Make sense of: France’s online medical records

Anyone with a Carte Vitale can sign up for a dossier médical partagé (DMP), a personal online medical records system.

25 December 2019
By Connexion journalist

It keeps information from medical sources in one central place – as opposed to keeping records at home and taking them to appointments.

The service is free and is also available for children.

Currently, having a DMP is optional but from July 2021 everyone will be given one unless they opt out. 

Only patients and professionals to whom they allow access may consult and add to the file and you can also hide items on it if you wish.

It can also be accessed by the emergency services if required.

Just under 13% of people currently use one of these but the national body in charge of the Cpam service, the Caisse Nationale de l’Assurance Maladie (Cnam), is convinced this will soon increase significantly.

A DMP can contain, for example, hospital and X-ray notes, blood tests, allergies, important medical procedures undertaken, blood groups, medicines prescribed and delivered, and contact details.

Information can be added by doctors and by patients.

There is also an option to consult it via a ‘DMP’ mobile phone app, meaning you have your records to hand anywhere, which may be useful if you are on holiday and need to see a doctor who is not your GP.

You can set up a DMP on your own via dmp.fr or with help from a pharmacist, or doctor or at your Cpam or other health caisse.

It is likely to be especially useful if you often consult different doctors, or you may change your GP in the future, or in the event of an accident when emergency services doctors could access it for information about your health conditions and medications you are taking (unless you have stated opposition to this).

One Connexion reader, who asked not to be named, said she has found it useful.

“My husband has a rare cancer and dementia and falls a lot,” she said.

“I think it’s a great system, especially when doctors can access vital details in an emergency. For example, when my husband was whisked off to hospital after a fall, I didn’t have to rush around finding his latest prescription.”

Cancer survivor Robert Hodge signed up for a DMP shortly after the scheme started. “The oncologist uploads his reports directly to the DMP, and I upload things such as blood tests, ultrasounds and scan results myself.

“Hopefully, more and more professionals and laboratories will offer automatic uploading and surely the best encouragement will be demand.

“I find it comforting to know that the information is available to medical staff if they need it in a hurry. There is a sticker on the front of my Carte Vitale to show that my DMP exists.”

To set up a DMP yourself at dmp.fr the first step is to click on the button marked: Créez votre DMP, which takes you to this page. You then have to obtain a ‘creation code' at the Link marked Cliquez ici which takes you to this page. You have to put in your social security number twice to obtain this. The code should be emailed to you.'

Open up the Créez votre DMP page again to input this code.

In further steps have to give an email address or mobile telephone number, so you can be alerted when a new document is added to your DMP, and include the names of the doctors and medical staff you agree should have access to your DMP. 

You then obtain details which will be required to log into your account on the website (logging in is done by clicking on ‘Mon DMP’ or via the mobile phone app).

The website dmp.fr says all beneficiaries of a ‘social security regime’ may have a DMP. For many French people or Britons working in France this will be the le régime général de la sécurité sociale and its network of local Cpams.

For purposes of the DMP the Cpam English-speaking helpline said retirees who benefit from the European S1 form scheme because they are linked to another country’s social security system are treated as if they are under this regime (other regimes range from Cavimac for religious ministers to Enim for fishermen). The benefit of the S1 form system is expected to remain for Britons living in France before the end of the Brexit transition period, assuming that, as now expected, the UK leaves with the negotiated deal.

However one Connexion reader queried whether it was possible for a person who is merely an ayant droit – dependent – of an S1 holder to have a DMP. She said that as she has French healthcare as the spouse of her S1-holder husband she struggled to set one up on the website.

A spokesman for Cnam told Connexion there is nothing barring such people from opening a DMP, however they should do it via a doctor, pharmacy or their Cpam rather than online.

The DMP has been a long time coming: a necessary legal framework was put in place in 2002 giving patients the right to consult medical records about them and allowing doctors to share medical notes between themselves to coordinate care.

A first version of an online medical records system was trialled soon afterwards, but it did not take off. Initially referred to as Dossier Médical Personnel, it was relaunched again for trials in 2018 under its current name and format and this was rolled out nationwide by 2019.

The introduction of the phone app was one of the most recent developments.

The latest figures from national health insurance body Ameli show nearly nine million people are registered with a DMP but also that many doctors do not use the system.

Dr Jean Christophe Calmes, spokesman for the biggest GP union MG France, told Connexion that doctors back the concept but think it is not user-friendly.

“Firstly, we must be confident it is completely secure, so an insurance company cannot find information which might make them refuse cover.

“Secondly, we cannot be sure a DMP gives a complete picture as it is possible not all the patient’s doctors may have access to a file and it may not be methodically updated.

“Thirdly, in its present configuration it is not easy to use, and it is difficult for doctors to find the relevant documents. Practising doctors like myself simply do not have the time to enter details on our own surgery’s records and on the DMP system. I would advise my patients to sign up, but would not guarantee it will be used by all medical staff.” 

In a written statement replying to questions from Connexion, Cnam said the organisation is encouraged by the numbers of people creating a DMP, and is near to its target for the end of 2019.

It says patients can easily add documents, for example by taking a photo of blood test results using the DMP phone app, so they are added from the photo.

Information is protected by a high level of security and it underlines that only the patient and health professionals can access the files: “No other actor, laboratory, top-up health insurance, bank, general insurance etc has access to the DMP. Not even the Assurance Maladie can consult it.”

Cnam said it recognised doctors can find it difficult to use and they are planning further changes to how the dossiers are set up, as well as free training sessions for GPs.

“It is a service which is developing, and which will improve over time.

“Almost half (46%) of doctors consult the DMP, a figure infinitely higher than two-and-a-half years ago when we were around 2-3%.”

This year Cnam will also work with laboratories so they will be able to add test results automatically into DMPs.

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