Digital healthcare: Alliance e-Health France calls for a more ambitious policy

The first announcements do not live up to the ambitions of the Government and the majority in the National Assembly when it comes to digital healthcare.

Thus, the PLFSS 2018 is a mixed bag, with:

• Certain telemedicine procedures , such as teleconsultation and tele-expertise, will become widespread, while telemonitoring trials will continue for a further 4 years.
• The procedure for registering new procedures on the List of Reimbursable Products and Services (LPPr) has been streamlined, but with the reintroduction of the impossibility for companies involved in experimentation to benefit from it. This continues the negative signal given to manufacturers in the sector by the previous government, while mature solutions outside the specifications could continue to benefit from this registration. This is all the more true as there is no guarantee that the data collected during the trials can subsequently be used by the HAS for product evaluation purposes.
• Provisions for organizational innovation and the organization and remuneration of procedures are included, but only on an experimental basis.
• A plan to support the transformation of the healthcare system will be unveiled at the end of 2017 for 2018-2022 with a multi-year program of 6 projects, but without including digital healthcare at this stage, which nevertheless requires multi-year programming.

Furthermore, the Grand Plan d’investissement announced by the Government lacks ambition when it comes to digital healthcare: only €420m is earmarked for the digital transformation of hospitals, out of the €80bn invested each year by hospitals, €100m for the exploitation of databases and AI or… €50m for the deployment of telemedicine across the territory!

Last but not least, the new national healthcare strategy (SNS) currently being drawn up must lead to new budgetary guidelines, as one of the main areas of focus is digital, technological and organizational innovation.

Meanwhile, stalemate continues in the field of remote monitoring experiments.

So, after a delay in the start-up phase linked to the drafting of specifications, operational problems persist, such as the issue of access to the NIR by manufacturers for billing purposes, which is still awaiting an effective solution.

We also need to clarify the exit trajectory of the trials, in particular with regard to the management framework to be offered at the end of the trials (brand name registration, generic line, etc.) and the methodological framework to be used for evaluation.

As the Cour des Comptes emphasized in its annual report, “the wait-and-see attitude of the public authorities, their scattered actions and their inability to define a clear framework for the spread of telemedicine, must rapidly give way to a coherent, continuous and methodical overall strategy”.

The digital healthcare industry is therefore calling on the government and the majority to change the scale of its reforms, in order to speed up the digital transformation of our healthcare system.

With regard to the PLFSS 2018, the Alliance eHealth France calls for the momentum generated by the initial announcements to be amplified, and for support for the amendments tabled in the Assembly aimed at:

• Reverse the ban on reimbursing telemedicine solutions under ordinary law during the trial period , by allowing them to be registered on the List of Reimbursable Products and Services (LPPr).
• Resolve bottlenecks in remote monitoring experiments, particularly on the subject of access to NIR and billing.
• A way out of telemonitoring trials that will enable standard coverage of technological solutions that have been shown to be effective, with the onus on these solutions to demonstrate their effectiveness in real-life studies. A methodology adapted to connected solutions will need to be defined with stakeholders, with the aim of becoming the benchmark evaluation methodology.
• Include digital in the plan to support the transformation of the healthcare system to come at the end of 2017 for 2018-2022 in order to initiate a reflection on the multi-year programming of investments in digital healthcare that manufacturers are calling for.

With regard to the resources allocated to the digital transformation of the healthcare system, the Alliance eHealth France is calling for work to begin as soon as possible, bringing together public authorities, healthcare professionals and industry to identify the investments required, as well as the expected savings and efficiency gains. The organizations of the Alliance are ready to participate.

Finally, we call on the public authorities to accelerate the rollout of Internet and mobile network infrastructures across the country, a sine qua non for the use of digital health services throughout the country, and particularly in rural areas.