Question 19110 — social security

Summary

Ms. Laure de La Raudière draws the attention of the Minister of Solidarity and Health to the subject of reimbursement conditions for telemedicine procedures on French territory. Already successfully implemented in a number of countries, telemedicine constitutes a key issue for improving the organization of the health system and access to care for all. By allowing faster patient care and monitoring, Telemedicine is a way to reduce waiting times, unnecessary travel, forgoing care and overcrowding in the emergency department. The experience of foreign countries such as Norway, Canada or island states demonstrates that telemedicine is also an effective tool for combating medical deserts. In this context, Law No. 2017-1836 of December 30, 2017 on financing social security for 2018 has generalized the deployment of telemedicine in France and entrusted conventional partners (health insurance, mutual insurance companies, unions of private doctors) with the task of defining the implementation methods and the prices applicable to teleconsultation and teleexpertise acts. However, the ratified agreement (Amendment 6 of the Medical Convention on the conditions of coverage of teleconsultations by health insurance) poses a certain number of conditions which restrict the scope of application of telemedicine. Telemedicine procedures must in fact be carried out with the attending physician, or with another doctor if the patient is referred by their attending physician. The patient must also be known to the teleconsulting doctor and have seen him physically for at least the twelve months preceding the teleconsultation. These conditions do not apply to patients under 16 years of age, patients whose state of health is incompatible with the availability time of their treating physician, as well as patients without a treating physician. However, these conditions limit the use of telemedicine, particularly in the territories that need it the most. Patients from a medical desert will have even more difficulty accessing a telemedicine offer since health professionals in the territory are already in insufficient numbers. If the conditions set by conventional partners can reduce unnecessary travel for patients, they are not likely to reinject additional medical time into regions with a shortage of doctors. However, the primary problem of medical deserts in France is not the shortage of health professionals, but rather their very unequal distribution across the country. national territory. Consequently, she would like to know if the Government is considering measures to extend the possibilities of reimbursement for telemedicine procedures, so as to reduce inequalities in access to care between territories. In particular, she would like to know whether the Government is in favor of authorizing telemedicine procedures by health professionals other than the treating doctor or a referred doctor, for patients living in medical deserts, and who would not have access to a teleconsultation offer within a reasonable time according to current criteria.

Machine translation from French. The official text remains authoritative.

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