A friendly face appears on the screen and so begins what could be yet another Zoom call, except I’m sitting inside a white booth that looks like a doctor’s office designed to fit on an airplane, and I’m kind of nervous.
Attached to the walls are a stethoscope, blood pressure monitor, oximeter, and other instruments that I will be asked to use on myself during my teleconsultation.
As France struggles with doctor shortages, its hardest-hit regions are rolling out high-tech telehealth booths, where patients can get their checkups done during a video call with a doctor in another part of the country.
It’s a slightly surreal experience, as I discovered firsthand, and a controversial solution to a very human problem recurring across Europe.
While France’s healthcare system is often hailed as one of the best in the world, it is facing a demographic crisis where doctors are aging and not being replaced where they are needed most.
Second government datanearly 7 million people in France – one in 10 – do not have a general practitioner (GP) and 30% live in a medical desert.
Those are regions where it’s nearly impossible to see a doctor because there simply aren’t any nearby, or because the few in the area are so busy that they aren’t taking on new patients.
In places like Montréal-la-Cluse, a village east of Lyon near the Swiss border, authorities are now hoping the technology could help bridge the gap.
“This is a very dynamic economically region and we regularly have more people settling here. So the population is growing, the needs are growing, but our doctors are getting older and, when they retire, unfortunately they won’t be replaced,” said Murielle Derderian, director of a local pharmacy.
Right next door in the city’s health hub is the “Consult Station,” a hi-tech booth built by start-up H4D, whose connected medical tools allow patients to conduct their own physical exam while speaking to a doctor on one screen.
Inside, follow your doctor’s lead and manipulate the instruments yourself to measure your temperature, blood pressure, blood oxygen level, and heart rate.
Other scopes let you check inside your ears and mouth and share the high-definition images with your doctor in real time.
The doctor tells you to insert them at just the right angle and adjust the focus wheel a bit like you would binoculars — except here, your target isn’t a rare bird but your swollen tonsils or infected eardrum. – until an incredibly sharp image appears on the screen.
It’s graphic – a lot more information than you’d get from a regular consultation, as you’re now seeing what the doctor sees, and it won’t look pretty if you’re sick.
Dr Arnaud Mehats, the general practitioner who guided me through my trial consultation, said the H4D stand was particularly helpful when dealing with ear, nose and throat (ENT) conditions such as nasopharyngitis, sore throat or sinus infection, as well as lung conditions such as asthma and bronchitis.
“For all of this, it’s like being in a doctor’s office. There is no difference in the quality of the physical exam,” she said.
Using a connected dermatoscope, patients can also illuminate specific moles and freckles with a light. They will appear on the screen as if under a microscope and will help the doctor evaluate remotely if any of them look suspicious and need further checks.
Running all these applications requires a powerful internet connection, so H4D partnered with Bouygues Telecom to provide a 5G wireless hotspot alongside the stand.
“We could even hook it up to a satellite if needed,” the company’s chief executive Valérie Cossutta told RockedBuzz via Euronews Next.
Local authorities paid €100,000 to install the stand in October 2020, at the height of the COVID-19 pandemic. He now sees about 30 patients a week, and many more have been spread across the region.
No other choices
Of course, there are limitations to the technology. Patients are selected for this booth when they make their appointment online. For example, they cannot make a reservation if they have gastrointestinal, neurological or bleeding symptoms.
And if something alarming occurs during the teleconsultation, the doctor can directly alert the emergency services, who will come and collect the patient directly at the counter.
While the technology may seem intimidating, there are also staff within the medical center to guide patients, give instructions, and sanitize the booth after each consultation.
Overall, the patients who have used this booth are very satisfied. But I see it only as a temporary solution. It’s not a sustainable solution
“The important thing is that the patients who come here receive a medical response and know that they can come back, which often happens. Some patients return because unfortunately, in the meantime, they have not found a doctor,” said Caroline Millet, who looks after the stand in Montréal-la-Cluse.
A teleconsultation costs between 25 and 30 euros, like a normal visit to the doctor.
But not everyone in the village is willing to try. Several elderly people interviewed at the nearby pharmacy said they were put off by the very idea of not seeing a doctor in person.
Others who have tried the cabin said it was definitely better than nothing.
“Overall, the patients who have used this stand are very satisfied,” said Derderian, the director of the pharmacy. “But I see it only as a temporary solution. It is not a sustainable solution and does not fit the idea we have of a family doctor and the ability to follow up”.
“Why can’t doctors work from home too?”
H4D has launched around 140 of its booths so far and has another 100 in the works, mostly smaller, cheaper ones designed for offices. Its main market is France, but these days it also ships to Italy, Portugal and the UK.
Other companies like Medadom and Tessan are deploying hundreds of telehealth booths in healthcare facilities, pharmacies and even grocery stores across France.
“It’s important that everyone has access to healthcare,” Cossutta said. “But the way doctors and the population are distributed isn’t evenly distributed, so with telehealth booths you solve part of that equation.”
Companies argue that the COVID-19 pandemic has made telehealth much more acceptable to patients, and the technology surrounding it is getting smarter.
The way doctors and the population are distributed is uneven, so telehealth booths solve part of the equation
Another start-up, i-Virtual, has just received EU certification for its new non-contact diagnostic technology, which can monitor vital signs using just a 30-second selfie video. ‘Caducey’ measures a patient’s heart rate, respiratory rate and stress level by analyzing the way blood flows through the skin.
The company says a clinical study of more than 1,000 patients showed 95% accuracy. It now hopes to license the technology to teleconsultation and telesurveillance platforms, to provide healthcare workers with a quick view of their patients’ vital signs.
There is no need for patients to handle complicated instruments, nor to disinfect them after each consultation, said Myriam Benfatto, marketing manager at i-Virtual.
“It reduces unnecessary trips to a doctor’s office and can easily be added to a tablet that a nurse might carry with her from patient to patient, instead of taking vital signs every time – it’s much faster,” she explained .
When asked what doctors thought of the technology, he said there were “two schools.”
“One school is more traditional and reluctant towards digital health. But others are very enthusiastic about the prospect of saving time. They realize that digital is a part of our lives,” she said.
“A doctor recently said to me, ‘why can everyone work from home, but not doctors?’ His point was that they too should be able to do some things remotely.”
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