Massive accumulation of health data: tracing the origins of the pharmaceutical database leak

In the heart of France, a digital revolution is taking place within the nation's pharmacies. The Pharmaceutical File, also known as the DP, has been transforming the landscape of healthcare for 15 years now. Managed by the CNOP (National Council of the Order of Pharmacists), this innovative system was created to address the medical nomadism of patients and has the potential to save 3.5 billion euros annually.

The Pharmaceutical File, a module that integrates into the existing IT infrastructure of pharmacies, is a highly secure storage device, accessible 24/7 for both day and on-call pharmacies. In 2019, 99.9% of pharmacies were equipped with this system, and 70% of pharmacy patients had an active file.

The economic model of the Pharmaceutical File is based on financial balance for each functionality. The cost is financed by the pharmacist, and it remains free for patients. Interestingly, the Pharmaceutical File does not use data exploitation algorithms, allowing each pharmacist to use their own knowledge or rely on these algorithms.

The goal of the Pharmaceutical File was not cost reduction but to adapt to the lifestyle of patients. It enables each pharmacy to be connected online and have access to information not available in its local computer system. This connection is facilitated by a standardized protocol initially defined to allow all pharmacies to consult and upload information, with the objective of connecting all pharmacies and allowing each patient to access this service.

Looking towards the future, the National Order of Pharmacists aims to integrate over-the-counter medicines into the Pharmaceutical File without the need for a health card. They are also open to the idea of integrating the unique identifier of an e-prescription into the Pharmaceutical File. This integration could allow a seamless transition between prescription and dispensing, securing the latter.

The DossierPharma Application, which allows the consultation of the Pharmaceutical File, is currently in the testing phase and will soon be available on Android and iOS devices. Furthermore, the National Order of Pharmacists has developed a new identifier, the NDP (Pharmaceutical File Number), for children who do not have a social security number.

Funding for the Pharmaceutical File is gradually ensured by external sources, such as laboratories and healthcare establishments. The state's ambitions for My Health Space include gathering more health data and offering more services. However, health data requires a high level of security, a aspect that the Pharmaceutical File has prioritized since its inception.

The Pharmaceutical File is obligatory for pharmacists to maintain, unless the patient objects. This system, created by the legislator, is a project of the pharmacist profession that is in contact with the entire population. In 2019, 430 million data were shared between pharmacists through the Pharmaceutical File, with 1.6 billion boxes of medicines being fed into the files.

The original software manufacturers involved in the Pharmaceutical File project were Compudent GmbH (later Compugroup Medical) and others who aimed to develop integrated medical and pharmacy information systems. The project likely involved firms specializing in hospital, pharmacy, and physician information systems in Europe and beyond.

In conclusion, the Pharmaceutical File represents a significant step forward in the digitalization of French pharmacies. It is a testament to the profession's commitment to adapting to the needs of patients, ensuring data security, and fostering a more connected healthcare system.