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France’s physicians are foundational to modern medicine. René Laennec invented the stethoscope in 1816. Jean-Martin Charcot joined Paris’s Salpêtrière Hospital in 1862 and founded modern neurology, documenting multiple sclerosis and Parkinson’s Disease. Louis Pasteur developed pasteurisation in 1864. Alexis Carrel trained with a seamstress to improve his surgical sewing, advancing vascular surgery and winning the Nobel Prize for Medicine in 1912.
Country’s healthcare system in a nutshell
The French healthcare system France’s universal coverage operates under a statutory health insurance (SHI) model, providing universal coverage to all citizens. This system covers a wide range of healthcare services, including . SHI’s wide coverage includes hospital care, physician services, long-term care, and prescription drugs. While the SHI covers the majority of healthcare costs, patients Patients are responsible for certain out-of-pocket expenses, such as coinsurance, copayments, and additional charges if fees exceed the covered amounts.
SHI funding is primarily comes from payroll taxes paid by both employers and employees, along with a national income tax and levies on specific industries and products. To offset out-of-pocket costs, 95% of French citizens also hold voluntary complementary private health insurance (VHI), which . It helps cover expenses for services like dental, hearing, and vision care.
Governance of the healthcare system is shared between SHI funds and the national government, though recent . Recent reforms have delegated some authority to regional health agencies. Despite this decentralisation, the central Central government retains considerable control over 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 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
History
In 2019, The "Ma Santé 2022" programme of 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 in 2019. Point 15 aimed to establish a Digital Health Space to enable citizens to choose and access digital health services securely and easily within the healthcare system. Action 16 focused on providing healthcare professionals with a secure platform for delivering clinical telemedicine services, while . And Action 8 mandated that all health professionals' software be interoperable interoperate 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) was the new name in a 2021 decree. The decree outlined its specific specified content and functionality (Simon and Moulin, 2022). The launch of Mon Espace Santé 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).
The creation of Mon Espace Santé was made possible through is 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 ; and 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 collaboration, which also involved the National Health Insurance Fund (CNAM), culminated in the development of the Mon Espace Santé (MES) platform. 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 the complexity of the project, Atos was given 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, responsible for the platform’s communication features (Atos International, 2022).
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Other key sections of the record include (Mon Espace Santé, n.p.):
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.
Documents: A section where both healthcare professionals and patients can upload important documents like vaccination certificates. 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 medical team. 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.
Another feature is The privacy control : patients can feature lets a patient 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:
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Challenges include:
Automatic data integration from hospitals remains inconsistent due to the platform being in its early stages, and automatic data integration from hospitals varies widely.
Even when healthcare systems are connected to Mon Espace Santé, the data are not yet fully structured or coded for optimal use.
Mon Espace Santé has not yet gained widespread daily use, as the adoption statistics indicate.
The platform lacks functionality 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.
(PKB interviews, 2024)
Published outcomes - statistics
According to the latest report from the National Health Insurance Fund (CNAM), Mon Espace Santé has been adopted by 65.7 million policyholders. HoweverAn 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 French citizens—representing over 90% of the insured population— have a profile. Of these, however, only 7.9 million users—around (11.5%—are 5%) have actively engaging engaged with the platform.According to an update from L'Express, as
From 1 January 2022 to January 2023, over 42.5 million health documents were shared with patients via Mon espace santé, and more than 1.7 million messages have been sent by healthcare professionals to users through the platform (Agence du Numérique en Santé, 2023).
As of 21 March 2024, Mon Espace Santé has 11 million active patient users, while 11 million patients (16.7%) and 45,000 general practitioners are also utilising the platformactively using MES (L'Express, 2024).
Screenshots
Once patients click to view When a patient clicks to see their medical profile, they find get this menu to navigate the record:
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Bibliography
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