ESMS numérique, Ségur and the DUI: is yours compliant?

If you run a home-care or medico-social service in France, your record system is no longer just an internal tool. Under the Ségur du numérique en santé, the resident or user record, the DUI (Dossier Usager Informatisé), is expected to be a Ségur-referenced solution that connects to the national health systems. The ESMS numérique programme funded that migration, and the funding deadlines are the mechanism that is turning what looked like an incentive into an obligation.

This guide is the operator’s view of that shift: what a DUI is, what “Ségur-referenced” means in concrete terms, where ESMS numérique money sits in 2026, and why the direction of travel matters for anyone choosing or building software. It’s part of our broader look at how France assesses autonomy and funds home care. The reform dates are the moving part here, so read them as “true when checked”, not settled.

What is a DUI, and why does the Ségur care about it?

The DUI (Dossier Usager Informatisé) is the digital user record that an ESMS keeps on each person it follows. ESMS stands for établissements et services sociaux et médico-sociaux — the sector that includes home-care services (SAD), nursing homes, and services for disabled people. The DUI is where the care plan, the visits, and the health information live.

The Ségur du numérique en santé cares about the DUI because it is the point where a person’s information either connects to the rest of the health system or stays trapped in one vendor’s silo. The medico-social wave of the Ségur set out to fix that. Its goal is simple to state: the DUI should speak the same national language as the rest of French health IT, so that information follows the person rather than the software. That is why “having a digital record” and “having a compliant DUI” are not the same thing.

What does a Ségur-referenced DUI actually have to do?

A Ségur-referenced DUI has to connect to three national services. Being “référencé Ségur” means the Agence du Numérique en Santé (ANS) has listed the solution as meeting the requirements. It is not a label a vendor can award itself.

The three connections are:

• INS: the Identité Nationale de Santé, the qualified national health identifier. It ties each record to the right person, using verified civil-status traits, so that two services talking about the same patient are provably talking about the same patient.
• MSSanté: the secure health messaging network. It is how professionals exchange health information about a person without falling back on ordinary, non-secure email.
• Mon espace santé and the DMP: the citizen’s national health space, and the Dossier Médical Partagé inside it. A compliant DUI feeds documents into it, so what happens in home care shows up where the person’s other care providers can see it.

A record that scores AGGIR, plans visits and prints an invoice but does none of these three is not, in the Ségur sense, a compliant DUI. That gap is the practical test.

What is ESMS numérique, and where does the money stand?

ESMS numérique is the national programme that funds ESMS to adopt a compliant DUI. It has mobilised on the order of €600 million (the Ségur/PNRR envelope, 2021-2025) to pay for the migration, run jointly by the state and the CNSA (the fund that manages the autonomy branch of the Sécurité sociale).

The money moves in waves, and the timing is the part that changes the picture:

• Vague 1 (the first wave) was the early round of credits. 2025 was the last year to commit them.
• Vague 2 documents were published in March 2026, opening the second round, with deployment to be finalised by 15 March 2029.

If you read only the funding, ESMS numérique looks like a subsidy: money to help you move to a better record. But two things change how that reads. First, the waves close — once a commitment window has passed, the support attached to it is gone. Second, and more important, the framing itself is moving from incentive to obligation, a shift reinforced through the 2026 PLFSS (the social security financing bill). Put together, the funding is less a bonus for early adopters and more the on-ramp to a requirement.

Why does this turn from incentive into obligation?

Because the deadlines and the financing bills are converging on the same point: at some stage the compliant DUI stops being the funded option and becomes the expected baseline. France has run this pattern before with télégestion, where electronic proof of home visits went from good practice to something départements check.

For an operator, the practical reading is this. Choosing a record system that is not on the ANS Ségur reference list is not a neutral choice you can revisit at leisure. It is a bet that the obligation won’t arrive, against a clear signal that it will. The safer position is a DUI that already does the INS, MSSanté and Mon espace santé work, so that when the requirement firms up you are on the right side of it rather than migrating under time pressure.

Where does this sit next to télégestion?

The Ségur DUI rules and the télégestion rules are separate obligations that both apply. It’s worth being clear about the boundary, because they are easy to conflate.

Télégestion and the contrôle d’effectivité cover the electronic time-stamping of each home visit, so départements can check that funded hours were actually delivered. A décret of 29 April 2024 fixed the reference period at no less than six months. That is a different requirement from the Ségur DUI work, and we cover it in the télégestion and contrôle d’effectivité guide. The reorganisation of home-care services into the single Service Autonomie à Domicile (SAD) is a third strand again. A serious French home-care product has to satisfy all of these at once, which is more than most off-the-shelf schedulers were built to do.

Frequently asked questions

What is a DUI, and does ours have to be Ségur-referenced?

The DUI (Dossier Usager Informatisé) is the digital user record an ESMS keeps on each person it follows, including home-care services. To count under the Ségur du numérique, it has to be a Ségur-referenced solution: one the Agence du Numérique en Santé lists as handling the INS, MSSanté and the feed to Mon espace santé. A record that scores AGGIR but does none of that is not a compliant DUI.

Is ESMS numérique compliance mandatory or just funded?

Today it is mostly funded rather than strictly mandated, but the direction is towards obligation. ESMS numérique paid for the migration, with 2025 the last year to commit first-wave credits and a second wave running to a 2029 deadline. Provisions in the 2026 social security financing bill (PLFSS) reinforce that shift from incentive to requirement.

What does ‘speaking the national plumbing’ actually mean?

Three connections. The INS (Identité Nationale de Santé) is the qualified national health identifier that ties each record to the right person. MSSanté is the secure messaging network used to exchange health information between professionals. And the DUI has to feed Mon espace santé, the citizen’s health space, and the DMP inside it. A Ségur-referenced DUI does all three.

Does the télégestion decree change our DUI obligations?

No, they are separate rules that both apply. Télégestion and contrôle d’effectivité (electronic time-stamping of home visits, with a reference period of at least six months under the 29 April 2024 decree) sit alongside the Ségur DUI requirements, not inside them. A serious French home-care product has to satisfy both.

What we built into Domihome, and why

When we set out to build Domihome, the part that shaped the most decisions was exactly this: the record couldn’t be a private notebook, it had to be a DUI that talks to the national systems. That means INS-qualified identity on every user, MSSanté for exchanging information with the person’s other care providers, and feeding Mon espace santé — not as an add-on, but as how the record works. I’m a nurse before I’m anything else, and what I wanted was a record that a professional trusts because it’s the same person, the same identity, everywhere it appears. Off-the-shelf packages move at their own pace on the Ségur reference list, and that pace is rarely yours. See what we did for Domihome, or book an intro call to talk through where your DUI stands.

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This guide is informational and not legal, billing or medical advice. France’s digital-health obligations are evolving, and the ESMS numérique waves and Ségur requirements are still in transition; the deadlines above are the moving part. Confirm current rules and figures with the official sources, including l’Agence du Numérique en Santé for the Ségur, INS, MSSanté and DMP requirements, and the CNSA for ESMS numérique. Last verified 14 July 2026.