Interoperability between hospital information systems remains the main technical barrier to managing medical records in France. Successive programs (HOP’EN, SUN-ES, HOP’EN2) have set ambitious goals, but the reality on the ground shows that the quality of structured data and recent regulatory requirements are reshaping priorities well beyond mere dematerialization.
Structuring health data: a challenge that software solutions cannot solve alone
An installed EHR (Electronic Health Record) does not guarantee usable data. We still observe significant gaps between actual data entry by caregivers and the level of structuring expected by national standards. The issue lies not in the tool, but in the granularity of the data produced at the point of care.
Recommended read : The surprising reasons why farmers water in full sun
Hospital discharge summaries, prescriptions, and laboratory results often transit in unstructured PDF format. This format, readable by humans, remains opaque for any automated processing. Without structured data in CDA-R2 or FHIR format, interoperability is an empty promise. The Ségur wave 2 certified publishers are gradually integrating these standards, but effective deployment in institutions depends on software updates and local configurations that each IT department must manage.
Players like Irist Santé focus their approach on this integration layer between business tools and national infrastructures, where the fluidity of the digital care pathway is truly at stake.
See also : How to react to an invasion of aphid insects in your home?
The digital Ségur has imposed a compliance timeline on health software publishers. Wave 2 targets hospital establishments with specific requirements for the automatic feeding of My Health Space. In practice, this means that every documented action in the EHR must be able to generate a document usable by the patient’s DMP without additional manual intervention.
My Health Space in 2026: mass adoption and operational limits
More than 24 million My Health Space profiles are activated in France. About 2.5 million people access their documents each month. Nearly 420 million documents have been deposited in users’ files, a 40% increase over the past year. Approximately 70% of French people have received at least one document in their space.
These figures show that the logic of a shared medical record fed by digital solutions is no longer a pilot project. Mass feeding is underway, driven by office software, hospital information systems, and laboratory analyses.
Volume does not solve everything. Several limits persist:
- The documents deposited are mostly PDFs, which hinders secondary exploitation (clinical research, automatic alerts, multidisciplinary coordination).
- The active consultation rate by patients remains modest compared to the number of profiles created, raising questions about the actual ownership of the tool by users.
- The coexistence of My Health Space with secure health messaging (MSSanté) and dedicated hospital portals creates a fragmentation of access to information for both patients and primary care physicians.
Health data hosting: the HDS 2026 decree changes the game
The decree of March 24, 2026, strengthens digital sovereignty over health data hosted in France. Certified HDS hosts must now ensure that the data is not subject to extraterritorial legislation, directly targeting American cloud providers operating under the Cloud Act.
For healthcare establishments, this evolution has direct consequences on the choice of infrastructure. A hospital using an EHR hosted by a provider not compliant with the new HDS standard will have to migrate its data or require its publisher to change the host. HDS compliance becomes a selection criterion as crucial as the functional coverage of the software.
The reinforced obligations focus on transparency (physical location of servers, identified subcontractors) and on data reversibility. An establishment must be able to recover all its patient records in a usable format in case of a provider change. This technical requirement, often overlooked in contracts, takes on critical importance when it concerns millions of clinical documents.
Artificial intelligence and medical records: legal framework and real use cases
The automation of medical summaries by AI constitutes a concrete use case, already tested in nursing homes. The Health Digital Agency (ANS) has evaluated projects for automating medical record summaries and visit reports. The goal is not to replace the clinician but to reduce the administrative writing time that weighs on caregivers.
The legal framework 2024-2026 requires that any AI processing of health data complies with GDPR and HDS standards. Patient consent, data minimization, and traceability of algorithmic treatments are non-negotiable prerequisites. An AI model trained on French clinical data must be hosted on HDS-certified infrastructure compliant with the 2026 decree.
In practice, EHR publishers are integrating modules to assist in coding actions, detecting drug interactions, and pre-filling reports. These discreet functionalities produce a measurable time gain on a daily basis. They require quality input data, which brings us back to the structuring issue mentioned earlier.
City-hospital coordination: the still fragile digital link
The transmission of information between the hospital and the primary care physician currently relies on MSSanté and the feeding of the DMP. The average time to receive a hospital discharge report by the general practitioner remains a key indicator of a facility’s digital maturity. HOP’EN2 prioritizes this.
Digital tools exist. The barrier is organizational: late medical validation, non-digitalized signature processes, incomplete configurations in the EHR. An establishment that masters its document chain (from data entry to automatic deposit in My Health Space) reduces disruptions in care pathways for patients with chronic illnesses, a population for which informational continuity between professionals is crucial.
The digital transformation of medical records in France is progressing in successive layers. The next step is not to add another tool but to ensure the reliability of the data circulating between those that already exist.