Paris (AFP)

Develop telemedicine for diagnostics and prescriptions, but also to avoid hospitalizations and unclog emergency services: this is a crucial issue for the managers of nursing homes and clinics, who are suffering from plasters in a field where everything has to be done.

In recent months, players in the "old age" sector have launched themselves: the private group Orpea wants to halve the hospitalizations of its patients and residents in three years, by generalizing telemedicine to its 354 establishments in France (retirement homes , follow-up and psychiatric clinics).

"The residents of our retirement homes are 87 years old, two-thirds are undernourished, and over a year 30% of them will be hospitalized, most often in the emergency room. However, hospitalizing a disoriented resident, extremely weakened is to take a risk, "said AFP Jean-Claude Brdenk, chief operating officer in charge of operations at Orpea.

"Above all, we want to prevent him from going to the hospital, but when necessary, telemedicine makes it possible to improve his care, by directing him towards the right service, thanks to the examinations carried out beforehand with help -caregiver, "he said.

Developed by the Bordeaux start-up Exelus - in which Orpea took 20% -, the Nomadeec platform allows clinical exams (pulse, blood pressure, electrocardiogram, etc.) to be sent to the doctor or to the emergency room. or everyday.

The examination reports go directly to the patient's file and the platform connects emergency medicine - 25 remote control centers in Samu are equipped with it, as well as certain CHUs - city doctors - provided that they have a good wifi - and retirement homes.

Orpea will invest 10 million euros to train its teams (carers, nurses) and install broadband internet in its establishments.

It will also have to motivate doctors to adopt teleconsultation. "We will have to get them on board by showing them interest in them. But the main challenge is technical," said François Bertin, France medical director for Orpea.

With the development of 5G mobile technology, "it will be much better, but in the meantime it is not easy: there are a lot of connection interruptions that waste time for professionals", adds Bruno de La Rochebrochard, analyst from Parisian broker Bryan Garnier.

- Need for standardization -

Due to the aging of the population, the "silver economy" - which refers to the consumption of seniors as well as the economy of "aging well" - will weigh by 2024 some 101 billion euros in France, against 91 .5 billion this year, according to Xerfi Précepta.

Within it, "the generalization of useful sustainable digital services is a necessity", says Xerfi. "The fact remains that nursing homes or home care services display very disappointing levels of equipment and maturity of their information systems": investing "must be at the center of their priorities".

For its part, the number one European retirement home Korian will also deploy teleconsultation this year, thanks to the start-up Omedys, of which it took 70%.

Founded by two emergency doctors, it performs medical examinations in a network of connected teleconsultation rooms, created with the support of local authorities in eastern France.

"All these tools are coming, it's exciting, and they will make huge savings," said AFP M de La Rochebrochard. "But for them to be able to communicate with each other," he says, "standardization is needed, and the private companies that develop them have no interest in opening up their solutions."

"The + data + is worth the money and everyone wants to remain its owner", underlines the analyst. In addition, the management of personal data is sensitive, and "no safeguard exists yet".

Since September 2018, medical consultations carried out remotely are reimbursed at Social Security rates if they meet certain criteria such as going through the attending doctor.

But the deployment of telemedicine is slow: only 60,000 teleconsultations were taken into account between September 2018 and September 2019 - while the government was counting on 500,000 acts in 2019 -, and 1,600 liberal doctors or health structures had billed for it.

© 2020 AFP