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Télémédecine :
Une Révolution nécessaire ?
Philippe A. Coucke
pcoucke@chuliege.be
Accessibilité
50 – 42 – 10 - 5
Qualité et sécurité
en matière de soins ?
Raisons de ce désastre: multiples!
• Le tsunami gris.
• La pénurie « humaine » dans le monde des soins (OMS).
• La croissa...
• Vieillissement de la population:
– Le tsunami annoncé
– Poly-pathologies
– Pathologies complexes
– Actes plus invasifs e...
PIB et politique sociale:
Chiffres pour la Belgique
• PIB 42% • Retraites 12%
• Education 8%
• Aides Sociales 5%
• Autres ...
Les Français ont le sentiment d'une médecine à deux vitesses
Par AFP — 19 mai 2014 à 14:58
Selon un sondage, pour 92% des ...
Le modèle de la médecine libérale est largement obsolète!
www.mediquality.net Paris 24-03-2017
Tous les principes de la mé...
Stop à la médecine à deux vitesses
Jean Hermesse Mutualité Chrétienne / 04-04-2019 En Marche
Les témoignages de patients a...
Trump's travel ban could spark crisis in
Michigan's doctor shortage, health care leaders
say
Foreign-born doctors play hug...
Quatre hôpitaux généraux sur dix vont mal
HealthCare Magazine 25 octobre 2018
Le résultat courant des hôpitaux s’est forte...
"Pour préserver nos soins de santé, il faudra toucher aux vaches sacrées"
BRUXELLES 26/02/2019
Douze hauts responsables fl...
Relation à la technologie:
 L’hyper-connexion
 Usage digital intuitif et permanent
Relation à la culture:
 Le travail e...
Big Data in Health Care in the era of a connected patient in the IoTPatients generate 1 million data points an hour. What ...
Artificial Intelligence Industry – An Overview by Segment
Last updated on March 1, 2018 by Daniel Faggella tech emergence
...
The Top Telemedicine Solutions Bringing
Patients and Doctors Closer To Each Other
www.themedicalfuturist.com August 2017
...
Avantages du modèle ?
Electronic Consultations to
Improve the Primary Care-
specialty Care Interface for
Cardiology in the Medically
Underserved...
Rexuti, a software-based online platform that promises to lessen the burden on traditional healthcare
systems by cheaply d...
Quels sont les défis à relever ?
Ambitieux et Multiples!
 Les 10 objectifs principaux de la télémédecine:
 Améliorer le ...
What’s preventing doctors from adopting virtual care technologies?
A Deloitte survey of 624 primary care and specialty car...
What’s preventing doctors from adopting virtual care technologies?
A Deloitte survey of 624 primary care and specialty car...
What’s preventing doctors from adopting virtual care technologies?
A Deloitte survey of 624 primary care and specialty car...
Les moteurs du changement
Télémédecine : l’AHA s’y met aussi !
Dr Jean-Yves Hindlet - Lundi 6 février 2017
La prestigieuse American Heart Associatio...
American Well survey: most people
want video visits, 20 percent would
switch doctors to get them
By Heather Mack January 2...
Survey: 21 percent of Americans have used virtual healthcare, 78 percent are interested
By Jonah Comstock February 09th , ...
FDA clears Current Health's remote monitoring platform for home use
Recently deployed in US and UK hospitals, the company'...
L’explosion de l’engouement
poussé par les « professionnels »
It has nurses and doctors and a cafeteria, and
the staff spend their days looking after the very
sick―checking their vital...
Intermountain creates a virtual hospital with telehealth tools and services
The Connect Care Pro program aims to reduce co...
Walgreens partners with
NewYork-Presbyterian to offer
in-store telemedicine
December 12, 2017 www.mobihealthnews.com
NewYo...
Telemedicine’s challenge: Getting patients to click the app
February 6th , 2019 AP News
Walmart workers can now see a doct...
Patients have been slow to embrace virtual care. Eighty percent of mid-size and large U.S. companies offered telemedicine
...
To increase adoption, digital therapies need to fit into patients’ and doctors’ lives
By Jonah Comstock September 16, 2016...
Growing demand for telemedicine fueling
multibillion dollar market growth
With a significant rise in the prevalence of the...
Bipartisan bill seeks to remove roadblocks to telemedicine
under Medicare
May 4th 2017 www.mobihealthnews.com
Called the C...
Médecine : la Sécu rembourse aujourd'hui les téléconsultations… sous conditions
Par Isabelle de Foucaud le 15.09.2018
 Le...
