Heva: Design office and data controller
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CNIL and transparency
France has a number of medico-administrative databases containing exhaustive, centralized information provided by social security organizations and hospitals.
These medico-administrative databases are reimbursement databases. Although they were created with the aim of tracking healthcare expenditure (payment of benefits, calculation of budget allocations, etc.), they are also an invaluable resource for a wide range of healthcare research activities. They provide exhaustive, permanent coverage of the entire population in a variety of fields, and enable health data to be collected individually and prospectively, in order to develop a better understanding of care pathways and the cumulative costs of different pathologies on a national or regional scale. Few countries have this type of nationwide information system, which can be used to gain knowledge of the healthcare system and improve its operation.
Given the growing interest of public and private research players in epidemiological or medico-economic studies based on these databases, and given the risk of invasion of privacy, the law to modernize the healthcare system reformed the system for accessing medico-administrative health data in 2016. This law modifies the legal framework, the opening of these databases and their governance.
The two main objectives of this law concerning data are:
- Open access to all data that does not present a risk of re-identification, by distributing it in the form of Open Data datasets; ;
- Limit and regulate access to indirectly nominative data (risk of re-identification), based on the following criteria: public interest purpose, quality of the protocol, need for access to data, security of procedures and quality of the applicant.
In 2017, this law led to the creation of the’National Institute for Health Data (INDS), which becomes the single point of entry for requests for access to the medico-administrative databases making up the new National Health Data System (SNDS).
The « Health data platform »or « Health Data Hub (HDH)» was created on November 30, 2019. It replaces the INDS and expands its previous missions in order to cross-reference the healthcare databases available in France and facilitate their use by the many research and development teams, while fully respecting the privacy of healthcare system users.
The company Heva, as a certified design office for the implementation of health data processing, via the HDH and the CNIL, carries out studies on all the databases making up the SNDS, in particular the following:
- The PMSI (Programme de médicalisation des systèmes d'information), which is a medico-administrative database managed by the’Agence Technique de l'Information sur l'Hospitalisation (Technical Agency for Hospital Information) (ATIH) since 2000. It collects all the activity of healthcare establishments; ;
- SNIIRAM (Système National d'Information Inter Régimes de l'Assurance Maladie) which is a medico-administrative database managed by the Caisse Nationale d'Assurance Maladie (CNAM), which collects all health insurance reimbursements made in towns and cities, the Inter-regime consumption datamart (DCIR) and hospitalization data by chaining with the PMSI; ;
You will find below the various information and transparency measures concerning the studies carried out on the medico-administrative databases in which Heva is involved.
ADAPT-Single decision 2019-112
PMSI data is processed by Heva to feed the ADAPT website, a decision-making tool used to draw up medical projects for healthcare establishments, and to plan and optimize the healthcare offering through pre-calculated aggregate activity indicators.
This decision-support tool has the following main objectives:
- Drawing up medical projects for healthcare establishments, taking into account their environment, in terms of healthcare provision and costs, and meeting their legal obligation to analyze their activity (article L. 6113-7 of the Public Health Code); ;
- Planning care provision through comparative analysis of care activities, study of catchment areas (attractiveness, leakage), study of collaboration between establishments within a defined perimeter; ;
- Enhancing the value of our care offering through the development of indicators for managing and enhancing the value of stays.
As provided for in the single decision, you will find below the number of requests made using the ADAPT solution and their breakdown by category:
| Period | Number of requests | Field of activity | Ambulatory (AM) | Ambulatory (GDR) | Category of care activity | Homogeneous Group of Patients (GHM) | Relevance of care |
|---|---|---|---|---|---|---|---|
| From 04/09/2019 to 05/09/2020 | 1324 requests by 43 users | 35.12% | 0.83% | 1.28% | 14.58% | 46.45% | 1.74% |
| From 06/09/2020 to 13/09/2021 | 1024 requests per 30 users | 54.2% | 4.3% | 1.07% | 18.26% | 20.9% | 1.27% |
| From 09/14/2021 to 09/05/2022 | 1144 Requests by 51 Users | 28.1% | 0.5% | 0.2% | 3.5% | 67.0% | 0.7% |
ADAPT-Single decision 2022-064
PMSI data is processed by Heva to feed the ADAPT website, a decision-making tool used to draw up medical projects for healthcare establishments, and to plan and optimize the healthcare offering through pre-calculated aggregate activity indicators.
