Key Benefits:
The Minister of Solidarity, Health and the Family,
Given the code of public health, including articles L. 1112-1, L. 6113-7, L. 6113-8, R. 710-5-1 to R. 710-5-11, R. 710-5-23, R. 710-5-24 and R. 714-3-43;
In view of the Code of Social Security, in particular Articles L. 162-22-6 and following;
In the light of the Penal Code, in particular Articles 226-13 and 226-14;
In the light of Law No. 78-17 of 6 January 1978 relating to computers, Files and freedoms, as amended by Act No. 2004-801 of 6 August 2004 on the protection of natural persons with regard to the processing of personal data, in particular its Chapter X;
Law n ° 2003-1199 of 18 December 2003 Social Security Funding for 2004, including Article 25;
In view of the letter from the National Commission on Informatics and Freedoms dated 26 October 2004, number 04-1064,
Stop:
I. -Within each institution, the categories of information recorded in the HPSR are:
1 ° Patient identification information:
-identification number Patient permanent (NIPP);
-patient's date of birth;
-sex of patient;
-postal code of place of residence or place of patient care;
2 ° Other information:
-identification of health care facility in National Health and Social Facility (FINESS) file:
-the legal entity's FINAL number;
-the institution's number FINESS; and
-the number of stay in hospital stay at home: Hospital stay at home;
-date of entry;
-mode of entry and provenance;
-exit date;
-exit mode and destination;
-sequence number in full stay;
-start date Of the care sequence;
-the end date of the care sequence;
-primary care mode;
-associated support mode, if any;
-primary diagnostic;
-Karnofsky index;
-scoring the Dependency on activities of daily life;
-subsequence number within each care sequence;
-subsequence start date;
-end date of subsequence.
This information must conform to the content The medical folder.
II. -With the exception of 1 ° of the I of this article, if the person was treated on the condition of anonymity, the identity information is limited to the year of birth, sex, and the patient's residence number.
I. -The main and associated modes of care are coded according to the list provided in Annex I. The Karnofsky index is listed according to the grid provided in Annex II. Dependence on the activities of daily living is listed in a grid provided in Appendix III. The main diagnosis is coded according to the 10th revision of the International Classification of Diseases of the World Health Organization (ICD 10) and according to the relevant extensions provided for in the document set out in Annex IV to the present Stopped.
II. -Several summaries by subsequence (RPSS) can be produced successively during a stay. A subsequence summary is produced for each billing period within the same care sequence. A sequence of care is defined by a particular combination of primary care mode (PM), possibly associated support mode (MA), and Karnofsky (IK) index. During a stay, there may be several sequences of care. The sequence of care changes with each change in the MP or MA or IK. A methodological guide, set out in Annex V to this Order, provides details on the production and coding of HPSR.
III. -The main support mode combinations, the associated support mode, and the Karnovsky index are called homogeneous support groups (GHPC). All possible combinations are not allowed. The list of homogeneous groups of authorised care is set out in Annex VI to this Order. Each homogeneous group of support is assigned a weighting index, for implementation of the activity pricing.
Each subsequence summary is grouped into a homogeneous group of rates as listed And set out in Annex VII to this Order.
I. -In the framework of the provisions laid down in Articles R. 710-5-1 to R. 710-5-11 of the Public Health Code, the Medical Information Officer is responsible for the Constitution, from the data File, from a RPSS file.
II. -The physician in charge of medical information implements the grouping of HPSR into homogeneous groups of rates (GHT) and performs the processing of the nominative medical data necessary for the analysis of the activity. According to modalities adopted after the opinion of the Medical Commission or the medical conference of the establishment, it shall ensure the dissemination of the information resulting from these treatments to the management of the health care facility, the President of the Medical commission or medical conference of the institution, to practitioners who provided care, under conditions that guarantee confidentiality of data and anonymity of patients. It is informed of the purpose of the processing of the information requested and is involved in the interpretation of their results.
