La télémédecine, une révolution nécessaire ?

1. Télémédecine :
Une Révolution nécessaire ?
Philippe A. Coucke
pcoucke@chuliege.be

2. Accessibilité
50 – 42 – 10 - 5
Qualité et sécurité
en matière de soins ?

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. • 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. PIB et politique sociale:
Chiffres pour la Belgique
• PIB 42% • Retraites 12%
• Education 8%
• Aides Sociales 5%
• Autres services publics 5%
• Santé 10%

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. 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. 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. 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. 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. "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. 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 »

14. 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!

15. 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

17. 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.

18. Avantages du modèle ?

19. 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.

20. 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

21. 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.

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
 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.

23. 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.

24. 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.

25. Les moteurs du changement

26. 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.

27. 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.

28. 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

29. 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.

30. L’explosion de l’engouement
poussé par les « professionnels »

31. 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

32. 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

33. 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.

34. 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.

35. 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.

36. 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,"

37. 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.

38. 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.

39. 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 »

40. Les solutions techniques.

41. 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.

42. 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

43. 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.”

44. 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.

45. Conclusions

46.  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.

47. NT
New Technology + OO
Old Organization
=
COO
Costly Old 0rganization
We have rocket science technology
in a Flintstone architecture

48. 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

49. Disponible le 19 juin en librairie
Disponible à partir du 20 juin sur