This decision-support tool has the following main objectives:
- Drawing up medical projects for healthcare establishments, taking into account their environment, in terms of healthcare provision and costs, and meeting their legal obligation to analyze their activity (article L. 6113-7 of the French Public Health Code); ;
- Planning care provision through comparative analysis of care activities, study of catchment areas (attractiveness, leakage), study of collaboration between establishments within a defined perimeter; ;
- Enhancing the value of our care offering through the development of indicators for managing and enhancing the value of stays.
| Period | Number of requests | Field of activity | Ambulatory (AM) | Ambulatory (GDR) | Category of care activity | Homogeneous Group of Patients (GHM) | Relevance of care |
|---|---|---|---|---|---|---|---|
| From 05/09/2022 to 04/09/2023 | 1144 requêtes par 51 utilisateurs | 28.1% | 0.5% | 0.2% | 3.5% | 67.4% | 0.7% |
| From 05/09/2023 to 04/09/2024 | 733 requests by 30 users | 31.4% | 0.8% | 0.8% | 3.1% | 63.4% | 0.4% |
| Du 05/09/2024 au 04/09/2025 | 491 requêtes par 24 utilisateurs | 24.6% | 0% | 0.4% | 3.5% | 71.1% | 0.4% |
ADAPT-Décision Unique 2025-048
PMSI data is processed by Heva to feed the ADAPT website, a decision-making tool used to draw up medical projects for healthcare establishments, and to plan and optimize the healthcare offering through pre-calculated aggregate activity indicators.
This decision-support tool has the following main objectives:
- Drawing up medical projects for healthcare establishments, taking into account their environment, in terms of healthcare provision and costs, and meeting their legal obligation to analyze their activity (article L. 6113-7 of the French Public Health Code); ;
- Planning care provision through comparative analysis of care activities, study of catchment areas (attractiveness, leakage), study of collaboration between establishments within a defined perimeter; ;
- Enhancing the value of our care offering through the development of indicators for managing and enhancing the value of stays.
| Period | Number of requests | Field of activity | Ambulatory (AM) | Ambulatory (GDR) | Category of care activity | Homogeneous Group of Patients (GHM) | Relevance of care |
|---|---|---|---|---|---|---|---|
ESND-Single decision 2022-039
Using data from the SNIIRAM sample, the ESND (Échantillon du Système National des Données de Santé - National Health Data System Sample), the purpose of processing is to enable Heva to determine whether certain research projects can be carried out solely using data from the SNIIRAM sample, when the latter is sufficiently representative of the population of interest, or whether SNIIRAM data processing is necessary.
We query this sample to count the number of patients suffering from a pathology of interest, or with a management of interest (drugs, medical devices, medical procedures or hospitalizations).
Subsequent data processing of the SNDS that may be implemented following these exploratory requests will fall within the framework of the provisions of Articles 66, 72 and following of the amended "Informatics and Liberties" law, which require that each research, study or evaluation project be justified by public interest and be subject to its own formalities.
ESND-Single decision 2024-005
Using data from the SNIIRAM sample, the ESND (Échantillon du Système National des Données de Santé - National Health Data System Sample), the purpose of processing is to enable Heva to determine whether certain research projects can be carried out solely using data from the SNIIRAM sample, when the latter is sufficiently representative of the population of interest, or whether SNIIRAM data processing is necessary.
We query this sample to count the number of patients suffering from a pathology of interest, or with a management of interest (drugs, medical devices, medical procedures or hospitalizations).
Subsequent data processing of the SNDS that may be implemented following these exploratory requests will fall within the framework of the provisions of Articles 66, 72 and following of the amended "Informatics and Liberties" law, which require that each research, study or evaluation project be justified by public interest and be subject to its own formalities.
Minimisation des sources-ESND-Décision Unique 2025-018
Using data from the SNIIRAM sample, the ESND (Échantillon du Système National des Données de Santé - National Health Data System Sample), the purpose of processing is to enable Heva to determine whether certain research projects can be carried out solely using data from the SNIIRAM sample, when the latter is sufficiently representative of the population of interest, or whether SNIIRAM data processing is necessary.
We query this sample to count the number of patients suffering from a pathology of interest, or with a management of interest (drugs, medical devices, medical procedures or hospitalizations).
Subsequent data processing of the SNDS that may be implemented following these exploratory requests will fall within the framework of the provisions of Articles 66, 72 and following of the amended "Informatics and Liberties" law, which require that each research, study or evaluation project be justified by public interest and be subject to its own formalities.