CNAM is a national public administrative authority which reports both to the Ministry of Health (FR MoH) and the Ministry of the Economy and Finance.

The legal reform of August 2004 gave it responsibility for regulating the healthcare system and CNAM reorganised itself accordingly and made risk management a priority. It has several roles:

• it defines the strategic directions, principles and objectives guiding its actions and implements them;

• it implements the conventions agreed between the Union des Caisses d’Assurance Maladie and the unions representing the various healthcare professions;

• it defines good practices in terms of issuing prescriptions in order to keep healthcare costs down;

• it defines and promotes a strategy for the prevention of disease, workplace accidents and occupational illness and injury;

• it defines and oversees the actions of organisms belonging to the network (CPAM, etc.);

• it ensures consistency in the services provided to the public throughout the country;

• it also manages one of the most extensive information systems in Europe.

Together with its network (DGCDR, CPAM), it is also supporting the roll-out to healthcare professionals and establishments of core eHealth services (DMP, MSS, e-prescriptions, etc.).

And lastly, within the framework of negotiating the conventions with the representatives of the various categories of healthcare professional, it is helping to define and implement conventions to promote the rolling out and use of digital tools in the health domain.

They cover all aspects of healthcare:

• prevention, and promotion of good health;

• health and safety monitoring;

• coordination of outpatient care (non-hospital Health Professionals) and hospital care;

• coordination of social care.

Thanks to transversal connections and the sharing of regional health policies at a national level, the ARSs help to develop a synergy between regional players and a global overview of healthcare, resulting in a more seamless care experience for beneficiaries. They are the sole interlocutor for the various stakeholders in the health domain at the regional level.

An ARS is responsible for defining a region’s eHealth strategy and coordinating its implementation. 

The Groupements Régionaux d’Appuis au Développement de l’e-Santé (GRADeS, regional eHealth support centres) are their go-to operators for elaborating and implementing regional eHealth strategy in a spirit of reciprocal commitments.

These support centres bring regional stakeholders together around a regional eHealth strategy, promote the use of eHealth services in the regions, and share their expertise with regional players. They can also spearhead projects not directly originating from the regional strategy in partnership with national institutions such as CNSA and CNAM.

Its mission is to meet the needs of these establishments by organising events and interventions, and providing methodologies and tools elaborated with and for professionals on ground, in line with the 4 major priorities set by the Ministry of Health (FR MoH): 

• offer a more seamless experience for service users in terms of treatment and care;

• facilitate access to information about available healthcare services and decision-making tools, and improve coordination between different hierarchical levels within the organisation; 

• work together to improve treatment and care for service users;

• optimize the support functions.

ANAP has been developing and coordinating an extensive network of eHealth professionals that has the capacity to:

• contribute to ANAP’s projects and publications; 
• play a role in the dissemination and adoption of tools, resources and practices by professionals on the ground;
• provide periodic assistance to a healthcare establishment or help run mutual aid collectives.

This network currently brings 80 professionals from the health and social care fields with a variety of profiles (digital engineers, managers, executives, healthcare professionals, etc.) and regularly publish toolkits (guides, tools and feedback) helping health professionals reaching better performance.

CNSA is responsible for:

• balancing the books of this branch. To this end, it manages its accounts, settles invoices, records all transactions conducted by the branch, and manages risk;

• elaborating policies to promote the autonomy of the elderly and disabled and coordinating their implementation with an emphasis on guaranteeing fairness (including regional fairness) and the quality and efficiency of the services provided to these groups. To this end, it collects and exploits data on beneficiaries’ needs and the range of services being offered. It designs and rolls out information systems with the capacity to host health data in conjunction with the public authorities, as provided for by Article L. 1111-24 of the Public Health Code. It places its technical expertise at the disposal of public agents and of professionals working in the autonomy field, as well as helping to develop training programmes in this domain. To guarantee service quality and fairness when processing requests for financial aid to assist and promote the autonomy of the disabled and the elderly, it supports regional authorities working in this domain and evaluates their policy proposals for promoting autonomy;

• contributing to the financing (fairly distributed across the country) and oversight of

  • policies to prevent the loss of autonomy and combat isolation;

  • social care establishments and services;

  • individual services to promote autonomy and of systems set up at the local or national level to support autonomy and informal caregivers;

  • contributing to investment in initiatives to support autonomy.

CNSA is in charge of a national digital program whose aim is to increase digital maturity of all medico-social facilities : the ESMS digital programme (in French).