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Country’s healthcare system in a nutshell
The French government determines the national health strategy and distributes budgeted funds to regional health agencies responsible for planning and service delivery. France operates healthcare system operates on a statutory health insurance (SHI) system that offers model, ensuring universal coverage to all for its residentscitizens. This system covers most hospital, physician, and long-term care costs, as well as prescription drugs, with patients paying for coinsurance, copayments, and balance bills for charges exceeding covered fees. The SHI is mainly funded by payroll taxes from employers and employees, a national income tax, and specific industry and product levies. Ninety-five percent of citizens have additional voluntary complementary private health insurance (VHI) to cover out-of-pocket expenses and dental, hearing, and vision care.
The SHI funds and the national government are the principal entities overseeing the French healthcare system. Although recent reforms have decentralised some authority to regional health agencies, the central government maintains significant control over governance (World Health Organization, 2024)
Public vs private
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The national PHR
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In 2019, the French Minister of Solidarity and Health set out a plan for the Digital Health Delegation (DNS) as part of the "Ma Santé 2022" programme. Among the 30 proposed actions, point 15 aimed to establish a Digital Health Space allowing citizens to choose and access digital health services securely and easily within the healthcare system. Action 16 aimed to provide healthcare professionals with a platform for communicating service packages to facilitate clinical telemedicine securely and efficiently, while action 8 requested the software used by all health professionals to be interoperable with the Digital Health Space by July 2023 (Simon and Moulin, 2022).
The decree outlining the implementation conditions for the Digital Health Space was published on 4th August 2021. Following this, the space was renamed "Mon Espace Santé” (My Health Space) with its specific content defined in the decree (Simon and Moulin, 2022).
The launch of Mon Espace Santé on January 1st 2022 represented a milestone in the digitization of healthcare services in France. The platform is available for all individuals under the umbrella of Health Insurance, with provisions for opt-outs (Simon and Moulin, 2022).
The realisation of Mon Espace Santé was possible thanks to a collaboration between the French government and a consortium led by Atos, a player in the field of computer and information technology. This partnership culminated in the creation of the Mon Espace Santé (MES) platform, which was co-developed with CNAM (the National Health Insurance Fund). The project, awarded to Atos at the conclusion of negotiations in November 2020, included design, development, hosting, operation, and maintenance of Mon Espace Santé. Despite its intricate nature, the timeline for the development of the project was of 13 months.
The consortium led by Atos comprises three notable French entities: Maincare Solutions, expert in Identity Management and health directories; Gravitee, an API platform specialist, which contributes to the integration of diverse systems and functionalities.; Beezim, which focused on the platform’s communication features (Atos International, 2022).
Features
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Patients can view their health data in the record, and can also add their own data to any part of it. The first part of the record is ‘Mon histoire de santé’ (my health history) and shows every interaction the patient had with the healthcare system, including going to the pharmacy, to the GP, etc.
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https://www.monespacesante.fr/A carer feature is currently being developed.
Challenges and areas for improvement
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Atos International. (2022) Atos successfully deploys Mon Espace Santé, France’s online health platform. Yahoo! Finance. 23 November. Available at: https://finance.yahoo.com/news/atos-successfully-deploys-mon-espace-091000705.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAADikyhlgsw7wl8s3ZW_OBJsmDRWARPuuGjHtoZwUYmM-B7rlV06bwH4tb4dZ9ozlzoIP7V4iT1T3awlB0wY4q1Sgr-_e1JtwlyXO6e39Yb8pm4lf7wRCbQay6q0AIsTW1Ku8_3sYdyC75nrsgjv6chVlk7mhLiA79P6hWJ1c3yiN (Accessed: 30 October 2023)
Fischer, A., 2024. "Mon Espace Santé", une action de santé publique bienvenue. L'Express, 21 March. Available at: https://www.lexpress.fr/sciences-sante/mon-espace-sante-une-action-de-sante-publique-bienvenue-par-le-pr-alain-fischer-MALU573CHVAXBJ7AZNRKQVBRSI/ (Accessed 20 April 2024)
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The Commonwealth Fund, (2020). France: International Health Policy Center. [online] Available at: https://www.commonwealthfund.org/international-health-policy-center/countries/france (Accessed 18 July 2024)
World Health Organization, 2024. France: Health System Summary 2024. Health System Summary. 20 May 2024. [online] Available at: https://eurohealthobservatory.who.int/countries/france [Accessed 25 July 2024].