The French Digital Health Agency unveils the Telemedicine Barometer Ehealth innovation

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The Digital Health Agency, with the Health Mag, unveils the results of a first Telemedicine Barometer carried out with Odoxa. Discovery of the results.

The inclusion in common law of reimbursement by Health Insurance of telemedicine and teleconsultation acts is a real lever for the deployment of these practices.

The digital health agency is setting up a barometer in order to monitoring the appropriation of new telemedicine services by actors in the field, patients and health professionals: their interest manifested during this first wave suggests the expansion of uses in 2020. However, this interest goes hand in hand with real and legitimate expectations on the performance of the tools necessary for their realization.

First lessons

The new concepts of telemedicine, teleconsultation, tele-expertise and medical telesurveillance are all widely known by carers (more than 84% know them all), but also by French people (8 out of 10 know telemedicine and teleconsultation and 6 out of 10 know TV. – medical expertise and telemonitoring).

They are already attracting the interest of many French people – 4 out of 10 would like to use telemedicine – and especially their caregivers (1 in 2 would like to use telemedicine and teleconsultation). More generally, the French (60%), and even more health professionals (70%) have a good overall opinion of telemedicine.

In fact, 6% of French people and 13% of doctors have already experienced teleconsultation. One doctor in two (51% vs 47%) even believes that "teleconsultation is now included" in their practices. Most often this teleconsultation was done at the patient's health home for patients who live far away or can hardly move.

Teleconsultation satisfies patients (71%) and even more healthcare professionals (86%) who have experienced it. In fact, they are convinced that teleconsultation will develop in the future and 64% of doctors who have never used it are convinced that they will come.

Develop usage and improve satisfaction

How to further develop usage – only 6% of patients – and further improve satisfaction (all the same around 30% dissatisfied among patients) with regard to teleconsultation?

First, by "technique". It is the main driver of patient / caregiver satisfaction / dissatisfaction with telemedicine and the main reason for non-use by professionals who have never used it.

Then, by relying on good information for caregivers and especially doctors. The survey shows that the doctor will have a decisive role in the future development of teleconsultation, with 62% of French people saying that they would follow his advice if he offered to use it.

If doctors could also convince their patients that telemedicine does not dehumanize their relationship (fear often mentioned) and that it is as effective as face-to-face consultation (the French do not think so), there is no doubt that it would further boost uses …

10 key points of the Telemedicine Barometer

1. Knowledge of French and caregivers on telemedicine and its avatars

The new concepts of telemedicine, teleconsultation, tele-expertise and medical telesurveillance are all widely known: 8 out of 10 French people know telemedicine and teleconsultation and 6 out of 10 tele-expertise and medical telesurveillance.

They are already attracting the interest of many French people: 4 out of 10 would like to use telemedicine. Health Professionals are even more positive than the general population: they know almost all (84% to 98%) all the dimensions of telemedicine and think that it is a good thing for the quality of care (56% to 85% ) and 1 in 2 would like to use telemedicine and teleconsultation.

1. Overall opinion and detailed image of telemedicine

More generally, the French (60%), and even more health professionals (70%) have a good overall opinion of telemedicine.

On the other hand, with regard to the detailed image with French people and patients, a certain ambivalence remains. It has many positive image traits (the various qualities tested are recognized by 63% of French people) but it suffers from just as many perceived defects (66% attribute the tested defects to it).

In summary, telemedicine would save time for both the patient (65%) and the doctor (72%), but at the same time it would dehumanize the relationship between them (75%). Healthcare professionals share this ambivalent vision, even if the positive most often trumps the negative with them: 66% agree with the qualities tested and 60% agree with the defects.

Nevertheless, obviously, in their weighting, French and caregivers attach greater importance to qualities rather than faults, since overall, their image of telemedicine is positive (60%).

Moreover, the way in which the French and healthcare professionals look at the major developments that may arise in the area of ​​health also testifies to their fairly wide openness to new technologies: 5 out of 7 arouse more hope than fear. But fears remain about consultations and especially remote operations.

1. Perception on the cost of telemedicine

Regarding the price of telemedicine, patients and caregivers are fairly well advised: A large majority of French people (74%) and healthcare professionals (91%) know that teleconsultation procedures are well reimbursed by health insurance.

The French also know that the cost of a teleconsultation for patients is the same as that of a standard consultation, or in any case, is not more expensive (24% still think so).

1. Use of teleconsultation: 6% of French people and 13% of doctors have already tested it

6% of French people have already experienced teleconsultation and 14% have been exposed to it, either by being offered one, or by having a loved one who had experienced it. 9% of healthcare professionals and 13% of doctors have already done (at least) a teleconsultation with one of their patients.

On average, doctors who have done teleconsultation have not been satisfied with an experiment and have carried out 22 teleconsultations with their patients. 21% have even done more than 30… but conversely, 4 out of 10 have done between 1 and 5, a sign that the expression “teleconsultation, to try it is to adopt it” is not not (yet) apply to all doctors who tested it.

