How teleconsultation can be a remedy for the medical desert in Eure-et-Loir

Reimbursed by the Health Insurance since September 2018, teleconsultation has experienced a rapid development during the Covid crisis. To continue following their patients, physicians have discovered this practice during periods of confinement. Only between 2019 and 2020, the number of remote consultations has increased tenfold in the department, from 5,000 to 55,000, according to the Primary Health Insurance Fund (CPAM) in Eure-et-Loir.

“The momentum that began in 2020 has continued. We repaid 58,000 teleconsultations in 2021, if we only take into account those performed by GPs,” notes Richard Vieau, director of CPAM in Eure-et-Loir.

What are the rules?

Many private companies, such as Doctolib, MédecinDirect, Qare or Medadom, offer this service. Mutuals has also developed partnerships with telemedicine platforms.

As a starting point, “the doctor with whom you perform a teleconsultation must be located near your home”, explains Sygesikringen on its website. “There are exceptions to this rule. The condition of proximity is not required if you do not have a general practitioner and if you live in an area where the supply of care is weak and there is no coordinated territorial organization in your area.”

With 57.47 doctors per. 100,000 inhabitants, Eure-et-Loir is according to the Center-Val de Loire Regional Health Agency strongly affected by medical desertification. Richard Vieau suggests:

“If the delay in getting an appointment with the general practitioner is too long, teleconsultation may be an answer, but it is not a solution to everything. We need to target pathologies that do not require a clinical examination and for which there is no crucial problem. »

Richard Vieau (Director of the Eure-et-Loir Primary Health Insurance Fund)

A Eurélienne testifies to her experience

Valérie, who lives in a rural town 15 km from Dreux, called for this service. “With my husband we have three daughters and our much older doctor is in high demand,” explains this Eurélienne, who responded to our call for testimony.

“A few years ago, I had to wait six hours in the emergency department at Dreux hospital with one of my daughters who had a urinary tract infection. When the problem returned, last October, it was a Saturday and our doctor was not available. We tried to find a solution other than emergencies. »

While researching the Internet, this mother came across a teleconsultation platform. “On my mobile phone, I downloaded the Qare application. I was a little in doubt, but my daughter was not feeling well. It was late, I got an appointment for Sunday morning, “describes Valérie, who adds:

“My daughter ended up in video with a doctor prescribing treatment and lab tests. I paid € 60. »

Valerie (Dreux)

This Eurélienne has a warning: “It is not suitable for everyone. My husband has a chronic illness and needs to be monitored regularly by our attending physician. We do not know what happens when he retires,” she worries.

Teleconsultation terminals in pharmacies

Since the beginning of the pandemic, telemedicine terminals have flourished in Eurelian pharmacies. The Professional Territorial Health Community (CPTS) in the north-west of Eure-et-Loir has signed a protocol with CPAM 28 to regulate this practice.

“Our CPTS shines on the rural municipalities. We only have about twenty general practitioners for 55,000 inhabitants and more than half are over 60 years old. We need to find solutions to avoid satisfying emergencies, ”says Stéphane Fortin, pharmacist at Saint-Lubin-des-Joncherets and vice-president of the CPTS in the north-west of Eure-et-Loir.

Eight pharmacies * out of the eleven installed in this CPTS have been equipped with teleconsultation equipment. Stéphane Fortin illustrates:

“We have compiled a list of approved pathologies. The use of our telemedicine terminals should be reserved for unplanned minor care, such as treating cough for less than 48 hours, isolated abdominal pain lasting less than 24 hours, suspected cystitis or an insect bite. »

Stephane Fortin (Pharmacies in Saint-Lubin-des-Joncherets and Vice-President of the Professional Territorial Health Community of North-West Eure-et-Loir)

In his pharmacy, a former storage room now houses a telemedicine terminal. The pharmacy sees an average of two patients there per week. The Medadom platform manages this tool, which is equipped with connected medical devices.

“The goal is for these terminals to have a real impact on people’s lives. We focus on what is called bobology, ”says Bruno Sablière, Head of Territorial Development and Public Affairs at Medadom. And to add:

“We are here not to replace the doctors in the area, but to give them medical time back. »

Bruno Sabliere (responsible for territorial development and public affairs at Medadom)

This company has installed 23 terminals in Eure-et-Loir and registers an average of 300 teleconsults per month on all this equipment.

The pharmacies equipped with a telemedicine terminal in the CPTS in the north-west of Eure-et-Loir are located in Courville-sur-Eure, La Ferté-Vidame, La Loupe, Saint-Lubin-des-Joncherets, Saint-Rémy-sur-Avre , Tréon, Tremblay-les-Villages and Senonches.

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