The health crisis has given a powerful boost to teleconsultation. In just a few weeks, it has become an essential tool for supporting and monitoring patients' health.

In the first half of 2020, the number of teleconsultations billed to Medicare increased from 40,000 procedures per month to 4.5 million in April. At the time of the containment, teleconsultation represented one consultation out of 4. The government decided to facilitate the use of teleconsultation by decreasing its reimbursement to 100% by the Health Insurance, which has been extended until the end of 2022.

The period of confinement changed the profile of patients benefiting from teleconsultation: those under 30 years of age used it less often (19% compared to 32% before confinement), while those over 70 years of age used it more often (20% compared to 8% before). Still over-represented in densely populated areas (mainly Île-de-France), teleconsultation has continued to progress in other areas.

While the number of teleconsultations has been declining since the summer (1.9 million in June, 650,000 in August), the trend has reversed since the beginning of the school year: from approximately 150,000 per week in August, the number of teleconsultations rose to 209,000 the first week of September, then 237,000 the second, 250,000 the third and 252,000 at the end of the month and beginning of October. In September, it represented 3% of consultations.

A higher proportion of people under 50 years of age, especially those aged 30-40, used teleconsultation. After age 50, the use of teleconsultation decreased sharply and steadily with age.

This trend was reversed during containment, with the proportion of patients over 70 years of age increasing from 8% of procedures billed to 20%. " Since last May, this trend seems to be settling in since the oldest patients, even if they are still proportionally less numerous than the youngest, constitute 19% of the patients who use teleconsultation" noted this summer the National Health Insurance Fund.

Three-quarters of general practitioners have implemented teleconsultation since the start of the Covid-19 epidemic, compared with less than 5% who previously practiced it. During the first week of decontainment, 7 out of 10 physicians performed at least one teleconsultation. Of these, 1 in 10 reported that they performed even more than 25% of their consultations via this method.

However, the use of this tool causes some difficulties for GPs: more than half of those who have used it believe that the face-to-face clinical examination is still often or systematically indispensable, according to a survey carried out by the Research Directorate (DREES) of the Ministry of Health. Slightly less than half have often or systematically encountered technical problems. Billing of fees, on the other hand, was not a "major difficulty for physicians in the use of teleconsultation".

Doctors are, moreover, divided on the satisfaction they get from practicing medicine via teleconsultation: slightly less than half of the doctors say they are moderately satisfied, but a third of them are little or not satisfied and, conversely, a quarter of them are very or completely satisfied. It is in the departments most affected by the epidemic that its use has been the most important and that doctors' satisfaction is rather higher.

The draft bill on the financing of social security (PLFSS) for 2021 plans to extend the full coverage of teleconsultation until December 31, 2022. The extension of this " derogatory measure" should allow " health professionals to equip themselves with the tools and technical solutions that allow its management in the common law" and "leave time for the conventional partners to redefine the conditions of the use of this practice".

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