Moreover, only one in two (51% vs 47%) would say that “teleconsultation is now registered” in their practices. The technical concerns pointed out by users probably explain that teleconsultation is not of advantage registered in future practices of health professionals.

1. Inventory of teleconsultation today: how and for whom is it implemented?

For those who tested it, most often, the teleconsultation took place in the patient's health home (57%). Health facilities (27%) and retirement homes (22%) are the other privileged places.

Most often, caregivers used a ehealth transmission tool offered by a platform (45%) or proceeded by webcam and telephone (35%).

But consumer tools like the Skype, WhatsApp or FaceTime apps are also breaking through since more than a quarter of caregivers (27%) have used these tools.

Who are teleconsultations for? The types of patients most often favored are those who live far away (49%) or can hardly move (27% for "patients who move with difficulty" and 22% for those "hospitalized or housed in nursing homes"). Necessity therefore far outweighs comfort.

1. Teleconsultation satisfies patients (71%) and even more healthcare professionals (86%) who have experienced it

This is obviously very encouraging, but with 29% dissatisfied, progress is nevertheless possible with the general population. "Technique" is the main driver of patient satisfaction / dissatisfaction with telemedicine.

Thus, the two main reasons for satisfaction with teleconsultation are: "it works" (36% of French people explain their satisfaction by saying that "everything worked well") and "it's the same as normal consultation (29% said they were "at ease as in a face-to-face consultation").

Conversely, technical and confidentiality issues are the main reasons for dissatisfaction with people with a bad experience.

Solving these two problems is therefore technically entirely possible and would further improve the overall level of satisfaction with teleconsultation with patients. It would be the same with caregivers. Thus our screen of detailed satisfaction of health professionals with regard to teleconsultation shows that there are already possibilities for improvement on the technical level: Even if they are much more satisfied with the technical aspects, with more than 63% satisfaction, health professionals using teleconsultation also recognize technical problems related to sound (25%), image (33%) and connection (33%).

Conversely / vice versa, the fact that they do not have the necessary tools is the first reason (1time with 50%, or 13pts in front of the 2th reason cited) mentioned by healthcare professionals who have not yet used teleconsultation.

This is good news: Firstly, by no longer attributing this to their patients (only 5% thus justifying their non-use), this proves that healthcare professionals do not lie to each other / or more. And then, because the technical means are something easy to change.

1. Bright future for teleconsultation: two-thirds of currently non-user physicians believe they will use teleconsultation in the future

Health professionals who are currently reluctant to teleconsultation are well aware that this practice is bound to develop in the future. 60% of them – 64% from doctors – plan to use teleconsultation in the future.

In addition, they anticipate a potentially very wide use in terms of patient base: apart from very elderly patients, healthcare professionals are convinced that teleconsultation could well correspond to very many categories of patients, and in particular those who have difficulty moving.

But conversely, caregivers are convinced that many specific types of patients should be "excluded" from teleconsultation: infants and children, pregnant women, demented or traumatized patients would not be good candidates for teleconsultation.

1. For which French consultations and health professionals do they most consider the development of teleconsultation?

French people and healthcare professionals are considering very many concrete scenarios for which teleconsultation could be well suited, particularly particularly bureaucratic or repetitive acts.

Three main types of consultations seem to make particularly sense for teleconsultation, both from the point of view of the French and of caregivers: To renew a prescription (79% from French and 70% from health professionals) and / or obtain other administrative papers (81% from the French), to obtain information or ask questions to their doctor (79% and 82%) and finally, to exchange information on examination results (74% and 84%).

But teleconsultation is also perceived by the French and their caregivers as being well suited to a patient with mild symptoms (71% and 59%)… or even for monitoring after 2 days of treatment (66% and 69%).

On the other hand, teleconsultation is not perceived by caregivers as being well suited to the management of pain (only 35%) for which face-to-face seems to impose itself in their eyes.

1. The role of caregivers in the development of teleconsultation

All health professionals (92% of nurses and 82% of doctors) are convinced of the value of having a professional accompany the patient during a teleconsultation.

The caregivers think that this would reassure or help the patient, but above all, they are convinced that it could well help them themselves by allowing them to complete the acts of care.

1. The doctor will have a decisive prescribing role on the development of teleconsultation

One thing is certain in any case, the doctor will have a decisive role in the future development of teleconsultation: 62% of French people would follow his opinion if he offered to use it.

It is in the south of France that the French are most likely to say yes (20 to 21% compared to 15% to 18% in central and northern France).

Trust in him is the main reason to follow his doctor's advice to accept a teleconsultation. This patient-doctor trust far outweighs all the other considerations – including practicality related to distance – that can justify following such advice.

Conversely, it is the too "impersonal" side, dehumanizing the relationship that would most encourage patients to refuse to follow a teleconsultation recommendation from their doctors.

Our barometer finally points to a final element of improvement likely to favor the development of teleconsultation: ensuring that it would have an effectiveness comparable to a physical consultation.

Indeed, whatever the current French appetite for teleconsultation and their openness to it, 61% of them do not think that teleconsultation is as effective as a physical consultation.

Source: Digital Health Agency, Odoxa

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