Les solutions techniques.
The Top Telemedicine Solutions Bringing Patients and Doctors Closer To Each Other
www.themedicalfuturist.com August 2017
1...
Teladoc eyes the global market
after its latest acquisition of
Advance Medical
By Laura Lovett June 04, 2018 www.mobihealt...
Teladoc Health acquires MédecinDirect to secure French foothold
The terms of the deal, which fits into a larger global exp...
Ping An Good Doctor launches commercial
operation of One-minute Clinics in China
The company announced last week then it h...
Conclusions
 The essence of practicing medicine has been
obtaining as much data about the patient’s health
or disease as possible and...
NT
New Technology + OO
Old Organization
=
COO
Costly Old 0rganization
We have rocket science technology
in a Flintstone ar...
Patient’s voice !
We don’t want to be seen as a weak vulnerable,
unhealthy,…
Sick, passive, less productive, expensive, …
...
Disponible le 19 juin en librairie
Disponible à partir du 20 juin sur
LUXEMBOURG CREATIVE 2019 : la télémédecine (2)
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  1. 1. Télémédecine : Une Révolution nécessaire ? Philippe A. Coucke pcoucke@chuliege.be
  2. 2. Accessibilité 50 – 42 – 10 - 5 Qualité et sécurité en matière de soins ?
  3. 3. Raisons de ce désastre: multiples! • Le tsunami gris. • La pénurie « humaine » dans le monde des soins (OMS). • La croissance des coûts. • L’avènement des « digitally natives » • La force du « GAF-BAT ». 23 juillet 2018
  4. 4. • Vieillissement de la population: – Le tsunami annoncé – Poly-pathologies – Pathologies complexes – Actes plus invasifs et plus coûteux – Pénurie de soignants (OMS: 7.10 6) • Evolution des dépenses de santé par rapport au PIB – En France depuis 1950 : • En 60 ans, sur la période 1950-2010, elles sont passées de 2,6% à 9,1% du PIB. • Elles ont cru à un rythme moyen annuel supérieur de 2,4 points à celui du PIB. • Si elles ne sont pas maîtrisées par des décisions publiques, le système actuel de financement collectif explosera tôt ou tard. C’est une certitude économique basée sur un raisonnement mathématique simple. Dépenses de santé en France : 100% du PIB dans un siècle ! Contrepoints 6 octobre 2014
  5. 5. PIB et politique sociale: Chiffres pour la Belgique • PIB 42% • Retraites 12% • Education 8% • Aides Sociales 5% • Autres services publics 5% • Santé 10%
  6. 6. Les Français ont le sentiment d'une médecine à deux vitesses Par AFP — 19 mai 2014 à 14:58 Selon un sondage, pour 92% des Français, avoir de l'argent accroît les possibilités de se faire soigner convenablement. Seules 42% des personnes interrogées estiment que tous les patients sont traités de manière équitable. 74% pensent que «les innovations et les meilleures traitements ne sont pas proposés à tous les patients» Les inégalités se creusent selon les ressources financières, près de la moitié des personnes interrogées disant ainsi avoir au moins une fois renoncé à consulter ou à réaliser des soins à cause du coût jugé trop élevé. La répartition des médecins est un autre facteur d’inégalités: 75% des personnes interrogées pensent que les patients ne disposent pas des mêmes chances de se faire soigner où qu’ils vivent.
  7. 7. Le modèle de la médecine libérale est largement obsolète! www.mediquality.net Paris 24-03-2017 Tous les principes de la médecine libérale posent un certain nombre de problèmes: La liberté d’installation  Les déserts médicaux Paiement à l’acte  Consultations courtes / beaucoup de prescriptions Avance par patient  Renoncement à des soins ….
  8. 8. Stop à la médecine à deux vitesses Jean Hermesse Mutualité Chrétienne / 04-04-2019 En Marche Les témoignages de patients ayant subi une forme de pression pour séjourner en chambre individuelle lors d'une hospitalisation se multiplient. Cette pratique illégale de certains prestataires de soins, leur permettant de facturer des suppléments d'honoraires, entache tout un secteur. Elle atteste d’un système de santé favorisant l’accès aux patients qui ont davantage de moyens financiers. Les primes d'assurance hospitalisation à la hausse Le sous-financement des hôpitaux est l'argument avancé par le secteur hospitalier pour légitimer la pratique des suppléments d’honoraires.  la santé financière de l’hôpital ne semble pas liée à la hauteur des suppléments d'honoraires. La MC propose une solution simple et efficace : interdire tout supplément d’honoraires à l’hôpital et réinjecter l’équivalent de la masse totale de ces suppléments (environ 600 millions d'euros) dans le budget de l’assurance soins de santé. Comment ? Via les cotisations sociales et le financement alternatif de la sécurité sociale. Ce financement solidaire sera moins cher pour tout le monde : employeurs, citoyens et patients. Un budget correct sera alloué aux hôpitaux et des moyens budgétaires seront disponibles pour rémunérer correctement les spécialités médicales qui en ont besoin. Cette proposition est tout à fait réaliste. C’est une question de choix politique.
