Documentation 

Introduction: Access to care is a major public health concern particularly in medically underserved areas (MUAs) (Zones d'Interventions Prioritaires). Teleconsultations were legalized in France in 2010, however, have been reimbursed by the national health insurance since 2018. Large-scale studies assessing the impact of teleconsultations on access to care are limited. The objective of this study was to evaluate the impact of teleconsultations in MUAs at a national scale. Methods: An observational, multicenter cross-sectional study was conducted in seven teleconsultation centers. Teleconsultations were included if they were with patients living in France and received ambulatory care at primary ambulatory care settings by registered medical doctors between August 1 and November 30, 2021. Each center provided a randomized sample of 3,000 case data per month, yielding a total of 84,000 patients. Teleconsultation incidence was measured in MUAs and non-MUAs as the primary outcome. Results: In total, 25.1% of French patients lived in MUAs, with a mean age of 30.1 ± 0.08 years. Incidence of teleconsultations was 1,964 per 100,000 compared with 787 per 100,000 in non-MUAs (p < 0.0001). Teleconsultations were mostly performed during the day (88.6%), on weekdays (90.6%), were booked (88.3%), involved a general practitioner (GP) (89.0%), and were carried out as a video consultation (96.5%). The median delay to access was 60 min for GPs. Discussion: This was the largest study of teleconsultations in France and the first in the world to pool data from competing telemedicine companies. The incidence of teleconsultations was higher in MUAs, which may show that teleconsultations improve access to care.

Introduction: The utilization of teleconsultation (TC) via synchronous video calls has surged globally and in France since the onset of the COVID-19 pandemic in 2020. The objective was to describe the knowledge, attitudes, and practices regarding TC among the general population and physicians in France. Methods: We conducted two national voluntary anonymous online surveys for the general population and for physicians. The sample size, calculated for a 95% confidence level and a 5% margin of error, was determined to be 2,001 participants for the general population and was estimated with the quota method to ensure representativeness. The survey for physicians was sent from April 27 to June 2, 2023. Results: Among the population, 32% were TC users primarily conducted for themselves (83%) or their children (28%), as a replacement for a physical consultation (75%) and not with their treating physician (56%), while considering the physician location as not relevant (68%). The satisfaction among TC users was 88%. They experienced quicker access to care (54%) and similar or better experience (74%), and 84% agreed that TC improved access to care. If TC had not been available, 28% would have gone to the emergency department (ED). The main reasons cited for consulting remotely were to obtain a medical opinion related to new symptoms (38%) and to acquire a medical certificate or sick leave (35%). Among non-TC users, 53% were considering using it. Among physicians, 83.6% used TC for 1-4 years (68%), with 32% practicing for at least 3 years. Discussion: Thirty-two percent of the French population practiced TCs in France in 2023 with a very high satisfaction rate of 88%. Almost one-third of patients would visit the ED if they could not do a TC.

Introduction: Telemedicine research in France remains relatively underexplored, with a notable absence of comprehensive literature reviews or bibliometric analyses guiding research prioritization and funding allocation for public health interests. The objective of this study is to provide a comprehensive overview of telehealth research in France, elucidating its current trends and primary funding sources. Methods: A bibliometric analysis was conducted spanning a 20-year period from January 1, 2004, to December 31, 2023, using six open-access databases, including the Ministry of Health of France (public research funding), Health Data Hub (research protocols from France), Clinicaltrials.gov (global repository of research protocols), PubMed (scientific publications), Theses.fr (PhD database in France), and DUMAS (master's and doctorate theses database in France). Results: The French Ministry of Health funded 41 telehealth research projects between 2009 and 2022, amounting to €15 million, which constituted 1.1% of all projects funded during this period. 279 study protocols were identified on ClinicalTrials.gov, peaking in 2021 with 58 protocols (20.8%), representing 5.8% of worldwide protocols. Public hospitals provided most of the funding (66%), with 18% coming from the industry. A total of 1,254 publications related to telehealth were identified in PubMed, representing 2.5% of worldwide telehealth publications. Discussions: This is the first study in France and Europe to describe the trends in telehealth research over a 20-year period. Telehealth research in France started in the early 2000s, had a linear growth between 2011 and 2021, peaked during the COVID-19 pandemic, and decreased in 2022 and 2023. All types of telehealth interactions were covered, and funding came mostly from public sources. Funding for telehealth research was however limited and should be increased in France.

Extrait du site de la CDC : "Les téléconsultations ont pour objet de permettre à un professionnel médical de réaliser une consultation à distance à un patient, au moyen d’un dispositif utilisant les technologies de l’information et de la communication. Lors des confinements sanitaires liés à la pandémie de covid-19, elles ont permis d’assurer la continuité des soins : leur nombre est passé de moins de 140 000 en 2019 à plus de 18 millions en 2020. Selon les objectifs affichés par les pouvoirs publics, les téléconsultations constituent un levier de transformation du système de soins puisque d’une part, elles favorisent l’accès aux soins dans les zones souffrant d’un déficit d’offre médicale et pour des publics cibles ; d’autre part, elles permettent de libérer du temps médical et donc d’augmenter le nombre de patients examinés par les médecins."