A liberal physiotherapist sends a report to a hospital doctor. The message is sent from Mailiz, arrives in the hospital’s MSSanté inbox, and the report is automatically filed in the electronic patient record without re-entry. Everything works because Mailiz and MSSanté are not two competing systems, but two layers of the same device. Understanding where one ends and the other begins changes the way exchanges are organized on a daily basis.
Mailiz integrated into the business software: what the webmail alone does not do
When using Mailiz through its web interface, you have a functional, free messaging service that complies with GDPR. You write a message, attach a PDF, and send it. The problem arises as soon as you work with a regular volume of patients: each received attachment must be manually downloaded, renamed, and then stored in the correct folder of the practice software.
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Several MSSanté operators (software publishers for practices or hospital EHRs) now offer MSSanté inboxes integrated directly into the patient record. Sending a report is triggered from the patient’s file, the recipient is pre-filled via the MSSanté directory, and structured archiving occurs without additional manipulation. This integration reduces recipient errors and eliminates back-and-forth between the webmail and the business software.
To clearly understand the differences between Mailiz and MSSanté, the situation can be summarized as follows: MSSanté is the trusted space (the secure network, the rules, the directory), and Mailiz is one of the messaging operators participating in it, operated by ANS and accessible for free. Other operators, often paid, offer this software integration that Mailiz in webmail mode does not provide natively.
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MSSanté trusted space: multiple operators, one directory
The MSSanté trusted space brings together all operators who have contracted with the Digital Health Agency. Each operator adheres to the same framework of technical and organizational requirements. You can send a message from Mailiz to a box operated by a hospital publisher, or vice versa, without any security breach.
The MSSanté directory centralizes the addresses of all authorized professionals, regardless of their operator. This is what makes the system interoperable. A general practitioner using Mailiz and a radiologist whose clinic uses another operator can exchange messages via the same trusted space, with the same level of encryption.
Feedback on this point varies among institutions: some healthcare establishments report that the initial configuration of their MSSanté operator takes time, particularly to connect the messaging to the existing EHR. Mailiz, on its side, can be deployed in a few minutes with a CPS card or e-CPS access, which explains its massive adoption among liberal professionals.
What concretely distinguishes operators from each other
- Integration into business software: some operators inject messages and attachments directly into the patient record, while others operate only as a separate webmail
- Connectors to Mon espace santé: competing solutions to Mailiz automatically deposit received reports into the correct Mon espace santé folder of the patient, without any manual action from the professional
- Cost: Mailiz is free for all healthcare professionals registered with the RPPS, while third-party operators often include messaging in a global software subscription
- Technical support: ANS manages Mailiz with centralized support, while private publishers generally offer dedicated assistance for configuration
European convergence and cross-border exchanges in 2026
ANS has evolved the MSSanté interoperability frameworks to align them with European cybersecurity and electronic identification frameworks, notably eIDAS 2 and the European digital identity wallet. This convergence opens the prospect of secure cross-border health data exchanges from MSSanté inboxes.
Mailiz remains currently limited to strictly national use. A French practitioner corresponding with a Belgian or German colleague cannot use Mailiz for this exchange. The European dimension concerns the MSSanté system as a whole, not a specific operator. However, it is indeed through the trusted space that these gateways could materialize by 2026.
For liberal practices whose activity does not exceed borders, this evolution changes little in daily operations. It is more relevant for hospital centers, border establishments, and coordinated care networks managing mobile patients in Europe.
Choosing between Mailiz alone and a third-party MSSanté operator: practical criteria
The choice does not arise in terms of security. All MSSanté operators guarantee the same level of data protection, as they adhere to the same framework. The real question concerns the workflow.
A liberal professional who sends a few reports per week and uses practice software without an integrated MSSanté module has no reason to leave Mailiz. The interface is simple, the directory is complete, and the cost is zero.
On the other hand, a group practice or a multi-professional health center that handles several dozen messages per day saves time with an operator whose messaging integrates into the patient record. Automatic archiving, depositing into Mon espace santé, and pre-filling recipients become measurable operational gains over a week of work.
- Low volume, solo practice: Mailiz in webmail covers the need without extra cost
- Medium to high volume, coordinated practice: an MSSanté messaging integrated into business software streamlines the process
- Cross-border or multi-site activity: monitor developments in the European framework to anticipate compatible connectors
The key point to remember is that Mailiz is not an alternative to MSSanté. You choose Mailiz as an operator within MSSanté, or you choose another operator. The network remains the same, as do the confidentiality guarantees. What changes is how the messaging fits into the work routine, and this is where each structure must assess its own needs.