Digitalization of reimbursement care sheets, online appointment system or analysis results, eHealth is already part of our patient journey. But there are still many possibilities for development. In addition, French doctors face challenges as many unfulfilled appointments, always full calendars and non-replacement of retiring doctors… What solutions can digital technology offer for the medical consultation?
Rapid development of online appointment scheduling platforms.
Mondocteur or Doctolib are French eHealth startups who want to make life easier for doctors and patients. A simple idea is behind this purpose, create online appointment scheduling platforms.
1500 doctors were connected in 2015, they are now 40,000 in France (out of about 200,000) to go through the Doctolib platform for their appointments. And 2,500 new practitioners are tempted every month. Digital is helping doctors saving time and patients remembering their appointment thanks to Sms and emails reminders.
My ATAWAD doctor (anytime, anywhere, any device)
Dear reader, have you ever searched the internet for your symptoms in order to know what you are suffering from? This is well known that the information you find there is often approximate or very alarming…
What if I could ask my questions online and have a personalized answer according to my medical file? What if I could get useful advice in real time to help me deal with my diabetes or hypertension on a daily basis? In the future, this will be possible thanks to artificial intelligence and chatbots. The French startup Betterise introduced Smart Alfred the first health chatbot in France. Promising, but for the moment unavailable. It should be back again soon.
Overseas, the health authorities take a close look at it. Since the end of January, the UK NHS (National Health System) has been testing a medical chatbot for small problems. Its objective make a primary selection and determine whether a physician should be seen. A good initiative to relieve congestion in English hospitals where waiting times can be very long.
2018, the year that will see the rise of consultation at home or in the office
Teleconsultation is a consultation of a doctor by a patient carried out online in real time; only 2% of French people use it today, but this figure can only increase. The French government is willing to facilitate online consultation and has decided to reimburse it for certain patients.
The French start-up H4D invented and marketed the « consult station », the first connected medical cabin. Their objective? Allow employees to consult a doctor within 1 hour when their company has set up that cabin. 40 doctors are available for two options; the first one, teleconsultation to treat the same problem as your general practitioner would do and the second, a complete medical check-up. Indeed, the cabin is fully equipped and allows you a complete check-up, tension, respiratory or ears tract to treat your cold or otitis; even electrocardiogram, audio or visual test for further consultations. The prescription is made by the doctor in front of you and then printed in the machine so that you can go with it.
Online consultation has become the credo of insurance companies. Axa Insurance was the first to implement this service in 2015 for its members, the other companies have followed it or are planning to do so in the near future. According to the newspaper Les Échos, Axa already carries out 10,000 online consultations per year and only 20% of the problems raised by patients require the consultation by a general practitioner.
VYV, the grouping of Harmonie, MGEN and Istya, are also launching eHealth. They are offering teleconsultation to « Harmonie » members first, and then they aim at generalizing if this is working out. They are planning to reach 2 million online medical consultations by 2020. Teleconsultation in France has two purpose. First it should help doctors lightening up their agendas and second this is aiming at challenging medical deserts.
Artificial Intelligence in eHealth or the indispensable tools of medical consultation.
Already widely used in the field of eHealth, AI (Artificial Intelligence) will become indispensable to help doctors in their practice: saving time, reducing the number of possible errors. Above all, the AI will be able to assist the physician in his or her diagnosis. Indeed, as Ludovic Louis wrote in the article « The AI has become the stethoscope of the 21st century doctor ».
« The AI is able to read 20 million clinical studies in a few minutes while a doctor will read up to 200 publications a year. »
As a result, a diagnosis can be made more quickly. Datas on breast cancer were given for analysis to Watson, IBM’s artificial intelligence and to a group of pathologists specialized in this field. Watson was able to analyze these data in 10 minutes, unlike 160 hours for pathologists according to the same article.
The cabinet of the future, the hard core of eHealth.
A former Google executive, Adrian Aoun, recently opened the first futurist clinic, Go Forward, in San Francisco. He thought of it as a company and wanted it to be profitable, optimized and pleasant. For $149 per month you have unlimited access to medical consultations and Forward technologies. Each patient who enters is welcomed by an assistant. He is asked to fill in a questionnaire, is scanned and analyzed for a complete check-up, the first appointment lasts about one hour. All these data are crossed and analyzed by algorithms and the results are then distributed to the multidisciplinary team. The doctors are then responsible for discussing these data with the patient and giving personalized advice, all the conversation is recorded to allow the patient to leave with his or her report. You can then have a permanent follow-up thanks to the online application that manages your personal data.
Data: the key element of eHealth
You probably understood at this point that data is the key of all those evolutions. The future of medicine is hyper-personalization through the use of patient data. However, French regulation is restrictive and the Frenchs remain reluctant to share their health data ; this leads into restraining the evolutions in this field. Moreover, the DMP (Dossier Médical Personnalisée = Personalized Medical File) which was supposed to allow the smooth sharing of a patient’s health data between different health professionals, was initiated in 2011 and abandoned. It came out again in 2016. To date, it is still in a pilot phase and the deployment date has not yet been announced.
Moreover, the obvious question that arises is the one of the cyber-security.
I was writing above about the NHS ; last May, the institution was the victim of a cyber-attack that paralyzed several hospitals and forced them to even cancel appointments. Data protection will undoubtedly be the main challenge for the various players and will significantly influence the development of eHealth.
Technical progress is very promising and profound changes will certainly occurs in the health sector and the role of its professionals. These advances raise many questions, as: what will be the place of health professionals in the future? What will happen to the doctor-patient relationship?
Other articles in english :
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Programmatic kitchen. New challenges that e-commerce will face in 2018 by Daria Filippova
« Le cabinet médical de demain est déjà là » https://www.latribune.fr/technos-medias/electronique/le-cabinet-medical-de-demain-est-deja-la-733853.html
« La téléconsultation devient un standard chez les assureurs santé » https://www.lesechos.fr/finance-marches/banque-assurances/0301044817813-la-teleconsultation-devient-un-standard-chez-les-assureurs-sante-2140761.php
« IA, le Royaume-Uni va tester un chatbot medical pour les petits bobos » https://www.numerama.com/sciences/223053-ia-le-royaume-uni-va-tester-un-chatbot-medical-pour-les-petits-bobos.html
« A quoi ressemblera la médecine en 2030 » https://www.lesechos.fr/idees-debats/cercle/index.php