  9. 9. Trump's travel ban could spark crisis in Michigan's doctor shortage, health care leaders say Foreign-born doctors play huge role in underserved areas Crain’s Detroit Business February 17th 2017 Bill looks to address dearth of underserved areas with foreign doctors April 11, 2017 www.mobihealthnews.com Pennsylvania bill would expand role of nurse practitioners By Maria Castellucci | April 11, 2017 www.mobihealthnews.com The proposed legislation would allow nurse practitioners to provide care independent of a physician after they complete a three-year, 3,600-hour collaboration agreement with a physician. The nurse can practice independently within the clinical specialty area they received their license in.
  10. 10. Quatre hôpitaux généraux sur dix vont mal HealthCare Magazine 25 octobre 2018 Le résultat courant des hôpitaux s’est fortement détérioré en 2017. Par rapport, à l’exercice précédent, il est en baisse de 67,1 millions d’euros, soit une chute de 70 %. Les fédérations hospitalières sont inquiètes. Vincent Claes En termes relatifs, le résultat courant ne représente plus que 0,2 % du chiffre d’affaires (14,5 milliards d’euros), contre plus de 1 % en 2014 ce qui confirme la fragilité financière des institutions. « Pour adapter les secteur hospitalier aux besoins du patient et le maintenir financièrement sain, une réforme en profondeur est indispensable. » Maggie De Block L’étude MAHA 2018 fait craindre un « scénario à la Titanic » pour certains hôpitaux Geert Gielens Chief Economist Belfius
  11. 11. "Pour préserver nos soins de santé, il faudra toucher aux vaches sacrées" BRUXELLES 26/02/2019 Douze hauts responsables flamands des soins de santé ont appelé à un changement radical dans la politique menée jusqu'à présent. A les lire, de 10 à 30% des moyens des soins de santé sont mal utilisés, soit au moins 3 milliards d'euros. Ces personnalités estiment qu'une attention trop grande est portée à la maladie. A leurs yeux, le système des soins de santé doit évoluer vers un système qui maintient en bonne santé. Ils pointent du doigt le paiement des prestataires de soins à la prestation, source de surconsommation et de mise sous pression des travailleurs, l'excès de consultations inutiles ou le recours excessif aux urgences. Il serait, selon eux, plus judicieux de payer les prestataires en fonction de la population pour laquelle ils sont responsables. Les signataires plaident également pour un investissement accru dans la numérisation et la coopération entre les différentes professions de manière à ce que les soins soient pensés comme un seul parcours pour le patient. "Le modèle actuel n'est pas prêt pour le futur.
  12. 12. Relation à la technologie:  L’hyper-connexion  Usage digital intuitif et permanent Relation à la culture:  Le travail est considéré comme un moyen d’épanouissement  Plaisir et envie priment Relation à l’autorité:  Ils se considèrent comme partenaires, pas subordonnés. Relation au temps:  Ils sont dans l’immédiateté (tout, tout de suite)  Grande réactivité / multitâches / culture du zapping Relation à l’information:  Partage  Conscients de l’obsolescence immédiate  Importance de savoir où la trouver Relation au réseau:  Il plébiscite l’équipe, l’individu renforce les autres mais il n’est rien sans les autres. • La relation à la technologie  le patient connecté dans l’IoT  « Big data ». • La relation à la culture l’importance de la valeur ajoutée le concept du « value-based care ». • La relation à l’autorité  « l’empowerment » du patient. • La relation au temps  la télémédecine, la « globalisation » des soins, et le DIY. • La relation à l’information  changements des modèles de formation et le partage des données (la philanthropie des données). • La relation au réseau  la force et la sagesse du « crowd »
  13. 13. Big Data in Health Care in the era of a connected patient in the IoTPatients generate 1 million data points an hour. What can healthcare do with that? HIMSS June 4th 2018  Electronic Health Records  Public Records  Search Engine Data  Wearable Devices  Continuomics  Smart Phones  Payer Records  Government Agencies  Patient Portals  Research Studies  Generic Databases  OMICS  Exposome Genetic loads the gun, environment pulls the trigger!
