Governance is shared between SHI funds and the national government. Recent reforms delegated some authority to regional health agencies. Central The central government retains considerable control over the system's overall management (World Health Organization, 2024).

99.9% of the population in France is covered: 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.).

Public vs private

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The national PHR

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"Mon Espace Santé” (My Health Space) was the new name in a 2021 decree. The decree specified content and functionality (Simon and Moulin, 2022). The launch on January 1st, 2022, represented a milestone in the 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).

Mon Espace Santé is a partnership between the French government; , a consortium led by Atos; , and the National Health Insurance Fund (CNAM). 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 consortium led by Atos comprises three notable French entities: Maincare Solutions, expert experts in Identity Management and health directories; Gravitee, an API platform specialist , which that contributes to the integration of diverse systems and functionalities; and Beezim, responsible for the platform’s communication features (Atos International, 2022).

Features

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Patients using Mon Espace Santé can view and add 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 visits to GPs, specialists, and pharmacies.

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Additionally, a secure messaging feature allows patients and healthcare professionals to communicate. Only the professional can start communication.

Patients can also share a summary of their profile with selected healthcare professionals. For families, Mon Espace Santé allows parents to activate profiles for their children, automatically linking these to the parent's records.

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Challenges and areas for improvement

Challenges include (PKB interviews, 2024):

Automatic data integration from hospitals varies widely as remains inconsistent due to the platform is still being in its early stages.
Data are not yet fully structured or coded for optimal use.
Daily use is not widespread as the adoption statistics indicate.
Seeing or manage appointments directly is not possible in , resulting in patient profiles often displaying only a partial view of their health data.
Some information is not fully structured or coded. For instance, test results are typically provided as PDF files sent by healthcare facilities rather than being integrated into a structured format within the platform.
As the statistics below indicate, the platform has not yet achieved widespread adoption.
Patients are unable to view or manage appointments directly through the platform.

Published outcomes - statistics

An article published on 17 February 2023 by Agence du Numérique en Santé highlights the achievements of Mon espace santé in its first year. Since its launch, 65.7 million policyholders has adopted Mon Espace Santé according the latest report from the National Health Insurance Fund (CNAM). Only French citizens—representing over 90% of the insured population— have a profile. Of these, however, only 7.9 million users (11.5%) were actively engaging with the platform.have actively engaged with the platform.

From 1 January 2022 to January 2023, over 42.5 million health documents were shared with patients via Mon espace santé, and healthcare professionals have sent more than 1.7 million messages to users through the platform (Agence du Numérique en Santé, 2023).

As of 21 March 2024, 11 million patients (16.7%) and 45,000 general practitioners , are actively using MES as of 21 March 2024 (L'Express, as of 21 March 2024).