How do I transfer my US medical records to France?

As an American moving to France, the promise of universal healthcare and lower costs can be enticing. However, transitioning US medical records to this new system is not always simple.

That is precisely the issue Dinneen Viggiano, who plans to move from New York to Marseille next January, ran into as she prepared her transition to French living.

She quickly noticed that while guides on finding an apartment, paying your taxes and investment abound, information on managing your medical environment and transferring medical records once in France is more scarce. 

"It's a whole lot of not knowing and just sort of figuring it out," Ms Viggiano told The Connexion.

The challenge lies in the differences between the two countries' systems. In the US, people's health data lives in separate computer networks run by different hospital groups, private clinics, and insurance companies. However, a large share of this digital data is stored in the software MyChart, led by the private company Epic Systems.

In France, the system has two layers. Medical practitioners keep a record locally of patients' medical history and records. The Dossier Médical Partagé, a secure storage space that lives inside the patient portal Mon espace santé, is a free digital health record managed by French national health insurance. About a quarter of general practitioners in France use Doctolib as their medical record system, making it the most popular software among GPs, according to public data from GIE SESAM-Vitale, an economic interest group that pools the resources of French health insurance bodies. 

These differences mean that "moving to France does not automatically transfer your US medical record into the French healthcare system," said Dr Gregory Dacourt, a French GP in Paris who regularly cares for American and British expats.

A dual approach

To tackle this issue, a spokesperson from the Agence du Numérique en Santé (ANS) recommended a two-pronged strategy for Americans in France. First, patients should consult their French primary care physician and present them with their US medical documents, printed if possible. The doctor will then integrate the elements into their medical software and build the patient's file. Second, patients can upload the documents into Mon espace santé should they see any additional doctors who want to access the files that way.

The spokesperson said Mon espace santé cannot receive documents directly from American healthcare facilities or professionals, so patients must import their own. The simplest format recommended is PDF, and the portal also allows patients to take a picture of a document. Additionally, translation is not necessarily needed, as many doctors can understand medical terminology in English.

Dr Dacourt said that in his experience, when patients need to bring an X-ray, scan or other medical test result, they send it directly to him as a PDF, a printed report, a document shown through their US patient portal, or by sharing a secure imaging link. For CTs or MRIs, he said it is useful to have both the written radiology report and access to the actual images. 

Dr Simon Gordon, a doctor who works with English speakers, said there is no national system for dealing with records in the country, as not everyone uses Mon espace santé. Dr Gordon, who is based in the south of France, said the same variability exists with Doctolib: some doctors use it just for booking, while others look at notes and documents that the patient uploads there.

Another common difference he notices with American patients is that they have huge reams of notes from MyChart, something "we're not quite used to here,” he said.

To help avoid this problem of having too many documents, Ms Viggiano said she received advice from other expats to create a cheat sheet listing major diagnoses, major surgeries, current treatment plans and pharmaceutical prescriptions. 

The ANS spokesperson agreed with this idea, adding that any information that allows the doctor to better understand the patient's health status and medical history is welcome, and even handwritten documents can work. 

Medication info 

When communicating medications, patients should include both the brand name and active ingredient name, along with the dosage and how often they take it, Dr Dacourt said. This is because American and French brand names can differ.

Beyond medical records, Dr Gordon mentioned that patients with specific medical needs should research the region of France they are moving to, so they avoid a medical desert in rural areas where accessing the right care is difficult.

As she prepares to make the move to France, this is something Ms Viggiano has already looked into. She now knows which hospital she will work with and how far away it is, and has started preparing her medical information sheet. 

"You're in charge of your own health," she said.

Dr Dacourt urged patients not to wait until they are sick to start collecting records. Before moving, he said, they should gather the most important documents: medical history, medication list, allergies, major operations, specialist reports, recent test results, significant imaging and vaccination records.

"My main advice is: do not arrive with 500 pages of medical records and expect the doctor to identify the important information during a standard consultation," Dr Dacourt said.