Country’s healthcare system in a nutshell

France runs a statutory health insurance (SHI) system providing universal coverage for its residents. The system is financed through employee and employer contributions, and increasingly by earmarked taxes on a broad range of revenues. The main schemes that provide SHI are one specific to the agricultural sector and another more general scheme, with the same coverage and benefit policies. Funds are pooled at the national level with the possibility of subsidies between schemes. Voluntary, complementary private health insurance (VHI) also plays a large role. Almost 95% of the population has VHI

Public vs private

The national PHR

History

Mon Espace Santé, a digital platform established by the French government, represented a milestone in the digitization of healthcare services. Launched on January 1, 2022, for all individuals under the umbrella of Health Insurance, with provisions for opt-outs, the platform has witnessed substantial growth.

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.

Features

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.

Other parts 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: weight, height, BMI, heart rate, blood pressure…
the ‘documents’ section. Here both healthcare professionals and patients can deposit their important documents, such as 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 can only be initiated by the healthcare team.
Patents can also share a summary of their profile with the healthcare professionals of their choice.

Patients can activate ‘My health space’ for their children, and their profiles get directly linked to the parent’s records.

Patients can decide who access what. They can go through all the reports and determine who can see them.

https://www.monespacesante.fr/

A carer feature is currently being developed.

Challenges and areas for improvement

The platform lacks a feature to view or manage appointments

The platform is still not widely used, as the statistics in the next section show.

Published outcomes - statistics

As of the latest report by the National Health Insurance Fund (CNAM), 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 11.5%, have actively engaged with the platform.

Update

An Article in L'Express from 21 March 2024 reported that: