The phased implementation of the national health identifier

Interoperability | 21 May 2010
The national health identifier (INS) is a project that will greatly improve the structure of the healthcare sector. It responds to some major challenges, such as quality of care, and the fluidity of exchanging and sharing health data within a secure framework (see The challenges of the national health identifier (INS) : "The challenges of the national health identifier"). The INS programme specifies a phased implementation, adapted to the development trajectory of the health information systems. On overview of the INS programme’s development.
 
 

The first stages in the implementation of the INS programme 

Until the time comes when the INS is incorporated into the patient's insurance card (CV), it will be circulated via a national teleservice that will be accessible to healthcare professionals and institutions via a secure channel. The teleservice will read the patient's CV and record the identity details contained within it. The teleservice should be available in 2011. 
 
In order to respond to short-term needs, and avoid delaying the implementation of shared health information systems, a “calculated” national health identifier (INS-C) will be used. The INS-C will be available for use locally in all health information system (the electronic medical record programme for use in medical practice [LGC], hospital information system, network, etc) by applying an algorithm known by all stakeholders to a limited number of identity details extracted from the patient's CV. The choice of details used (national identification number – NIR, first name and date of birth) is intended to minimize the risk of one person being allocated more than one INS and prevent more than one person being allocated the same INS, since these personal details are among those most unlikely to change. 
 
Using this approach, over the course of 2010 it will be possible to allocate INS-Cs to some 50 million people whose NIR is contained in their CV (out of the 66 million entitled to health insurance). 
 
As under the current system, not everybody has their own individual CV, a national teleservice will be set up, which will enable healthcare professionals in particular to produce INS-Cs for people who are entitled to them.
 

A clear path for business 

The final version (1.0.0) of the planning dossier was published on 4 November 2009, following the consultation phase (which lasted from 2 July to 23 October 2009) and approval by industry representatives. 
 
Support has been provided for developers, in the form of instructions telling them how to incorporate the INS into their software: first they were given the algorithm for calculating the INS-C, along with sample code and test decks, and then they were given the application interfaces for the INS search teleservice. The pre-consultation with the software developers involved in the relaunch of the call for tenders showed that they were able to work with the INS in the short term. Some of them have already begun integrating the INS-C calculation into their software.
 
The INS steering committee
Set up in 2008, the INS steering committee (COPIL) is the authority managing the programme. In 2009 it was chaired by France's healthcare system computerization association (MISS) and its members included representatives from the following French bodies: the social security directorate; the directorate of hospitalization and healthcare organization; the general directorate of health; the national health insurance fund for salaried employees (CNAM-TS); the national old age insurance fund for salaried workers (CNAV-TS); the Sesam Vitale economic interest grouping (GIE); the healthcare professional card GIE; and the hospital information systems modernization group (GMSIH). France's data protection commission (CNIL) is also represented at COPIL meetings, when it is given an overview of the progress made. In 2009, three COPIL meetings were held.