Containment has brought telemedicine into practice, but what good are the French after the peak of the health crisis? To find out, the professional association Les entreprises de télémédecine (LET) has carried out the first collective survey. It draws the landscape of French practice, from the profile of teleconsultants to the way teleconsultation takes place.
For the first picture of this new sector, everyone posed. The teleconsultation access companies Doctolib, Livi, Qare, Teladoc, Medadom, Feeli and Tessan each reported (anonymised) data from 12,000 teleconsultations carried out through them between the beginning of August and the end of November 2021. This is a representative sample. the 1.8 million teleconsultations carried out during these four months analyzed by the company Télémédecine 360.
No attending physician
The lessons are many. “I will only remember one number: Teleconsultants are twice as likely as the general population to have no attending physician. [27,6 % contre 11 %, NDLR] “, Emphasizes the President of LET, Maxime Cauterman (Livi), who sees the capacity of telemedicine to fight against medical deserts. In fact, 25% of teleconsultants live in a medical desert compared to 17.3% of French people. It should be noted that the zoning of the deserts has evolved since the study, this point needs to be confirmed in the future.
Since the end of his imprisonment, teleconsultations in France have fallen to less than 10% of medical consultations. Who keeps using it? Above all, young people. The teleconsultant has an average age of 30 years, compared to 48 years for the French population. An active, connected generation, who traditionally rarely goes to the doctor and often has no attending physician, in Ile-de-France. And the teleconsultant is also, above all, a woman, in 64% of cases. Probably because they more often stand for children’s medical appointments. Those over 50 and under fifteen each represent only 9.7% of the teleconsultants.
4% without social security
The teleconsultant is overrepresented in the medical deserts, but “teleconsultation is a fact for all social classes,” the LET study emphasizes. If 73% have third-party payment, 4.4% do not have social security, and almost 8% benefit from supplementary health insurance.
Teleconsultation, where 97% includes video, takes place mainly by appointment (88%) and with a general practitioner (89%) rather than a specialist. It lasts an average of 10.5 minutes (6.8 minutes of median duration), which is less than a physical consultation (18 minutes on average). However, we must add the telecommunications doctor’s writing time after interruption of various documents, including the prescription, which results in 89% of the teleconsultations (against 81% for physical consultations).
The vast majority of teleconsultations take place during the week (91%) and during the day (89%). But 19% are carried out outside the opening hours of city offices (at night, on weekends, on public holidays), which helps to remove clogging of emergencies, emphasizes LET. Those that take place at night are significantly more frequent on weekends than on weekdays (17% vs. 11%, respectively).
This study has no qualitative data, but it is nevertheless a valuable basis for thinking about the development of this activity and preventing it from becoming a medicinal product that only serves to renew prescriptions.
“It would be a significant contribution for people who can not move, e.g. and Ehpad. But for that, we need to develop assisted teleconsultation “by a nurse or caregiver trained in palpations,” said Marguerite Cazeneuve, deputy director of the National Health Insurance Fund, during a roundtable discussion as part of the presentation of the study. its territory “, she continued. Relieve urban medicine yes, disorganize it, no.
Teleconsultation from abroad
The disorganization of the health care system is the great fear that telemedicine may free itself from geographical constraints. This helps to reduce the territorial divide and makes it possible, for example, to take advantage of the time difference to teleconsultate at night on the French mainland with overseas doctors who would integrate this role into their daily lives and vice versa.
But it also opens Pandora’s box. France has world-class medicine, and “we will be able to consult from abroad. Abroad – China, USA, etc. – can also offer a telemedicine offer to people living in France. There is a risk of pressure on the French system in all its components (insurance, complementary, etc.) that individuals can turn to teleconsultations elsewhere, “notes Claude Kirchner, director of the National Pilot Committee on Digital Ethics. he says.