Deployed as of 1998, SESAM-Vitale currently links more than 223,000 health care professionals with the French Health Insurance System, for the benefit of millions of insured persons who have the Vitale card. At the origin of SESAM-Vitale there was an innovating project consisting in using new technologies to simplify and accelerate exchanges, thereby doing away with any paperwork. The main benefits of the systme are an easier and faster reimbursement of health care fees as well as important gains in administrative productivity while processing patient identification, social rights and financial data.
The VITALE health insurance national card is based on de facto and de jure existing standards for interoperability with other smart card applications (.i.e. IAS, EMV, ISO). It is also one of the potential medium carrying required information for the announced electronic European Health Insurance Card (eEHIC). In this concern, the government's decision about the introduction of the VITALE card version 2 in France encompasses entitlement data for the delivery of health care abroad but inside the European Union and other EFTA countries, as it is mentioned in the Official Journal issued by Spring 2007. Moreover, SESAM-Vitale contributes to foster the European smart card and telecom industry leadership world wide.
Description of target users and groups
The SESAM-Vitale Economic Interest Grouping is at the core of the relationship between smart card-oriented business companies, health professionals, insured patients and the health insurance system. Acting on behalf the French Health Care Authorities SESAM-Vitale EIG is monitoring the program at nation-wide scale.
Description of the way to implement the initiative
The Groupement dâ€™IntÃ©rÃªt Economique SESAM-Vitale (Economic Interest Group) is a service provider whose missions are the technical expertise, the development and the promotion of the SESAM-Vitale program. The GIE SESAM-VITALE was created by the partners of the french Health Insurance to develop common solutions to meet the needs of all its members, whether they are part of the compulsory systems or the complementary insurance organizations. Basically, SESAM-Vitale is an organization integrating many components: - 50 million smart cards - An internet-based network and an email system - 25 receiving servers for electronic flows - 236 health software applications â€“ 144 software editors - 210,000 card readers - 24,600 smart card updating points The daily running of this organization requires constant monitoring of the level of service, which is currently of 99.5 % (timing, reliability, management of incidents, etcâ€¦).
Main results, benefits and impacts
Fully deployed since 2000, SESAM-Vitale is now connecting 230,000 health professionals to the Health Insurance for the benefit of the 50 millions of insured who have a Vitale card. A smart card has been distributed to all the insured and beneficiaries aged 16 years old or more. The system handles over 900 million health claim forms for reimbursement per year. Reimbursement of the insured person is managed within five days, instead of 2 to 3 weeks (paper circuit). Today, most of administrative procedures dealing with social and health insurance services of general interest are still standing on paper-based applications. Some European countries (e.g. Austria, Belgium, Finland, France, Germany, Slovenia, Italian regions, â€¦) have implemented smart card and/or telecom based applications in the social and health sector. In this respect, SESAM-Vitale is a program constantly associating many partners in the areas of high technology, industry and services .i.e.: Smart card business and industry, software editors or integrators for the health professionals, hosting services and Internet service providers, & so on & so forth, â€¦
Return on investmentReturn on investment: Not applicable / Not available
Track record of sharing
The SESAM-Vitale program has positively influenced several national or regional programs: .e.g. e-Card project in Austria, SIS/CRS project in Lombardy (Italy), the Slovenian health insurance card, the EGK project in Germany, â€¦).
Lesson 1 - Substantial dissemination actions and full support of the users (.i.e. Health Professionals, citizens) are of utmost importance. Lesson 2 - Controlling a multi cultural partnership environment is very challenging but it is one of the key factors for successful stories. Belief that previous individual work practices and mindsets are applicable without need to take account of the wider cultural environment would lead to failure. Thus, respecting partners work cultures while maintaining operational efficiency and effectiveness would be a factor for success. Further, being aware closed minds would limit learning within and from outside the company would be very helpful in this respect. Lesson 3 - Business and statutory partners needs to rely on relationship based on mutual trust and confidence.Scope: National