The verdict in three sentences
Any application storing personal health data for patients or professionals in France must be hosted by an HDS-certified provider (article L.1111-8 of the French Public Health Code). For an early-stage SaaS, hosting costs EUR 300 to 3,000 a month, or 30 to 80 % more than standard cloud, with 2 to 6 weeks of onboarding. The choice of host matters less than architecture: encryption, logging and the GDPR processing agreement determine real compliance.
What HDS certification covers, and what it does not
The HDS framework, aligned since 2024 with ISO 27001 plus specific requirements to keep data within the European Economic Area, distinguishes physical infrastructure hosting from managed operations. A host certified for activities 1 to 4 (infrastructure) does not make your application compliant: the application layer remains your responsibility.
| Requirement | Responsible party | Indicative 2026 cost | Watch point |
|---|---|---|---|
| HDS-certified infrastructure | Host | Included in the offer | Check the exact certificate scope |
| Encryption at rest and in transit | Vendor and host | EUR 0 to 150 a month (KMS) | Key management, annual rotation |
| Access logging | Vendor | EUR 50 to 400 a month | 1 year minimum retention, per-patient traceability |
| Encrypted off-site backups | Host or managed provider | EUR 80 to 500 a month | Quarterly restore test |
| GDPR processing agreement | Both parties | EUR 1,500 to 4,000 legal advice | Mandatory HDS-specific clauses |
| Data protection impact assessment (DPIA) | Vendor | EUR 3,000 to 8,000 | Mandatory for large-scale health data |
| Annual penetration test | Vendor | EUR 4,000 to 12,000 | Required by most hospital clients |
2026 estimate, order of magnitude for a health SaaS tracking 1,000 to 20,000 patients.
HDS hosting providers compared in 2026
Prices below are for a minimal production architecture: 2 application servers, a high-availability managed database, object storage and backups.
| Provider | HDS offer | Starting monthly budget | Premium vs standard offer | Onboarding time |
|---|---|---|---|---|
| OVHcloud | Public Cloud and Bare Metal HDS | EUR 400 to 1,500 | 30 to 50 % | 2 to 3 weeks |
| Scaleway | HDS instances and managed databases | EUR 350 to 1,200 | 30 to 45 % | 2 to 4 weeks |
| Outscale (Dassault Systèmes) | HDS and SecNumCloud cloud | EUR 800 to 3,000 | 50 to 80 % | 4 to 6 weeks |
| AWS (Paris and Frankfurt regions) | HDS-eligible services | EUR 600 to 2,500 | 20 to 40 %, plus Business support | 2 to 4 weeks |
| Specialised HDS managed provider | Hosting plus operations | EUR 1,200 to 3,000 | 60 to 80 % | 3 to 6 weeks |
To also target the US market, the equivalent is HIPAA compliance with a signed BAA (Business Associate Agreement): AWS, Google Cloud and Azure offer it at no licence premium, but architecture and audits remain your burden. One platform can serve both markets with two separate environments.
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Mini case study
Thomas, founder of a chronic-disease patient monitoring solution in Nantes, plans for 5,000 patients and 120 clinicians in year one. On standard cloud, his architecture would cost EUR 520 a month. With an HDS host such as Scaleway or OVHcloud, it rises to EUR 750 a month, a 44 % premium, plus EUR 150 for logging and KMS. He adds a EUR 5,000 DPIA, a EUR 2,500 processing agreement and a EUR 7,000 pentest. Year one therefore costs 12 × 900 + 14,500 = EUR 25,300. At EUR 8 per patient per month billed to care providers, 5,000 patients generate EUR 480,000 a year: compliance represents about 5 % of revenue, an acceptable ratio that unlocks hospital tenders.
FAQ
Do we need our own HDS certification? No, if you entrust hosting to a certified provider and do not operate the infrastructure. If your team administers the servers, HDS certification for managed operations may be required: allow 6 to 12 months and EUR 30,000 to 60,000.
Is a wellness app concerned? If it processes data from which the health status of an identified person can be inferred, yes. A simple step counter usually is not; blood glucose tracking is.
How long does migrating to an HDS host take? For an existing application, allow 3 to 8 weeks: contractual onboarding, encrypted data migration, testing and cutover.
Can we use a non-European US service? Since the 2024 version of the framework, data must be hosted within the European Economic Area, and access from third countries must be governed and documented.
Can Kolonell build and deploy the application? Yes, we design the compliant architecture, deploy with the HDS host of your choice and document logging, encryption and the reversibility plan.
Let's scope your project. Describe your health application, patient volume and target clients: we will price the HDS architecture, development and compliance work, with hosting at EUR 300 to 3,000 a month and 2 to 6 weeks of onboarding. Detailed quote within 48 h. WhatsApp +221 77 596 93 33.
Mohamed Bah
Fondateur, Kolonell
Passionate about digital and entrepreneurship in Africa, Mohamed has been helping Sénégalese businesses with their digital transformation since 2020. Founder of Kolonell, he believes every SME deserves a professional and accessible online présence.
