Teleconsultation: a difficult takeoff Ehealth innovation

January 07, 2020

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The 2nd edition of the B3TSI – Chronic Panel – Egora barometer on the uses of medical teleconsultation in France shows the difficulties of deploying teleconsultation in France.

Supported by the Health Insurance since September 2018, the medical teleconsultation takes off with difficulty and the uses hardly quiver. In addition, if it has long been presented as a response to medical deserts, teleconsultation appeals above all to the youngest, residing in the Paris region or in large cities.

For the 1re Edition of the barometer on the uses of medical teleconsultation in France, last November, there were only 8% of French people who had consulted remotely at least once in the last 12 months. The 2e edition of the barometer shows an increasing rate, with 12% of teleconsultants.

But this increase remains quite relative. Because if it was presented as a means of overcoming medical deserts, half (52%) of the teleconsultations carried out take place in agglomerations of more than 100,000 inhabitants and even 27% for the Paris region alone against only 16% in the zone rural, while this share of the population represents 26% of the sample sampled.

Distribution of the places of residence of the French having or not having teleconsulted

Teleconsultations are also done by young patients. 48% of them were carried out by French people under the age of 40 when they represent only 35% of the population.

"This use of teleconsultation, which is essentially urban and young, invites us to question medical consumerism" indicates Alexis Bonis Charancle, Associate Director of the B3TSI institute before completing: "However, if we look at the reasons linked to this use of remote consultation, we cannot really speak of a consumerist development. Although young and urban, the population using teleconsultation has quite legitimate reasons ”.

In fact, teleconsultants take more time to get to their doctor's office (14% take more than 30 minutes versus 6% for those who have never teleconsulted in the last 12 months). 39% have used the emergency services of a hospital or clinic in the same past 12 months (versus 21% for those who have not teleconsulted) and 42% are affected by a chronic or permanent illness requiring them regular treatment (versus 33% of non-teleconsultants).

Other insights into this new health practice, for the last teleconsultation carried out, in 41% of the cases, people felt pain and in 48% of the appointment times were too long.

For Dr Alain Trébucq, President and CEO of Global Média Santé, publisher of Egora: "This urban use, corresponding to long meeting times, shows how much the concepts of medical deserts and access to healthcare should not be restricted to rural areas only. Demographic and social developments, both for health professionals and for the general population, mean taking a fresh look at this challenge ”.

A restrictive reimbursement framework…

12% of French people have therefore already tele-consulted in the past 12 months. But do these teleconsultations meet the definition of endorsement 6 of the medical agreement giving entitlement to reimbursement?

First of all, 70% of French people who teleconsulted did so with their treating physician (54%) or a doctor recommended by their treating physician (16%), thus falling within the scope of the endorsement. 8% consulted a doctor recommended by their entourage, 14% a doctor previously unknown on his own initiative and 8% a doctor proposed by their mutual insurance company.

But only 30% of teleconsultations were carried out on ehealth, one of the other key points giving entitlement to reimbursement.

So, if we cross these two criteria, it is only 20% of teleconsultation acts that correspond to endorsement 6 of the medical agreement …

… But French people satisfied with the service

In the months and years to come, will teleconsultation develop as desired by the Ministry of Solidarity and Health and Health Insurance? If we are to believe the satisfaction rate of people who have already teleconsulted, there is a good chance.

Satisfaction with teleconsultation

Thus, more than 7 in 10 French people indicate that teleconsultation is at least as good as traditional consultation, 14% even consider it better or much better (against 29% believing that it is less or much less good). On the other hand, 30% are ready to recommend it to a loved one (versus 17% against and 53% neutral).

On the side of those who have not teleconsulted in the last 12 months, 63% specify that they will probably or certainly use teleconsultation (in its conventional mode, by ehealth and with their attending physician or a physician recommended by this one).

In the end, only 7% of respondents totally agree (score of 9 or 10 on a scale of 10) with the statement that teleconsultation will ultimately be the main method of consulting their treating physician.

Is the level of knowledge and information about teleconsultation sufficient to see it develop rapidly? 83% of respondents indicate that they do not know any teleconsultation platform. Only the Doctolib site is emerging a little, with 8% spontaneous awareness of this type of activity. And even by offering respondents a list of platforms, Doctolib retains its first place with 67% of assisted awareness, followed by Mesdocteurs (6%), Doctoconsult and MédecinDirect (with 5% each).

2e Edition of the B3TSI – Chronic Panel – Egora barometer on the uses of medical teleconsultation in France. Online survey, carried out in June 2019, with a representative sample of the French population from 18 to 75 years old in terms of sex, age, csp of the head of the family, region and size of agglomeration. The differences indicated are significant at the maximum risk threshold (α=0.05).

Source: B3TSI, Egora

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