  14. 14. Artificial Intelligence Industry – An Overview by Segment Last updated on March 1, 2018 by Daniel Faggella tech emergence CB Insights is a New York-based research firm with under 200 employees, specializing in tech intelligence from various sources, to include venture capital, startups, patents, partnerships, and new media.  CB Insights highlights the AI acquisitions and fundraising deal frequency across various industries.  Their own research shows healthcare topping the list
  15. 15. The Top Telemedicine Solutions Bringing Patients and Doctors Closer To Each Other www.themedicalfuturist.com August 2017  At the dawn of the radio age, in 1925, Hugo Gernsback, a never-resting German technologist invented the concept of the “teledactyl” that would allow doctors to not only see their patients through a viewscreen but also touch them from miles away with spindly robot arms.  The need for healing from a distance was already there (more than) a century ago. Patients who could or would not want to go into cities or doctors who yearned for consulting a specialist colleague, they all wished for something to make their lives easier. That something is telemedicine.
  16. 16. Avantages du modèle ?
  17. 17. Electronic Consultations to Improve the Primary Care- specialty Care Interface for Cardiology in the Medically Underserved A Cluster-Randomized Controlled Trial Ann Fam Med. 2016;14(2):133-140. Telemedicine saves time, travel costs, even air quality, new study finds March 22, 2017 www.mobihealthnews.com Telemedicine Reduces Outpatient Visits, Hospital Admissions for IBD Patients www.medscape.com August 3rd 2017 E-consultation referrals improved access to and timeliness of care for an underserved population, reduced overall specialty utilization, and streamlined specialty referrals without any increase in adverse cardiovascular outcomes. Collectively, telemedicine visits saved patients nearly nine years of travel time, five million miles and $3 million in costs. “In an era of health-care cost reduction and a rising incidence of inflammatory bowel disease, telemedicine systems could be a valuable tool for reorganizing inflammatory bowel disease care towards more personal and value- based health care,” Dr. Marieke Pierik of Maastricht University Medical Center in The Netherlands and colleagues write in their report, online July 14 in The Lancet. New NQF report considers how to evaluate telehealth initiatives September 05, 2017 www.mobihealthnews.com In an effort to standardize the conversation around telemedicine efficacy, the Department of Health and Human Services commissioned the National Quality Forum to create a framework for telehealth measures. Now, after receiving and incorporating public comments, that framework has been published.
  18. 18. Rexuti, a software-based online platform that promises to lessen the burden on traditional healthcare systems by cheaply diagnosing common ailments through algorithms, questionnaires, and remote practitioners. Digital health apps could save NHS billions, says report A new study shows that effective pre-triage for telehealth could reduce patient pressure on GPs by up to 73 percent. By Nathan Eddy March 04, 2019 www.HealthcareITNews.com The study found the use of telehealth and digital consultations removed the need for a National Health Service general practitioner appointment in more than half (56 percent) of cases, and a hospital appointment in 3 percent of cases if digital health through app-based tech was rolled out across the population. Around a quarter (27 percent) of consultations via the app did not need to be handled by a GP and 41 percent could have been handed by another healthcare professional such as a pharmacist or nurse. Telepsychiatry saves east Texas hospitals $18 million over 7 years By Bill Siwicki March 28, 2019 www.HealthcareITNews.com Remote diagnosis tool Rexuti looks to reduce providers' burden, costs in 2018 By Dave Muoio December 06, 2017 New NQF report considers HOW to evaluate telehealth initiatives September 05, 2017 www.mobihealthnews. com
  19. 19. Quels sont les défis à relever ? Ambitieux et Multiples!  Les 10 objectifs principaux de la télémédecine:  Améliorer le devenir du patient.  Pourvoir les zones rurales en expertise clinique.  Augmenter « l’empowerment » du patient et sa satisfaction.  Rendre les soins accessible et pratique.  Servir de levier pour résoudre la pénurie médicale.  Réduire les visites inutiles aux urgences.  Réduire le taux de réadmission hospitalière.  Réduires les couts de la prise en charge.  Donner la possibilité à un accès spécialisé 24/7.  Améliorer l’efficience du travail de deuxième ligne. What are the biggest challenges for telemedicine programs? Mar 25, 2018 MedCity News  Pas de réglementation  Pas d’incitatifs financiers  Pas de DPM partagé.
