1.1 Definition and scope of the study
Telemedicine is a sub-domain of e-health, which includes innovations in the use of information and communication technologies (ICTs) for health activities.
In France, since 2009, telemedicine is regulated and the public health code defines 5 types of medical acts related to telemedicine [Article L6316-1 Legifrance ] :
- Teleconsultation: allows a medical professional to consult a patient at a distance;
- Tele-expertise: allows a medical professional to seek the opinion of other expert medical professionals on the basis of elements in a patient's medical record;
- Telemedical monitoring: allows a health professional to make decisions on the management of a patient;
- Tele-medical assistance: allows a medical professional to remotely assist another professional during the performance of a procedure;
- The medical response provided within the framework of medical regulation during calls made to the SAMU or the centres 15 is also part of telemedicine acts.
This study covers all these medical acts and shows how telemedicine can be a complement and/or substitute to traditional medical services.
In France, health expenditure is growing faster than GDP, which provides a strong foundation for this market to expand. [BpiFrance]
1.2 The development of telemedicine in different countries
Frost & Sullivan estimates the value of the global digital health market to be $***.* billion by ****, a ***% increase between then and ****. This growth is primarily driven by the needs of an aging population and the sharp increase in chronic diseases. [***]
The use of telemedicine varies by country: Saudi Arabia leads the ...
1.3 The domestic market
E-health encompasses innovations in the use of information and communication technologies (***) for health-related activities. Its turnover was estimated at * billion euros in **** in France. [***]
HIS includes the following categories: hospital information systems, information systems for healthcare professionals and archiving services. This market differs from the e-health market, which concerns online health ...
2.1 A response to different needs and expectations
Telemedicine is a fundamental lever for the establishment of new organizations to meet today's challenges such as :
the ageing of the population, an increase in chronic diseases (***) associated with a need for significant medical follow-up. France has set a target of * million patients to be monitored remotely in France by ****. [***]
2.2 An overview of the opinion on teleconsultation in France
The frequency of consultations varies according to specialties: general practitioners and dental surgeons/dentists are the most requested health professionals. This raises the question of the possibility of replacing some of these "face-to-face" consultations with teleconsultations. Indeed, we can see that the abolishment of the physical presence of a proffessional ...
2.3 The unequal distribution of health professionals
The ageing of the population also requires the development of solutions for the care of the elderly, particularly in the most isolated areas of France. Medical deserts, areas where the number of doctors per ***,*** inhabitants is low, are numerous in France. [***]
Doctor density by region France, ****, numbers of doctors per ...
2.4 Government support drives telemedicine progress
The willingness of public authorities to generalize the use of telemedicine is rooted in various reasons:
fight against medical deserts; reduce appointment delays. Indeed, these delays can reach several months for certain specialties, posing a real problem for patients in nusrsing homes in particular; an economic issue. There is ...
3.1 A wide variety of actors and stakeholders
At the instigation of the State, a public offer has been developed through regional platforms. The entry into the common right to reimbursement by health insurance has led to the emergence of a private offer (***) offer must be assessed continously.
In short, there are two types of telemedicine services on the ...
3.2 Regional actors
The regional platforms refer to all the platforms implemented under the guidance of the Regional Health Agencies and their Regional Support Groups for the Development of e-Health. A total of ** regional telemedicine platforms have been identified [***]. Of the ** regions (***) surveyed, only Corsica states that it does not have a dedicated regional ...
3.3 Private actors
Diversity of private stakeholders
The typology of the actors is very varied because of the diversity of the products necessary to carry out telemedicine acts:
large groups (***) also have a role to play in this area through their ability to retrieve, store and process large quantities of data. SMEs and startups ...
3.4 Diversité des acteurs privés : un marché qui se structure
Diversité des intervenants privés
La typologie des acteurs est très variée du fait de la diversité des produits nécessaires à la réalisation d’actes de télémédecine :
grands groupes (***) ont également un rôle à jouer dans ce domaine par leur capacité à récupérer, stocker ...
ANALYSIS OF THE OFFER
4.1 Different offers and support
The offer of diversified services is most often carried by regional platforms, whose economic model will have to be rethought following the arrival on the market of private MLT platform providers. [***]
Services can be offered by:
the regional telemedicine platforms (***); by other utility providers (***); by private operators (***).
The specialty services represented ...
4.2 The offer of the regional platforms
Different types of regional platforms
Telemedicine platforms are mainly available :
in full web, Saas mode, a service accessible only from the web (***) via a web portal requiring the installation of a lightweight application (***) via a heavy application (***)
Mobile access (***), on the main mobile environments when it is an application.
4.3 A varied but still incomplete offer
The table below lists the non-exhaustive specialties covered by the different telemedicine services in the regions that responded to the questionnaire of the ASIP . Thus, it can be seen that specialties not covered by telemedicine services are rare on French territory. The complete list is available on page ** of the Agence ...
4.4 Innovative offers
Examples of start-ups offering teleconsulting services . [***]
The launch of its teleconsulting solution occured in January ****. In September ****, more than **,*** teleconsultations were carried out on Doctolib, i.e. two thirds of the procedures reimbursed by the Social Security. According to the founder's estimates, ***,*** teleconsultations should be exceeded before the end of ...
5.1 Current Regulation
Telemedicine has developed, since its entry into French law in **** (***) around priority axes embodied in the various guides and specifications published by the DGOS, as well as legislative and regulatory texts
In ****, Article ** of the Social Security Financing Act No. ****-**°* provided for experiments on the deployment of telemedicine in towns ...
5.2 Des mesures gouvernementales pour favoriser l'intégration de la pratique
Intervention des pouvoirs publics
La volonté des pouvoirs publics de généraliser l’utilisation de la télémédecine pour différentes raisons :
Lutter contre les déserts médicaux Réduire les délais de rendez-vous (***) Maitriser les dépenses liées à la santé. Il y a donc ...
POSITIONING OF THE PLAYERS
6.1 Positioning of the players
- Ortif- Outil Régional de Télémédecine d’Île-de-France
- Qare SAS
- NEHS Digital
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