2024-01-11 10:19:29
After the time of pioneers and excessive expectations, it seems that we have shifted to one of skepticism, even denigration. Telemedicine would not live up to expectations and would only be used by urban “bobos”. In short, we would have collectively taken the wrong path. This observation seems reductive to us, unpragmatic and ultimately dangerous for our fellow citizens who are waiting for concrete answers to their difficulties in accessing care.
By Jean-Charles Dron, Operational Director e-Meuse santé
and Jean-Michel Meyer, President France Assos Santé Grand Est
Through the e-Meuse santé program (winner of the call for projects “ Territories of innovation”), we have been involved in the subject of daily teleconsultation for more than 4 years, within the departments of Meuse, Haute-Marne and Meurthe-et-Moselle. Our experiments cover numerous scenarios of access to care and health, from rural areas to cities, territories each facing medical desertification in their own way.
We have established teleconsultation centers there and have thus contributed in 3 years to the realization of nearly 4,500 teleconsultations reimbursed by Health Insurance thanks to our collaboration with more than 80 health professionals, patient associations, local communities .
12 recommendations to promote the deployment and sustainability of teleconsultation in the territories
Beyond the figures, above all we exchanged, tested, evaluated. In a report “Recommendations and measures for the replicability of the territorial deployment of telemedicine”, we analyzed what worked, what needed to be improved or adapted to the specificities of each territory. For us, the success of teleconsultation is due to respecting two essential prerequisites: a teleconsultation offer designed to support and serve health professionals in the area concerned; and an offer which is the subject of mobilization of care stakeholders and access to patient care, while respecting the role, status and expertise of each person.
Well designed, in co-construction with existing stakeholders and users, well deployed, telemedicine is an effective tool that offers solutions for access to care for thousands of French people.
Care is the sole domain of health professionals and the sovereign State. A telemedicine project (teleconsultation, teleexpertise or telemonitoring) can therefore only be carried out by and for health professionals in a region. This is why the organizational model proposed by e-Meuse santé is that of the facilitator serving the professional territorial health communities (CPTS) with whom we work.
In these projects, in coordination with regional health agencies, local authorities have their place in improving access to care, for example by installing teleconsultation centers in places and according to methods discussed and decided with health professionals or by participating in the remuneration of telemedicine assistant health professionals for tasks carried out in support of the strict consultation covered by Health Insurance.
Clarify the telemedicine offer thanks to specifications and validated methodologies
So, yes, we must clarify the telemedicine offer thanks to specifications and validated methodologies now available thanks to experiments. We are launching an appeal to all stakeholders concerned, the State, patient associations, health professionals, local authorities: let us not turn our backs on telemedicine!
Well designed, well deployed, it is a effective tool that offers solutions for access to care for thousands of deprived French people facing the shortage of caregivers and allows people without a treating doctor to be able to find a satisfactory care pathway. As for the risk of dehumanization of the medical relationship, France Assos Santé surveys show that there is no major break in the singular conference and that chronic patients say they are closer to their doctor in a less solemn setting than the doctor’s office.
Telemedicine deserves everyone to mobilize around good practices. She has all the qualities to be part of the solutions that will allow us to collectively respond to the challenges of healthcare provision in the coming years.
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