  20. 20. What’s preventing doctors from adopting virtual care technologies? A Deloitte survey of 624 primary care and specialty care doctors, which found only 14 percent said they have video visit capabilities, also provides suggestions about how hospitals can approach telehealth adoption. MedCity News July 18th 2018  Sixty-six percent of surveyed physicians said improved patient access to care is a benefit of virtual care technology.  Fifty-two percent listed better patient satisfaction.  45 percent cited staying connected with patients and their caregivers. However, while the advantages are clear, adoption is lagging. Only 14 percent of doctors said they have video visit capabilities, and 18 percent of the rest of doctors plan to add such tools within the next year or two.
  21. 21. What’s preventing doctors from adopting virtual care technologies? A Deloitte survey of 624 primary care and specialty care doctors, which found only 14 percent said they have video visit capabilities, also provides suggestions about how hospitals can approach telehealth adoption. MedCity News July 18th 2018 The survey asked doctors to list their reasons, assuming they received satisfactory reimbursement and didn’t have to overcome regulatory or licensing hurdles. The physicians gave a variety of responses: • Worries about potential medical errors (36 percent) • Concerns about maintaining patients’ private information (33 percent). • 35 percent of respondents said their workplace simply doesn’t offer virtual care technologies.
  22. 22. What’s preventing doctors from adopting virtual care technologies? A Deloitte survey of 624 primary care and specialty care doctors, which found only 14 percent said they have video visit capabilities, also provides suggestions about how hospitals can approach telehealth adoption. MedCity News July 18th 2018 The 556 respondents who see benefits in virtual care were also questioned about what they would need to increase the adoption of telemedicine. One of the top answers was interoperability. Sixty-seven percent said they want their technologies to be able to talk to each other. Fifty-one percent want training on the virtual care technologies. 28 percent desire improved wireless capabilities to support large video feeds.
  23. 23. Les moteurs du changement
  24. 24. Télémédecine : l’AHA s’y met aussi ! Dr Jean-Yves Hindlet - Lundi 6 février 2017 La prestigieuse American Heart Association vient de publier ses recommandations concernant l’implémentation de la télémédecine en cardiologie et en médecine cérébrovasculaire. Survey: Telehealth adoption, interest increased 340% among physicians since 2015 The American Well-backed poll of 800 doctors found increased interest among medical specialities often affected by burnout. By Dave Muoio April 17, 2019 www.Mobihealthnews.com https://www.americanwell.com/resources/telehealth-index-2019-physician- survey/?utm_source=ebook&utm_medium=email&utm_campaign=physician-survey-press-release The survey, which was conducted by M3 Global Research, polled 800 US physicians in late 2018. Of these, 62.5 percent were primary care physicians and the remainder were specialists.
  25. 25. American Well survey: most people want video visits, 20 percent would switch doctors to get them By Heather Mack January 23rd , 2017 www.mobihealthnews.com Convenience may override loyalty when it comes to sticking with a primary care physician, and those that offer telehealth may fare better in keeping their patients than those who don’t. In a poll over more than 4,100 consumers (conducted via two online surveys by Harris Poll), most say they are ready for telehealth technology and are actively seeking it out, and 20 percent said they would switch their current doctor for one who offered telehealth services.
  26. 26. Survey: 21 percent of Americans have used virtual healthcare, 78 percent are interested By Jonah Comstock February 09th , 2017 www.mobihealthnews.com Accenture. The consulting firm reached out to 1,501 US consumers and found that, while 78 percent were interested in receiving care virtually, only 21 percent had actually done so. Accenture defines virtual care as encompassing telemedicine, biometric tracking, and the use of apps for reminders and health management. Consumers are clear: In the 21st century, 20th century healthcare is not good enough ! TechCrunch February 2019
  27. 27. FDA clears Current Health's remote monitoring platform for home use Recently deployed in US and UK hospitals, the company's upper-arm wearable and accompanying platform may now go home with the patient. By Dave Muoio April 24, 2019 www.mobihealthnews.com “The post-acute FDA clearance comes as Current Health is experiencing overwhelming customer demand for its platform, combining its all-in-one wireless wearable, which provides ICU-level accuracy and tracks more vital signs than any other all-in-one wearable available today, with analytics to derive actionable insights,” The “hospital at home” movement driven by at-home remote monitoring technologies offers an opportunity to limit expensive hospital stays while keeping patients happily with their loved ones. And, for those post-acute patients whose conditions do take a turn for the worse, remote monitoring platforms help to promptly reconnect them to professional care.
