of a virtuous cycle of continuous improvement for the NPI.

A minimum of one prototypical study, one mechanistic study, two interventional studies, and one implementation study published in a peer-reviewed journal is required for an NPI proposal to be accepted by the expert committee tasked with validating the NPI file and awarding the NPIS© label. Specifically, experts must have evidence to anonymously vote on each criterion of the NPI file proposed to the NPIS by a submitter:

• Described (≥ 1 prototypical study)
• Explainable (≥ 1 mechanistic study)
• Effective (≥ 2 interventional studies)
• Safe (≥ 2 interventional studies)
• Implementable (≥ 1 implementation study in the country)

A professional must understand all the specifics of the NPI, the criteria justifying its use, how to implement its protocol, whom to contact, useful tips, required materials, and any prerequisite training needed.

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.

The NPIS has outlined a roadmap from 2021 to 2030 aligned with the strategies of European and international health institutions. To this end, it has initiated discussions with the European Public Health Association (EUPHA), involved in health service innovation, the European Centre for Disease Prevention and Control (ECDC), which is planning to create a registry, the European Commission, which aims to promote "health, nutrition, mental health, and psychosocial support to communities," and WHO Europe, which intends to identify the "most effective health interventions" by 2030. The NPIS submitted several European projects in 2024.

The NPIS is also engaging with WHO, which has advocated for "self-care interventions" since 2022, included NPI in its Global Action Plan for Mental Health published in 2022, and identified "the most effective and feasible interventions in a national context" in a report published in 2021. Additionally, it is collaborating with other international organizations such as UNESCO, which has promoted "specific health and well-being education interventions" since 2016, UNICEF, which has advocated for sharing "effective health interventions" since 2016 and developing "primary healthcare" since 2018, the UN, which has called for "accelerating essential health services" since 2023, and the Coalition of Partnerships for Universal Health Coverage and Global Health, advocating for "people-centered, comprehensive, and integrated services" since 2021.

Thus, an ecosystem for NPI, from research to practice through training and delivery, is being constructed, with NPIS actively participating. It involves all stakeholders, both academic and non-academic, to create a true value chain benefiting personalized and precision medicine based on science, sustainable health, and equitable longevity. With over 2.1 billion people aged over 60 by 2050, multistakeholder collaborations will be the foundation of a sustainable and equitable longevity economy.

This is why forums on NPI have been organized since 2024 in France and Europe, called NPIS Forum. An international summit titled NPIS Summit takes place every year in October, and regional events called NPIS Satellite gather professionals and users around a health theme.

Before evaluating an NPI, it is essential to describe it. Sometimes, health practices may involve a combination of diagnostic methods and treatments, as seen in osteopathy. An NPI is not intended to identify or diagnose a health problem; rather, it serves as a preventive or therapeutic solution to address it, sometimes in conjunction with other treatments. A common confusion lies in distinguishing between an NPI and an approach or technique. An approach is too vague and does not accurately describe the content of the NPI, while a technique is too specific, representing only one ingredient of an NPI. A prototypical study allows for the comprehensive description of all characteristics of an NPI, including its health objectives, target population, mechanisms of action, content, implementation context, and the prerequisites for the professional involved.