A year after the entry into force of its reimbursement by the Health Insurance, teleconsultation starts timidly, doctors and patients gradually appropriating the new tools at their disposal to fight against medical deserts and waiting times too long.
Since September 15, 2018, medical consultations carried out remotely via a computer, a smartphone or a tablet equipped with a camera, are reimbursed to social security rates if they meet certain criteria (go through the doctor, be known to the doctor). teleconsultant physician).
"More than 60,000" teleconsultations have been supported in one year, according to estimates unveiled Thursday by the Health Insurance.
This is far from the 350 million physical consultations performed each year by private doctors, and the government forecasts that, in its 2018 budget, counted on 500,000 acts in 2019, one million in 2020, then 1.3 million in 2021 .
But for the Director General of Health Insurance, Nicolas Revel, "what matters is the rate at which things are progressing," he told AFP.
"After the first six months we were barely 8,000 teleconsultations," he said, touting a "sharp acceleration" in the second half.
"Telemedicine is developing, doctors are gradually taking ownership of it and patients too," said Revel.
Only 1,600 private doctors or health structures billed teleconsultations, generalists in mind, and nearly half were carried out in Île-de-France.
"This remains very marginal but it will eventually develop," said Dr. Jacques Battistoni, president of the syndicate of GP MG France.
Same observation for his counterpart of the CSMF, Jean-Paul Ortiz. "To make teleconsultation, you need a secure tool to exchange health data and integrate payment elements," says Dr. Ortiz. "So far there were not many offerers, it starts to develop."
The leader in making online medical appointments, Doctolib, thus launched on this market in January and claims two thirds of teleconsultations reimbursed by Health Insurance (40,000).
- Free up time -
Other actors had already invested the niche (Qare, Livi, Docavenue ...), but without necessarily meeting the criteria for reimbursement.
For example, the Livi platform, which offers teleconsultations throughout France to doctors based in Créteil (Val-de-Marne), now intends to establish "partnerships with local structures" to return to the "territorial" framework imposed by the secu.
General practitioner in Réalmont (Tarn), Margot Bayart (also vice-president of MG France) will soon launch into telemedicine, but not through a "commercial system", which she "absolutely refuses". It prefers the "secure platform" developed in its territory by "a public interest group" and funded by the regional union of health professionals.
Exercising in a "rural environment", Dr. Bayart hopes to be able to get away from "medical time" and avoid unnecessary travel, even if "the question of the (telecommunications) network may sometimes be a problem."
"If a patient has gastroenteritis and needs a work stoppage, a council, he can teleconsult and stay at home without contaminating my entire waiting room," she says.
Similarly, a patient who has been "prescribed a balance sheet" can teleconsult for the analysis of its results "rather than resuming a new appointment", says his side Dr. Bertrand Magnier, a client of the teleconsultation of Doctolib and GP in Paris.
Patients should also be reassured by their practitioner about this practice and take it, especially the older ones. Of the 30,000 teleconsultation beneficiaries identified by Health Insurance, more than half (56%) are under 40 years of age.
For Nicolas Revel, "the intervention of nurses, who will be from January January remunerated" by the Secu when they assist a patient for a teleconsultation at home, will be crucial for the development of this type of care for seniors . As the establishment of individual teleconsultation booths in pharmacists' pharmacies.
© 2019 AFP