  28. 28. L’explosion de l’engouement poussé par les « professionnels »
  29. 29. It has nurses and doctors and a cafeteria, and the staff spend their days looking after the very sick―checking their vital signs, recording notes, responding to orders and alarms, doing examinations and chatting with them. There’s one thing Mercy Virtual doesn’t have: Beds ! The most important factor driving Mercy Virtual isn’t technology or new thinking but new payment systems. In the near future, the hospital’s administrators believe, instead of earning fees for each treatment administered, insurers and the government will pay Mercy Virtual to keep patients well. A hospital without patients The cutting edge of health care is tucked off a St. Louis highway exit. And it's eerily quiet. By ARTHUR ALLEN 11/08/2017 Politico
  30. 30. Intermountain creates a virtual hospital with telehealth tools and services The Connect Care Pro program aims to reduce costs and length of stay for patients by extending medical services outside traditional hospital walls. By Bernie Monegain March 01, 2018 www.HealthcareITNews.com Connect Care Pro is made up of 35 telehealth programs, some 500 caregivers and includes basic medical care as well as advanced services such as stroke evaluation, mental health counseling, intensive and newborn critical care. Nine hospitals – outside of the Intermountain system of 22 hospitals – have already established the service, which aims to reduce costs of care and length of stay. Intermountain also anticipates a reduction in mortality rates. Hospital culture is shifting toward telehealth, experts say at ATA While reimbursement is largely seen as a roadblock, a number of bold companies are forging ahead now rather than waiting for payment issues to be settled. By Laura Lovett May 03, 2018 www.HealthcareITNews.com
  31. 31. Walgreens partners with NewYork-Presbyterian to offer in-store telemedicine December 12, 2017 www.mobihealthnews.com NewYork-Presbyterian and Walgreens are collaborating to offer remote access to NYP physicians on Walgreens’ website and at self- service kiosks at select Walgreens- owned Duane Reade drug stores in New York — while CVS has a similar arrangement with the Cleveland Clinic. Walgreens launches 'Find Care Now,' a digital platform for connecting customers to healthcare providers July 26, 2018 www.mobihealthnews.com The service is designed to be a curated way to connect customers to a range of healthcare providers that Walgreens has partnered with, including telemedicine companies (MDLive), digital-enabled house call companies, and more traditional providers. Amerigroup offers LiveHealth's telemedicine to members and more digital health deals November 22, 2017 www.mobihealthnews.com All five of Amerigroup’s Medicare Advantage Plans in Texas will be offering its members free telemedicine consultations throughout 2018 through LiveHealth Online’s web and app-based service. The service connects members with board-certified doctors and licensed therapists 24-7, and supports easy prescription through members’ local pharmacies.
  32. 32. Telemedicine’s challenge: Getting patients to click the app February 6th , 2019 AP News Walmart workers can now see a doctor for only $4. The catch? It has to be a virtual visit. The practice does gain fans once patients try it. UPMC Health Plan launches app-based video visits to all Pennsylvania residents March 24, 2017 www.mobihealthnews.com The University of Pittsburgh Medical Center (UPMC) Health Plan has launched an app-based, 24/7 telemedicine service to offer patients across Pennsylvania video visits from UPMC emergency room nurses and clinicians. Initially launched on desktop in November 2016 to UPMC Health Plan employees, the app version of AnywhereCare is now available to all patients within the state.
  33. 33. Patients have been slow to embrace virtual care. Eighty percent of mid-size and large U.S. companies offered telemedicine services to their workers last year, up from 18 percent in 2014, according to the consultant Mercer. Only 8 percent of eligible employees used telemedicine at least once in 2017, most recent figures show. To increase adoption, digital therapies need to fit into patients’ and doctors’ lives By Jonah Comstock September 16, 2016 www.mobihealthnews.com Millennials demand telehealth in a move away from traditional primary care model By Beth Jones Sanborn April 04, 2018 www.mobihealthnews.com Millennials and Gen Xers, who are more likely than baby boomers to report that a telemedicine option is "extremely or very important," with 40 percent of millennials reporting that telemedicine is an extremely or very important option, compared with 27 percent among Gen Xers and 19 percent among baby boomers.
