Numéro |
Therapie
Volume 69, Numéro 4, Juillet-Août 2014
XXIXes Rencontres nationales de Pharmacologie et Recherche clinique, pour l’Innovation et l’Évaluation des Technologies de Santé Tables rondes GIENS – 6 au 8 octobre 2013
|
|
---|---|---|
Page(s) | 347 - 354 | |
Section | Télémédecine / Telemedicine | |
DOI | https://doi.org/10.2515/therapie/2014043 | |
Publié en ligne | 12 août 2014 |
Telemedicine: What Framework, What Levels of Proof, Implementation Rules
1
Centre d’investigations cliniques plurithématique 9501, INSERM,
CHU de Nancy, Nancy,
France
2
Laboratoire Sanofi Aventis, Paris, France
3
Medtronic France, Boulogne Billancourt, France
4
Fédération française des diabétiques, Paris, France
5
Resmed, Saint
Priest, France
6
AP-HM, Pharmacologie médicale, Marseille, France
7
Ministère des affaires sociales et de la santé,
Paris,
France
8
Orange Healthcare, Paris, France
9
Laboratoire Novartis Pharma, Rueil Malmaison,
France
10
Access Conseil, Verrières le Buisson, France
11
JM Goehrs Partners, Versailles, Fance
12
LEEM, Paris, France
13
Careinnovations, Montmorency, France
14
Voluntis, Suresnes, France
15
CNAMTS, Paris, France
16
ANTEL, Evry, France
17
ARS Ile de France, Paris, France
Correspondence and offprints:
Philippe Maugendre, Sanofi Aventis, 9 boulevard Romain Rolland, 75159
Paris Cedex 14, France. E-mail: philippe.maugendre@sanofi.com
Received:
21
February
2014
Accepted:
27
May
2014
The concept of telemedicine was formalised in France in the 2009 “Hospital, patients, health territories” (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation. With this background, the round table wanted to produce recommendations on different areas of medical telemonitoring (the role of telemonitoring, the regulatory system, the principles for assessment, methods of use and conditions for sustained and seamless deployment). Whilst many studies carried out on new medical telemonitoring approaches have led to the postulate that it offers benefit, both clinically and in terms of patient quality of life, more information is needed to demonstrate its impact on the organisation of healthcare and the associated medico-economic benefit (criteria, methods, resources). Similarly, contractual frameworks for deployment of telemonitoring do exist, although they are complicated and involve many different stakeholders (Director General fo the Care Offering [Direction générale de l’offre de soins, DGOS], ARS, HAS, Agency for Shared Health Information Systems [Agence des systèmes d’information partagés de santé, ASIP], French National Data Protection Commission [Commission nationale informatique et libertés, CNIL], French National Medical Council [Conseil national de l’Ordre des médecins, CNOM], etc.) that would benefit from a shared approach and seamless exchange between the partners involved. The current challenge is also to define the conditions required to validate a stable economic model in order to promote organisational change. One topical issue is placing the emphasis on its evaluation and operation. Access to patient data, particularly data from the health insurance funds and the use of these data, may enable the process to be more effective. In addition, the budgetary non-fungibility of the various financial envelopes for the different areas of work, restricts the consolidation of financial impact. Funding methods will need to be adapted to this new distribution of roles, both at the centre of the healthcare system and in the industrial ecosystem. All of these changes will help the leaders of our healthcare system to bring this new ambition closer to all of the people working in the health economy.
Key words: telemedicine / medical telemonitoring / chronic diseases / evaluation / management / utilisation
© 2014 Société Française de Pharmacologie et de Thérapeutique