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The French healthcare system operates on under a statutory health insurance (SHI) model, ensuring providing universal coverage for its to all citizens. This system covers most hospitala wide range of healthcare services, including hospital care, physician services, and long-term care costs, as well as and prescription drugs, with patients paying for . While the SHI covers the majority of healthcare costs, patients are responsible for certain out-of-pocket expenses, such as coinsurance, copayments, and balance bills for charges exceeding covered fees. The SHI is mainly funded by payroll taxes from additional charges if fees exceed the covered amounts.
SHI funding primarily comes from payroll taxes paid by both employers and employees, along with a national income tax , and levies on specific industry industries and product levies. Ninety-five percent of citizens have additional products. To offset out-of-pocket costs, 95% of French citizens also hold voluntary complementary private health insurance (VHI) to cover out-of-pocket expenses and , which helps cover expenses for services like dental, hearing, and vision care.
The Governance of the healthcare system is shared between SHI funds and the national government are the principal entities overseeing the French healthcare system. Although , though recent reforms have decentralised delegated some authority to regional health agencies. Despite this decentralisation, the central government maintains significant retains considerable control over governance the system's overall management (World Health Organization, 2024).
According to the most recent data from 2011, health insurance covered 99.9% of the population in France. This coverage encompasses both those who are members of health insurance schemes and those who have free access to state-provided healthcare services (Our World in Data, n.p.)
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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 to enable citizens to choose and access digital health services securely and easily within the healthcare system. Action 16 aimed to provide focused on providing healthcare professionals with a secure platform for communicating service packages to facilitate delivering clinical telemedicine securely and efficientlyservices, while action 8 requested the software used by Action 8 mandated that all health professionals to ' software 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 . The decree outlined its specific content defined in the decree and functionality (Simon and Moulin, 2022).
The launch of Mon Espace Santé on January 1st 2022 represented a milestone in the digitization digitisation 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 creation of Mon Espace Santé was made possible through a partnership between the French government and a consortium led by Atos, a major player in computer and information technology. This collaboration, which also involved the National Health Insurance Fund (CNAM), culminated in the development of the MES platform. Atos was awarded the project in November 2020, and the scope of their work included design, development, hosting, operation, and maintenance, all within a tight 13-month timeframe.
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 collaboration, which also involved the National Health Insurance Fund (CNAM), culminated in the creation development 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 the design, development, hosting, operation, and maintenance of Mon Espace Santé. Despite its intricate nature, the timeline for the development the complexity of the project, Atos was of 13 monthsgiven a tight 13-month timeframe for its development.
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; and Beezim, which focused on responsible for the platform’s communication features (Atos International, 2022).
Features
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Patients using Mon Espace Santé 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 to their health records. The platform's core feature, Mon histoire de santé (My Health History), tracks all patient interactions with the healthcare system, including going visits to the pharmacy, to the GP, etcGPs, specialists, and pharmacies.
Other parts key sections of the record include:
Their conditions
Their treatments and medications
Their hospitalisation and handicaps
Their risk factors, such as allergies, family history, and habits
Their vaccinations
Their health measures: Medical conditions: A summary of diagnoses.
Treatments and medications: Details of current and past treatments.
Hospitalisation and disabilities: Information on inpatient stays and any disabilities.
Risk factors: Documentation of allergies, family medical history, and lifestyle factors.
Vaccinations: Records of immunisations.
Health measures: Metrics like weight, height, BMI, heart rate, and blood pressure…the ‘documents’ section. Here pressure.
Documents: A section where both healthcare professionals and patients can deposit their upload important documents , such as like vaccination certificates. This part also includes test results: patients download the document of the test results (these are not displayed within the record) Messaging feature: patients and professionals can message each other securely. However, these exchanges Test results are also stored here, although patients must download the test report itself, as it is not displayed directly within the record.
Additionally, a secure messaging feature allows patients and healthcare professionals to communicate, though these conversations can only be initiated by the
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medical team.
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Patients can also share a summary of their profile with
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selected healthcare professionals
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Patients can activate ‘My health space’ . For families, Mon Espace Santé allows parents to activate profiles for their children, and their profiles get directly linked automatically linking these to the parent’s parent's records.
Patients can decide who access what. They can go through all the reports and determine who can see themAnother feature is privacy control: patients can review all reports and decide which healthcare providers can access their information.
(Mon Espace Santé, n.p.)
Challenges and areas for improvement
Despite its comprehensive offerings, Mon Espace Santé faces several challenges:
The platform is still
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in its early stages
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, and automatic data integration from hospitals varies widely.
Even when healthcare systems are connected to Mon Espace Santé, the data
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are not yet fully structured
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or coded for optimal use.
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Mon Espace Santé has not yet gained widespread daily use, as the adoption statistics
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indicate.
The platform lacks
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functionality to view or manage appointments directly.
Published outcomes - statistics
As of According to the latest report by from the National Health Insurance Fund (CNAM), Mon Espace Santé has been adopted by 65.7 million policyholders have embraced this digital frontier, signifying its widespread adoption among the French populace. However, it is noteworthy that only 7.9 million users, equivalent to users—around 11.5%, have 5%—are actively engaged engaging with the platform.
Update
An Article in According to an update from L'Express from , as of 21 March 2024 reported that:
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11 million French people are using the platform.
, Mon Espace Santé has 11 million active patient users, while 45,000 general practitioners are also
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utilising the platform.
Screenshots
Once patients click to view their medical profile, they find this menu to navigate the record:
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