Implementation of the digital health space

 La loi du 24 juillet 2019 relative à l'organisation et à la transformation du système de santé est à l’origine de la mise en œuvre de l’espace numérique en santé (ENS).

This transformation aims to improve the efficiency of health services, the quality of care and access to health information for citizens.

Within the ENS, each citizen can find their health information such as medical records, prescriptions and test results..

In order to provide personalized prevention advice to each citizen on their ENS, Decree D. No. 2024-468, published on May 24, 2024 and entered into force on May 26, 2024, amended several existing articles (Articles L1111-2, L1111-8, L1110-4 of the CSP) of the Public Health Code and introduced new articles (Articles L1111-13 to L1111-16 of the CSP) to regulate the ENS.

The ENS allows centralize health information, such as medical records, prescriptions, and test results. Now, citizens can add personal notes and additional information.

The ENS offers new services such as appointment scheduling, teleconsultation, and health monitoring applications.

In terms of security and privacy, the decree imposes encryption protocols for all data stored and transmitted via the ENS. Furthermore, explicit consent must be obtained for sharing sensitive data with third parties, except in cases of medical emergency.

An interoperability framework has been put in place to standardize data exchanges between the different health information systems and ensure their consistency and integrity.

Finally, governance has been strengthened with the establishment of a national steering committee supervising the implementation of the ENS and ensuring its proper functioning. Annual reports on the use, security and performance of the ENS will be submitted to Parliament.

The decree thus improves the coordination of care by facilitating the sharing of information between health professionals. It also empowers patients by encouraging their engagement in their own care pathway.

However, concerns persist about the ability to guarantee data confidentiality in the context of increasingly sophisticated cyberattacks.

Furthermore, interoperability between different health information systems is technically complex and will require significant investments in infrastructure and training to ensure the success of the ENS.

It will also be necessary to pay attention to the digital divide which can exclude the elderly or those living in rural areas without access to the internet.

Finally, this decree risks generating an additional workload for health professionals who will have to adapt to new digital tools.

In short, while the decree on the implementation of the ENS represents a significant step forward towards the modernization of the health system in France, it will have to overcome technical, ethical and social challenges to fully realize its promises.

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