In recent years, teleconsultation has become one of the most effective ways to meet the challenges of the French healthcare system, particularly in terms of improving access to care. Despite the public authorities’ stated intention to develop teleconsultation, the adoption of this practice was very slow until 2020. The epidemic crisis of COVID 19 changed the situation and accelerated the adoption of teleconsultation among physicians and users. The practice is becoming established in the long term, even though it is encountering obstacles, such as concerns about the protection of health data. The removal of these obstacles will undoubtedly accelerate the adoption of telemedicine by all stakeholders.
Challenges to the health care system
The French healthcare system is currently facing several demographic and economic challenges. In particular, there is an explosion of expenses in the face of a growing and aging population and the progressive increase of medical deserts. In four years (from 2015 to 2018), the share of the French population living in areas with an under-supply of general practitioners has increased from 3.8% to 5.7%.
In 2018, the Health Insurance launched the reimbursement of teleconsultation with the stated objective of promoting access to health care for all.
Teleconsultation allows to:
- Simplify access to a doctor for people with mobility problems
- Reduce the cost of unnecessary travel and emergency room visits
- Reduce the risk of not seeking care due to delays in patient care
- Simplify the follow-up of chronic diseases and encourage patients to stay at home
- Remedy the shortage of practitioners by offering remote access to care
- Relieve the congestion of medical offices
The difficulty of access to healthcare and medical deserts are omnipresent issues in the French and even European landscape. The crisis generated by the COVID 19 epidemic has played an important role in the adoption of teleconsultation as a means to address these issues.
The COVID 19 crisis: an indicator of the effectiveness of teleconsultation
After a mixed record in 2019, the health crisis related to the COVID 19 epidemic, has accelerated the deployment and adoption of teleconsultation in France.
According to the Assurance Maladie, before the epidemic it counted only 10,000 teleconsultations per week. Since the first containment, this figure has increased significantly, reaching a peak of more than one million teleconsultations in April. Then the trend followed the epidemic situation with a drop during the summer with 150,000 teleconsultations at the end of August and a recovery in October to stabilize at 500,000 acts per week in November.
Regarding physicians, 3 out of 4 general practitioners have implemented teleconsultation since the beginning of the epidemic.
The epidemic situation has therefore accelerated the adoption of teleconsultation by physicians and patients.
How to drive adoption of teleconsultation
The french digital health agency (Agence Numérique de la Santé) launched a barometer on telemedicine at the end of 2019 in partnership with the ODOXA opinion institute. This study was broken down into three waves with the objective of measuring the adherence and brakes of healthcare professionals and users towards telemedicine.
The third wave of the barometer was published in January 2021 and confirms the increasingly common use of teleconsultation by French and European users.
Key results of the survey:
- The French are increasingly aware of telemedicine and more and more of them want to use it. 48% of French people consider telemedicine useful for health in France.
- France is one of the most favorable countries in Europe for telemedicine, with 73% of positive opinions.
- The practice of telemedicine has exploded in one year with a threefold increase for patients and a sixfold increase for GPs, but the progression slowed down after the first containment and France is still “behind” Spain and the United Kingdom.
- Doctors who have tried teleconsultation have adopted it massively and for all types of patients, most often at home.
- Teleconsultation generates a very high level of satisfaction from European patients with an average of 80% of satisfied users. The French are among the most positive users of this practice (88% satisfied). Doctors who have tried it are also completely satisfied (78% satisfied).
- The French, along with the Italians, are the European people who most demand that public authorities invest more in developing the use of telemedicine (69% for the French and 71% for the Italians).
- The use of teleconsultation is likely to increase in the future: doctors who are currently not using it say they will soon use it and 7 out of 10 French people say they would use teleconsultation if their doctor advised them to.
According to Gaël Sliman, president of Odoxa, “Telemedicine has a “boulevard” to develop further in our country, but for its rate of progression to be optimized, the public authorities will still have to communicate, reassure and explain, both to the French and to healthcare professionals, and in particular to general practitioners.”
One of the subjects of concern for doctors and patients and an obstacle to the adoption of teleconsultation is the subject of health data protection. Several doctors’ unions and user associations are concerned about the level of security of data storage. These actors are increasingly wary of non-European teleconsultation platforms or those hosted by actors subject to American law, which authorizes data collection. A survey conducted by the French Federation of Diabetics in 2020 confirms this feeling, as 79% of respondents expressed their opposition to companies such as Google, Amazon or Apple offering telemedicine services.
Furthermore, in July 2020, the European Court of Justice invalidated the Privacy Shield, a text that established that American legislation offered the same guarantees as European law.
The choice of 100% French or European teleconsultation platforms (technology and hosting) will undoubtedly reassure doctors and users, remove this obstacle and further encourage the adoption of teleconsultation.