It ensures the quality of the data transmitted to it and advises the medical facilities and Medico-techniques for their production.
Under the conditions laid down by law, public health inspectors and practitioners of health insurance organisations have access, through the information doctor Medical, to HPSR files. As part of the monitoring and data validation procedures, the practitioners responsible for the relevant structures are informed in advance of any HPSR confrontation with a medical file.
It consists, under the responsibility of the physician referred to in section 4, of anonymized summary files (RAPSS). Products by a computer program owned by the state, RAPSS has a key to chaining patient stays, built by the irreversible anonymization of the social security number, sex and date of birth, as well as All EPSS information with the exception:
-the patient's permanent identification number (NIPP);
-the HAD residence number, replaced by the sequential HAD residence number;
-the date of birth, replaced by The age calculated on the date of entry into the year and days (for children less than one year at that date);
-the postal code of residence or the place of care, replaced by a geographical code assigned according to a list agreed at national level, in Agreement with CNIL;
-start dates, start of sequence, and start of subsequence;
-end dates, end of sequence, and end of subsequence.
The following variables are added to the RAPSS :
-the time between the start date of the sequence and the date of entry in the stay;
-the time between the start date of the subsequence and the start date of the sequence;
-the number of days of the stay;
-the number of days Sequence;
-the number of days in the
subsequence-the month and end year of the subsequence.
A coupling file between the invoices and the HPSR is made. This file includes:
-the input number (listed on the billing slip);
-the invoice number (listed on the billing slip);
-the residence number (in the HPSR);
-the sequence number (in the HPSR) ;
-the subsequence number (in the HPSR).
This file is the responsibility of the physician responsible for medical information and is stored in the institution.
I. -The institution transmits quarterly to the regional agency of the hospital, by means of a teletransmission approved by the services of the State concerned, the data files referred to in Article 5. These cumulative data files are relative to the subsequences of patients whose end-of-sequence date is within the considered calendar quarter and, on the other hand, within the previous quarter or quarters of the current year. They are transmitted one month at the latest after the end of the relevant calendar quarter.
The files are from the latest version of the computer programs that generate anonymous subsequence summaries (RAPSSs) made available to them. Institutions by the State, and of which the State remains the owner. These programs attribute to each RAPS a key to chaining a patient's stay, built by the irreversible anonymization of the patient's social security number, date of birth and
. -Each regional hospital agency shall transmit all or part of this data to those of the sickness insurance bodies or the services of the State of the region which contribute to its activity, in accordance with the specified terms and conditions In the application for authorisation granted by the CNIL.
The regional hospital agency shall transmit to the technical agency information on the hospitalization, no later than 30 April of the current year, the files consisting of the whole Information provided by the health care institutions in the region in the previous calendar year.
The regional hospital agencies or the technical agency for hospitalization information communicate these files To any other sickness insurance body provided that it has been authorised to deal with them by the National Committee on Informatics and Freedoms under the provisions of Chapter X of the Act of 6 January 1978 referred to above.
III. -Within each hospital structure at home, the physician in charge of medical information backs up the subsequence summary file (RPSS), which is the source of the anonymized sub-sequence (RAPSS) files and ensures the Retention of copy produced for five years.
The director and the chairman of the medical commission or medical conference of the institution shall be the recipient of statistics for the structure or, on their request and under the conditions laid down in the Chapter X of the Act of January 6, 1978, as amended relating to computer, files and freedoms, anonymized summaries by subsequence (RAPSS) or extracts from data from these files.
The Director of Hospitalization and the Organization of Care in the Ministry of Solidarity, Health and Family Affairs shall be responsible for the execution of this Order, which shall be published in the Official Journal of the French Republic.
Done at Paris, December 31, 2004.
Philippe Douste-Blazy
Note. -The decree, accompanied by its annexes, will be published in the Official Gazette of the Ministry of Solidarity, Health and Family Affairs No. 2005-1, available at the Official Journals Directorate, 26 rue Desaix, 75015 Paris, at a price of 7.83 EUR.