  34. 34. To increase adoption, digital therapies need to fit into patients’ and doctors’ lives By Jonah Comstock September 16, 2016 www.mobihealthnews.com In JAMA editorial, physicians push for 'medical virtualist' specialty By Dave Muoio November 28, 2017 www.mobihealthnews.com As new telemedicine players sprout from the woodwork and employers more frequently offer telehealth optionsto their employees, a new breed of doctors may be needed to match the technology’s growing popularity. In a recent editorial published in JAMA, NewYork-Presbyterian physicians argued that adoption of a new multidisciplinary medical specialty focused on virtual care would best prepare practitioners to the unique challenges of telehealth. For doctors, telemedicine consultations come with unique challenges By Dave Muoio August 07, 2018 www.mobihealthnews.com The researchers identified a number of recurring challenges cited by the pediatricians.  Diagnosing at a distance,  Treat patients with whom they were unfamiliar,  Working alone,  Technological obstacles,  Urgency and volume of calls they received. Nature’s Pediatric Research Journal 2018 "It is clear that doctors working in this pediatric telemedicine service should have special qualities and skills beyond those required from standard physicians,"
  35. 35. Growing demand for telemedicine fueling multibillion dollar market growth With a significant rise in the prevalence of the geriatric population worldwide, telemedicine services are expected to go through favorable demand. Healthcare Finance December 20th 2017. Report: Global telemedicine market will hit $130B by 2025 Roughly half of the market will be within the US alone, although China and India are also poised for growth. By Dave Muoio March 26, 2019 www.mobihealthnews.com According to the study by Global Market Insights, this 19.2 percent compound annual growth rate (CAGR) will be largely fueled by worldwide telecommunication network developments, market opportunities in rural areas or those without easy access to healthcare services, and the continuing integration of healthcare and IT market sectors.
  36. 36. Bipartisan bill seeks to remove roadblocks to telemedicine under Medicare May 4th 2017 www.mobihealthnews.com Called the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, the bill primarily works to waive restrictions around Medicare telehealth coverage that many consider outdated or arbitrary. Along with the Senators, it also has the support of the American Medical Association, the American Telemedicine Association, and the Alliance for Connected Care along with many industry groups, health systems and tech vendors. Report: Nearly every state has updated its telehealth legislation since last year By Dave Muoio October 18, 2017 www.mobihealthnews.com “Consumer demand can drive regulation, which we have seen in the number of states with new or expanded parity laws requiring payers to cover telehealth visits in an increasing number of settings,” CHRONIC Act, which expands Medicare coverage for telemedicine, passes in Senate By Jonah Comstock September 27, 2017 www.mobihealthnews.com CHRONIC passed in the Senate by a unanimous vote. Among other things, the bill, which was originally introduced in April by Senator Orrin Hatch (R - Utah), includes provisions that would expand Medicare coverage for telemedicine.
  37. 37. Médecine : la Sécu rembourse aujourd'hui les téléconsultations… sous conditions Par Isabelle de Foucaud le 15.09.2018  Le remboursement n’est possible que si la téléconsultation respecte le parcours de soins, c’est-à- dire qu’elle passe par le médecin traitant ou par un spécialiste vers lequel le médecin traitant aura orienté le patient.  Le professionnel de santé doit aussi connaître le patient au préalable et ce dernier doit avoir été vu par son médecin traitant dans les 12 mois qui précèdent la téléconsultation.  La consultation doit nécessairement se dérouler en visioconférence, non pas par téléphone. Télémédecine : la France rembourse, la Belgique attend encore 26 aout 2018 Le spécialiste Jean-Jacques Rombout, vice-président de l'Ordre des médecins : « Il y a une réflexion globale avec le cabinet à propos de la télémédecine. Toutefois, l'Inami n'a prévu à ce jour aucun remboursement pour les avis à distance. Actuellement, il n'y a toujours pas de projets retenus en la matière »
  38. 38. Les solutions techniques.
  39. 39. The Top Telemedicine Solutions Bringing Patients and Doctors Closer To Each Other www.themedicalfuturist.com August 2017 1. Doctor on Demand supported by Google. 2. Health Tap to answer medical questions (with Dr AI service, and personal Health Record Service). 3. American Well (Boston based complete telemedicine company in cooperation with Cleveland Clinic). 4. Teladoc (New York based largest telehealth platform / 17 million members). 5. iDOC24 (telehealth dermatology within 24 hours) 6. Angels (Antenatal and Neonatal Guidelines, Education and Learning Systems, which is a consultative service to ensure that every woman in Arkansas at risk of having a complicated pregnancy receives the best possible care. 24/7 call center available). 7. Avizia (video chat system to ease access to doctors and patients). 8. Babylon Health (The British subscription, online medical consultation and health service; users report the symptoms of their illness to the app, which checks them against a database of diseases using speech recognition, and then offers an appropriate course of action.
