The ANS and the DGOS want to accelerate the deployment of the national health identifier in 2021

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The obligation to use the registration number in the identification directory of natural persons (called “NIR” or social security number) as a national health identifier (INS) came into force on January 1, 2021, recalls t -we.

After a pilot phase started in the first quarter of 2020, the INSi teleservice (integrated INS) developed by the National Health Insurance Fund (Cnam) is “fully in production since the end of 2020”, explained the ANS.

It allows two operations: the recovery of the INS from the Vitale card or the entry of the patient’s identity traits (name, first name, sex and date of birth), and the verification of the INS “that the structure already has or which has been transmitted to it by another actor “, in a” unitary or mass “way.

This teleservice is only accessible using a nominative CPx card authentication, which is “an obstacle to deployment in certain contexts”, conceded the ANS. To remedy this, it plans to deploy “server authentication” in May.

In addition, the INS has been integrated into the framework for interoperability of health information systems (CI-SIS). An INS repository was also published after a period of consultation.

Only this repository is opposable at the present time.Concerning healthcare establishments and professionals, the national identitovigilance repository (RNIV), the publication of which began in November, will become so.

It will have 5 components, 3 of which are already available on the Ministry of Health website: the common principles of the RNIV, the RNIV for healthcare establishments and identitovigilance in non-hospital structures.

Eventually, the INS will be present in “all dematerialized exchanges” and “on all unencrypted documents, in a cartridge which will soon be standardized or in the form of Datamatrix, the specification of which is being drafted”.

The ANS is preparing to launch a communication campaign aimed at users, health and medico-social structures and health professionals, which will also be available to them.

It also intends to “intensify support for structures and professionals” with the help of “deployment relays, including regional health agencies (ARS), regional groups supporting the development of e-health (Grades ) and the health insurance network “.

Regarding publishers, the INS “implementation guide” should become enforceable “during the second quarter of 2021,” said the ANS.

“Close support” will be set up by the agency, in partnership with the economic interest group (GIE) Sesam-Vitale.

“More than 60 publishers” are now authorized to use the INSi teleservice by the national deposit and approval center (CNDA).

When questioned, the ANS and the DGOS indicated “that they do not yet have deployment indicators” in the establishments.

“During the start-up phase, we followed 10 structures, of which 6 now use the INS in production,” said the ANS. These are the CHR of Orléans, the territorial hospital groups (GHT) North West Vexin Val-d’Oise (Novo) and Dordogne, the CH Aubagne (Bouches-du-Rhône, AP-HM) and in Cahors, and the Henri-Becquerel cancer center (CLCC) in Rouen.

Successful Review phase at Cahors CH

The CH de Cahors, a support establishment for the GHT du Lot, has been a pilot site since March 2020, said its CIO, Vincent Goutines, also present at the press conference.

The project “embarked the CH Gourdon (Lot) within the framework of the convergence of the information system of the GHT, because we have a common and unique identity server”, he indicated. He mobilized “two full-time equivalents over 10 months”.

Three challenges have been identified: “having an identifier that makes it possible to secure the identity of patients, being able to distribute the recovered and integrated INS in the information system, and put the INS on all medical data shared with all the partners of patient care “, including outside the GHT.

The project was carried out on three axes: identitovigilance, for the drafting of the RNIV to which the CH contributed, the organization, with “the awareness and training of personnel”, and a final axis “more technical”.

This one “impacted the publisher [des solutions utilisées par le GHT, Dedalus] and the ISD, who had to ensure that the posts are properly updated, and that all persons required to retrieve the INS are provided with a CPE card, including the staff of the entry office who is in charge of create and manage identity. “

In December 2020, Dedalus and the CH put into production an “INS-compatible” patient administrative management software (GAP), Hexagone, and made the first calls to the INSi teleservice. Over 96% were successful.

Likewise, “more than 80% of identities are qualified, that is to say that there is a strict equivalence between the INS and the local identity of the patient”, explained the DSI.

The next steps are “the distribution of the INS to the computerized patient record” (DPI) of the GHT, DxCare of Dedalus, then “to the medical-technical software: radiology, laboratory, pharmacy…”

Finally, the ultimate goal is “to be able to exchange data with partners” outside the GHT.

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