Paris (AFP)

Until then timidly practiced in France, reimbursed since September 2018, medical teleconsultation has experienced a meteoric boom since the confinement put in place to reduce the spread of the coronavirus pandemic, which should help it catch up.

According to figures published by the National Health Insurance Fund (Cnam) on Tuesday, between March 23 and 29, nearly half a million teleconsultations were billed, or more than one in ten consultations carried out in France , compared to less than 1% before the Covid-19 epidemic.

"There is sure to be a before and after an epidemic," said Stanislas Niox-Chateau, president and co-founder of Doctolib, to AFP. "There was a beginning of craze of health professionals last year and now that it has become a reflex for patients, it will change the uses".

Since Monday the French leader in teleconsultation records 100,000 video consultations per day, a hundred times more than before the epidemic and offers this service for free, like most of its competitors, during the crisis.

Reimbursed by Social Security since September 2018 and encouraged by the State, teleconsultation becomes unavoidable at a time when the epidemic, which has killed more than 4,000 people - pending the numbers of the Ehpad - is overwhelming the hospitals of the Ile-de-France after those in the east of the country. Its use was facilitated by a decree of March 9.

It allows patients with Covid-19, or presenting symptoms, to be followed at home and those suffering from other pathologies to be treated remotely by reducing the risk of being exposed to the virus, while reducing the use of emergency services and overflowed emergency services.

- Remote monitoring -

However, doctors who have never used it must be accompanied: in the Great East, the Pulsy public interest group - which brings together the Regional Health Agency, Health Insurance, local authorities, public and private health establishments - offers them a training, tutorials and a free phone line.

Some 2,000 liberal doctors have opted for this service hitherto developed for the hospital, "because we are a structure without commercial interest: they believe that it must be a free public service. However, there will be a commercial commitment, with Doctolib or its competitors after the crisis "underlines André Bernay, its director.

The epidemic also encourages the development of services such as remote monitoring: people with Covid-19 or suspected of having it, receive a secure link to a self-assessment questionnaire every day by text, and a doctor contact if their state of health worsens.

For its part, the Orpea group deployed in its 250 Ehpad "a night medical standby, which mobilizes 45 of our doctors: each of them receives around twenty calls per night, and answers questions from our caregivers in order to 'avoid hospitalizations,' says François Bertin Hugault, medical director. Teleconsultations thus went from 2 to 125 per week in these establishments.

They are also generalized in psychiatry, to "avoid decompensations of patients" usually followed in consultation in his clinics, he says.

If at the beginning of March, the MG France generalists' union alerted the government against the temptation to "sweep away the barriers that are difficult to set up" to supervise a teleconsultation which "increases the risk in decision-making", these days the concern changed.

"Almost all general practitioners, including the most reluctant, have switched to teleconsultation," said Jacques Battistoni, president of MG France, to AFP. "It is the first barrier measure to avoid contamination, which largely explains this phenomenon."

And in fact, "100% reimbursement" by Social Security "has made things much easier," says Jean-Paul Hamon, president of the Federation of Doctors of France. "Unquestionably, habits will be taken," says Dr. Hamon, and the care of the elderly and disabled will be "improved".

But faced with a coronavirus which is particularly lethal for the elderly and the chronically ill, prior knowledge of the patients is essential. "It does not replace, it is added and it completes the consultation in the office and the home visit," says Dr. Battistoni.

© 2020 AFP