Context : national regulation

Since January 1st, 2021, any software that manipulates health data in France must link the data with the right patient identity. Please see https://www.identito-na.fr/referentiel-national-d-identitovigilance for more information.

INS management is also a prerequisite in other regulations (ex: telemonitoring https://esante.gouv.fr/sites/default/files/media_entity/documents/referentiel_dmn_tls_v1_1_0.pdf).

INS: definition

An INS is the association of 3 identity features

• 5 key identity traits : first name, last name, birthdate, birthplace, gender
• the social security number (matricule INS)
• the assigning authority (a technical key)

Example :

INSq: definition

To assess the level of reliability of a patient identity, the INS (Identité Nationale de Santé) has different statuses.

The highest level of reliability of patient identity is when it is 'qualified' : it is means it has been verified by a healthcare professional (check with an identity card) + double-checked with France's national databases (téléservice INSi).

Usually, for a hospital, the "master of identity" is the PAS (GAM). Identities can be shared within the master of identities's domain without having to be qualified. Outside, it is mandatory for a healthcare software to have qualified a patient identity before sharing any data related with this identity with another healthcare software.

As Lifen Platform is connected with the PAS, it is within the master of identity's domain.

As a consequence, the patient identities made available by calling Lifen's Patient API can be qualified or not. The status will be given by the following extension on the Patient resources.

"extension": [
        {
            "url": "http://lifen.fr/fhir/StructureDefinition/Patient/Extension/ReliabilityINS",
            "valueCode": "QUALI"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/birthPlace",
          "valueAddress": {
            "city": "RENNES",
            "district": "35135",
            "postalCode": "35000",
            "country": "FRA"
          }
        }
    ],

The different possible values are