The GIE Sesam-Vitale details the roadmap for the Vitale card application

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The development of the Vitale card application is part of the ministerial digital health roadmap, it is recalled.

An experiment is underway by a “small panel of insured persons” of the primary health insurance funds (CPAM) of the Rhône and the Alpes-Maritimes and the mutual social security funds (MSA) of Ain-Rhône and Provence-Azur.

Its use will be gradually extended before generalization nationwide from the fourth quarter of 2022, for policyholders aged 12 and over from all health insurance plans, said GIE Sesam-Vitale on Tuesday.

It will be available on the application stores of Android and iOS (Apple) phones.

In November, it will be open to insureds aged 16 and over with CPAM, MSA and MGEN in the Alpes-Maritimes and Rhône, i.e. nearly 2 million people.

This first phase will ensure that the application works well with phones, operating systems and card reading devices used by healthcare professionals.

From April 2022, the departments of Loire-Atlantique, Saône-et-Loire, Sarthe, Bas-Rhin, Seine-Maritime and Puy-de-Dôme will bring 3.5 million additional policyholders.

The departments of Paris, Hérault, Nord and Gironde will join them in June 2022, with around 5 million additional policyholders.

A draft decree consulted by APMnews / TICsanté at the end of 2020 provided for extend and expand the experiment to these departments, we note.

In total, 10 million potential policyholders are affected by this deployment phase. The GIE Sesam-Vitale estimates that around 7 million will be able to use the application because of the rate of equipment in smartphone and the existence of a number of incompatible devices.

The application is not intended to replace the smart card Vitale, underlined the GIE. The two devices will exist in parallel and the insured will be able to use one or the other.

In 2021, the application continues to offer services identical to the Vitale card, explained the GIE: electronic treatment sheets (FSE), access to the shared medical file (DMP), to the pharmaceutical file (DP), to the Amelipro portal, and integrated teleservices (TLSi) for health insurance.

From 2022, new services will be available.

The “emblematic service” is the “identity provider”, which will allow policyholders to identify themselves and authenticate themselves on digital health portals and applications, for example appointment booking or ordering services. medical transport.

The application will offer an “identity portfolio” which will complete the compulsory health insurance data (AMO) of the beneficiary and his beneficiaries with the national health identity (INS), the identification data of complementary health insurance (AMC), and finally civil status, which will allow the ApCV to be used to connect to France Connect.

AMC’s data should be available “at the end of 2022” in the application, said the GIE.

A second service “eagerly awaited by policyholders” is planned for 2022: delegation to a third party, which will allow delegation of temporary use of their Vitale card to a third party from the application, without any physical action.

New uses for healthcare establishments

Following a Call for projects carried out in 2020, the GIE enriched the application roadmap with new uses, in particular for healthcare establishments.

In 2022, the application will be able to be used during pre-admission or admission to terminals or with reception agents.

This use case was presented by the public interest group (GIP) Cpage and Doctolib.

The application “will transmit all the administrative data of the patient to avoid him having to go to the entry office”, thus avoiding the agents having to re-enter information and reducing the risk of entry error, explained Damien Rebours, responsible for Cpage development projects.

The patient will gain 20 to 30 minutes per consultation, and the reduction in the number of people at the entrance office will reduce the waiting time by 10 minutes, estimated Aurélie Paget, project manager at Doctolib.

On the establishment side, the application will save four minutes per file and improve the quality of patient files by strengthening identity vigilance and the calculation of rights upstream, she added.

The application “will not replace” the integrated rights consultation teleservices (CDRi) and reimbursement of complementary organizations (ROC), it “will make it possible to retrieve the information necessary for calling these teleservices thanks to identity verification”, underlined Damien Rebours.

An experiment will begin in the second quarter of 2022 in public and private pilot establishments. A review will be carried out at the end of the year before generalization to all establishments in 2023.

A second use case has been identified around teleconsultations.

The application will be able to “facilitate the third party payment, because the practitioner will be able to have confidence in the identity of the patient”, certified by the application, and thus “to dispense with the bank pre-authorization of payment generally carried out upstream of the teleconsultation. , which can be a brake for some patients “, explained Richard Kritter, director of development of Maiia (Cegedim group).

In addition, it will allow practitioners “to limit time slots to their known patient base”, who will therefore have to authenticate with their application to make an appointment.

Several features are expected in 2023.

The GIE Sesam-Vitale wants the application to comply with the European security reference system eiDAS (Electronic IDentification And trust Services), which will allow the application to “fulfill all the obligations of identitovigilance” provided for by the national reference system ( RNIV), whose publication has started.

“The technical doctrine of digital health positions the application as the reference identification service in the health and social sector”, recalled the GIE.

Likewise, the collection of consent for administrative formalities in place of the signature on paper is planned for 2023, for health establishments but also by teleconsultation.

Its extension to cases of medical uses will be studied, but “it will require raising the level of guarantees”.

Finally, a use case for medical transporters is expected in 2023.

The application will make it possible to identify oneself in medical transport ordering applications and automatically transmit the data to the transporter’s billing service, explained Guillaume Philipp, general manager of the publisher specializing in medical transport Synovo.

It will “strengthen identity vigilance”: the carrier will be able to read the Vitale card application from the start of treatment, and thus ensure that he has the right patient and that his information is complete. The patient will have no other documents to present and the staff will have no information to enter, only a QR code to read. He can also sign the certificate of service made in the application.

The regulatory framework for the application, which is currently based on temporary measures, must become permanent “by the end of 2022”.

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