2024-01-11 08:13:14
Published on Jan 11, 2024 at 7:13 am
Teleconsultation booths should not be able to flourish anyhow, believes the High Authority for Health (HAS). The body published on Tuesday proposed recommendations on the locations for carrying out these remote medical appointments. An important step for the development of this emerging practice, but criticized by physician representatives.
Although teleconsultations represent a marginal share of all medical consultations billed to Health Insurance (around 4%), they have grown significantly since Covid. Surfing on the difficulties of accessing care in medical deserts, start-ups have not only created dedicated telephone applications, but also deployed gondolas or teleconsultation terminals equipped with connected objects such as blood pressure monitors.
Soon an approval
Able to be installed in town halls, these solutions have flourished in particular in pharmacies which can thus “capture” patients leaving teleconsultations. In 2022, more than 2,000 pharmacies offered a teleconsultation assistance service (out of some 20,000 pharmacies in mainland France), according to Health Insurance. And last year, a little more than 1,200 pharmacies were further equipped, notes the HAS.
Teleconsultation companies will be required to obtain ministerial approval to operate this year. However, at this stage there are no rules on the installation of cable cars. However, this is regularly subject to debate.
Train stations, shopping centers…
Last summer, Health Insurance deplored the installation of teleconsultation terminals “in places that are not very compatible with the practice of medicine”, such as supermarkets or station halls. She recommended prohibiting the installation of cable cars “in commercial premises which would not also be the place of practice of a health professional”.
Last November, the SNCF’s project to develop, in partnership with the company Loxamed, “health spaces” in nearly 300 stations by 2028 was widely criticized. For the Order of Physicians, this offer “will divert health professionals who will thus be less available to practice in the most vulnerable territories”. The first union of liberal general practitioners, MG France, considers that teleconsultations which are not carried out by treating doctors open the door to a “misuse of public funds and medical staff”.
On the other hand, Michel-Edouard Leclerc welcomed the SNCF initiative. Describing it as a “very good idea”, he suggested that he could develop a comparable offer in his supermarkets.
“False debate”
Hence the interest in the intervention of the HAS. At this stage, it is content to submit proposed recommendations for consultation until January 22. It does not explicitly recommend avoiding cable cars at train stations, supermarkets or shopping centers. Enough to reassure the organization defending telemedicine players, the LET, which welcomes a “positive and nuanced document”.
Its leader, Jean-Pascal Piermé, warns against “false debate”. “Today, you have lots of shopping centers in which you have a pharmacy, a biological analysis laboratory. » In his eyes, there is no question of installing a cable car “in the middle of a fruit and vegetable section”, but if this type of device is adjacent to a pharmacy, in a shopping center or a train station, “this is not a problem “.
Person responsible for teleconsultation
HAS would like teleconsultation equipment to operate in the presence of a “responsible person”. If this person should be “trained”, “easily identifiable and accessible” and “present during the entire opening range of the equipment”, they would not necessarily be a healthcare professional. Enough, at first glance, to allow the development of cable cars outside pharmacies.
However, certain proposals raise eyebrows among teleconsultation specialists. Like that of regulating the establishment “on a territorial scale”. The actors who install the cable cars should do so “in consultation with the local actors concerned”, according to the HAS, referring to health professionals and the Regional Health Agency. “This would certainly put brakes on the installation of teleconsultation booths,” warns the director of Medadom, Nathaniel Bern.
Discussions with the HAS will continue before the publication of the final recommendations. It also remains to be seen how the Ministry of Health and the legislator will handle it.
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