  40. 40. Teladoc eyes the global market after its latest acquisition of Advance Medical By Laura Lovett June 04, 2018 www.mobihealthnews.com With its eyes set on a global reach, telehealth giant Teladoc announced that it was acquiring fellow virtual care platform Advance Medical for $352 million this morning. The acquisition is expected to help Teladoc expand its clinical services internationally, specifically to multinational employers, and cater to patients in more languages. Teladoc Health announces 'worldwide' virtual care service for multinational customers The Teladoc Global Care service supports remote care in more than 20 languages. By Dave Muoio September 24, 2018 www.mobihealthnews.com Teladoc Health has announced the launch of a virtual health service designed to accommodate companies whose employees span national borders. Called Teladoc Global Care, the new 24-7 service is delivered through the company’s mobile app and available in more than 20 languages, according to Teladoc. Philips, Emory, Royal Perth use time zones, telehealth to provide nighttime care By Laura Lovett May 14, 2018 www.mobihealthnews.com
  41. 41. Teladoc Health acquires MédecinDirect to secure French foothold The terms of the deal, which fits into a larger global expansion strategy for Teladoc, were not disclosed. By Jonah Comstock March 19, 2019 www.mobihealthnews.com MédecinDirect will become the French office of Teladoc, which now operates in the UK, Australia, Canada, Spain, Portugal, Hungary, China, Chile and Brazil in addition to the United States. Teladoc taps IBM Watson machine learning for second opinion service By Dave Muoio February 28, 2018 www.mobihealthnews.com “It would take 29 hours a day for a doctor to stay up to date with the latest medical literature,” Trencher added. “So obviously it’s impossible, and even the best experts in the world can still benefit from having a technology doing that, and providing that individualized support for the patient.”
  42. 42. Ping An Good Doctor launches commercial operation of One-minute Clinics in China The company announced last week then it had placed its One-minute Clinics across 8 provinces and cities in China and signed service contracts for nearly 1,000 units. By Dean Koh January 07, 2019 www.mobihealthnews.com Just last week, the company announced that it had placed its One-minute Clinics across 8 provinces and cities in China and signed service contracts for nearly 1,000 units, providing healthcare services to more than 3 million users. The clinics currently provide online consultations for more than 2,000 common diseases, and can immediately answer tens of thousands of medical and health queries for users, with an international standard accuracy level. Ping An Good Doctor launches One-Minute Clinic at Shanghai Jiao Tong University In the near future, One-minute Clinics will be launched in more public areas, including shopping malls, airports, and train stations, which will complete the medical service circle in cities. By Dean Koh April 11, 2019 www.Mobihealthnews.com Last year, Ping An Good Doctor, a one-stop healthcare ecosystem platform from China, piloted unstaffed clinics that employ artificial intelligence. China’s one-stop healthcare ecosystem platform, Ping An Good Doctor, recently stationed a "One-minute Clinic" at Shanghai Jiao Tong University. This new offline service scenario provides teachers and students with an alternative option to the medical clinics on campus. The clinics provide users with one-stop medical and healthcare services, including consultation, rehabilitation guidance, medication recommendation, and medicine.
  43. 43. Conclusions
  44. 44.  The essence of practicing medicine has been obtaining as much data about the patient’s health or disease as possible and making decisions based on that. Physicians have had to rely on their experience, judgment, and problem-solving skills while using rudimentary tools and limited resources for centuries. The Top Telemedicine Solutions Bringing Patients and Doctors Closer To Each Other www.themedicalfuturist.com August 2017  The medical community still overvalues physical presence. And those who do diagnostics never meeting patients are considered rude outsiders. But as Bruce Judson explained it in The Huffington Post, the single most important lesson of the past two decades is that a physical presence is, ultimately, a weak barrier to virtual competition.
  45. 45. NT New Technology + OO Old Organization = COO Costly Old 0rganization We have rocket science technology in a Flintstone architecture
  46. 46. Patient’s voice ! We don’t want to be seen as a weak vulnerable, unhealthy,… Sick, passive, less productive, expensive, … Limited, small worthless, unemployed, low… We want to be seen as worthy like everybody else in society ! Stefanie Veraghtert, The Big C, Belgium REHUMANISE HEATHCARE by PATIENT DRIVEN INNOVATION
  47. 47. Disponible le 19 juin en librairie Disponible à partir du 20 juin sur
  • NatachaMathy

    Jun. 27, 2019

La télémédecine, une révolution nécessaire ?

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