To respond to medical desertification, the Pitiverese experimented an original telemedicine solution. We already knew about telemedicine cabins, where the patient must go, to be examined remotely by the doctor: this exists, for example, in Beaugency or Douchy-Montcorbon, near Montargis. The Beauce-Gâtinais territorial professional health community, located in Bazoches-les-Gallerandes, offers another approach: the doctor remains at a distance, but the teleconsultation takes place from the patient’s home, assisted by a nurse equipped with a specific case.
Extending home care for the elderly
Only patients who have mobility problems, permanent or temporary, are affected by this experience launched by 3 general practitioners, with the support of 2 nurses’ offices, one located in Janville-en-Beauce (Eure-et-Loir) and Beaune-la-Rolande (Loiret), particularly suffering municipalities that no longer have any doctors. “This experience is aimed at a well-defined targetsays Dr. Latifa Miqyassbased in Bazoches-les-Gallerandes. We mainly target elderly people, even very old people, who are isolated; the challenge is really to allow and prolong their stay at home, and not to leave them out of care.“
In practice, the nurse arrives at the patient’s home, with a telemedicine case, including a tablet, an otoscope and a stethoscope, and assists the doctor who carries out the consultation behind his webcam. “Our very first patient was 100 years oldrecount Carole Fourmenteznurse in Janville. His apprehension was not to see the doctor. But once it was explained to him that the doctor was going to appear on the screen, everything went well. The big advantage is that the patients know us, there is a trust that is installed, so we can easily be the link between the doctor and the patient.“
130 teleconsultations carried out in 2021
For this patient who, in any case, does not move, this system is much more relevant than a traditional terminal of telemedicine. And much cheaper: the equipment costs 2,000 euros per nursing practice, when a teleconsultation booth costs 30,000 euros… The teleconsultation is billed to the patient like a traditional consultation; the prescription is immediately transmitted to the nurse who can, if necessary, go immediately to the pharmacist.
– Francois Gueroult
In 2021, 130 teleconsultations were carried out, either in the Janville sector or in the Beaune-la-Rolande sector, representing approximately 80 patients who no longer had an attending physician – a situation shared by a third of the population in Pithiverais. “This teleconsultation solution is interestingcongratulates himself Stephane Maguetthe mayor of Janville-en-Beauce, although that only answers part of the problem. This allows elderly people who are not very mobile to have the doctor come to their home, certainly via digital technology, but at home, and this is essential to avoid placement in nursing homes.“
The experiment is closely followed by the Department of Loiret who plans to set up mobile telemedicine. “We are working on itconfirm Marc Gaudetthe president of the county council, because we must not deny ourselves any solution on this subject.“This could take the form of a mobile care unit, which would first be deployed in the Gâtinais: it is still necessary to find the doctors providing the teleconsultations.