Will 2018 be the year in which telemedicine takes off in France?
Officially recognised by French law since 2009 and implemented in the form of in-the-field experiments, telemedicine is still practised by relatively few healthcare professionals. To remedy this situation, the French government has decided to move things up a gear, in terms of medical practice both in the community and in hospitals.
“91% of GHT (regional hospital consortia) medical projects comprise a telemedicine aspect,” stated Clémence Mainpin, minister responsible for GHTs within the DGOS (French directorate general for the provision of care) at a recent debate*. For the GHTs, telemedicine, in all its forms, is a crucial tool in providing coverage for an entire region, and for bringing non-hospital practitioners together. Telemedicine has now been clearly identified as a key way to cope with the shortage of healthcare services in some areas and to ensure that access to care is available to all.
Funding finally in tune?
Until now, funding had not kept pace with requirements. For many years, telemedicine has been restricted to the realms of experimentation. The French government has now decided to step things up a gear and introduce telemedicine into general law. To this end, article 36 of the bill on social security funding for 2018 makes provision for the funding of tele-expertise and teleconsultation via conventional channels. The experimental system that has been in place until now will therefore come to an end, except with regard to telemonitoring.
Doctors in the front line
Negotiations to establish agreements with regard to telemedicine, between the French healthcare system and doctors, have already been scheduled for early 2018. And off-the-record discussions are already under way.
Although it was doctors who made the first move, they will very soon be joined by other stakeholders. Nicolas Revel, Director of the French healthcare system, says that although “negotiations will initially be limited to doctors only,” they will subsequently be extended according to conditions yet to be specified “because telemedicine has an impact not only on doctors but also on other healthcare professionals”.
“Although deciding the price of telemedicine practices in non-hospital medicine must be the factor that triggers the widespread implementation of telemedicine, hospitals will not be overlooked,” insists Nicolas Revel. Indeed, the generalisation of telemedicine will not be limited to medical practices in the community, and will also affect hospital doctors. In fact, hospital doctors are already involved, or even the driving force, in a certain number of experiments to implement telemedicine, for example, to obtain second opinions and in the context of tele-expertise. The prices applicable for such acts within establishments will be those applicable for acts performed at appointments outside such establishments, as already defined on the NGAP general list of professional healthcare acts. And, in view of the GHT medical projects, hospitals are well placed to become the true driving force behind the deployment of telemedicine in the regions.
The medico-social sector is another category of stakeholders that will be significantly affected. Owing to their patients’ difficulties in travelling to appointments, medico-social professionals are obvious users of telemedicine, whether they practice in the community or in hospitals.
A promise of growth
The field of telemedicine should now, at last, experience growth in line with the services and benefits expected of it. We hope that these new developments will have a significant impact on the discussions and outlook of the various telemedicine stakeholders who will be at the HIT trade show at Paris Healthcare Week 2018.
* At the “Transformation & Transmission” morning discussion held on 9 November 2017, on the subject of digital transformation for new applications in healthcare.
– teleconsultation: appointments between a patient and a medical professional, carried out remotely;
– tele-expertise: a medical professional seeks the opinion of one or more other medical professionals;
– telemonitoring: enables a healthcare professional to make decisions regarding a patient’s treatment on the basis of healthcare information obtained remotely.