New technologies

France has been making strides with adopting new technologies, and this accelerated during the Covid pandemic lockdowns and widespread homeworking that followed. In particular, téléconsultation – doctors’ appointments over the internet – is now common (see Chapter 1).

Likewise, the Doctolib platform for reserving appointments has really come into its own, and an estimated 87% of the population uses it. Alongside this, the government has made an effort to have people make use of an online digital space for keeping their important health documents.

A Mon Espace Santé personal online health space has been opened for everyone in the French system (unless they actively opted out). Previous schemes were voluntary and had poor take-up. The space is designed to store patients’ medical documents, such as prescriptions and X-ray and other test results, which historically have been kept by the patient and then brought by them to appointments. 

The new space also features a messaging function so patients can communicate with medical professionals and access health-related apps. It is hoped the platform will encourage better dialogue between patients and the doctors treating them. We explain more about how to use it later in this chapter.

A government survey published in early 2024 found that 90% of people in France said they had used some kind of ‘digital health tool’. The government hopes telemedicine will limit unnecessary travel and take pressure off emergency departments.

Telemedicine includes téléassistance (‘helping’ systems, e.g., via a watch or pendant to raise an alert in case of a sudden illness or fall), téléconseil (advice), télésurveillance (monitoring medical conditions using connected equipment), téléconsultation (a doctor’s consultation over the internet), and téléexpertise (an opinion from one doctor to another via internet, for example, a GP speaking to an oncologist).

For the latter, a specialist’s help is requested via messaging, and there is a €20 fee for the specialist and €10 for the other doctor. It is paid 100% by state health insurance, without upfront costs.

Examples of téléconseil include the 15 ‘health access number’ (to speak to a doctor for help in a medical emergency, including calling out an ambulance if necessary) or the out-of-hours line 116 117. The latter allows you to speak to a duty GP for simple advice, or to help you find an on-duty doctor to visit outside surgery hours.

One pioneer was the mairie of Oberbruck, Haut-Rhin, which set up one of the first dedicated areas for digital consultations. Patients can see a doctor via video in a surgery equipped with telemedicine diagnostic tools. It is staffed by nurses who assist and set up the patient’s dossier.

A more recent development are cabines médicales connectées – internet-connected health ‘cabins’ or booths, which are seeing a boom in interest.

Renault hopes to commercialise medical vans that would operate as a mobile version of this. Carrying a medical assistant on board, the van would have equipment linked to doctors and hospitals, and patients could have check-ups, be diagnosed at a distance, and have follow-up treatment. The vans, called U1st Vision (said as ‘you first vision’), would, it is proposed, include small, low-cost X-ray machines that can send images to health professionals. The intended kit also includes eye and hearing-test machines.

Another element is a chair fitted with sensors that can measure blood pressure, oxygen levels, pulse, and muscle tone, and send the results to a doctor or hospital. During a téléconsultation, a prescription can be sent via internet messaging or placed on a secure site, or posted out. Payment can be via any method the doctor accepts, from posting a cheque to online card payments.

The use of télésurveillance is also increasing. Patients use devices to send readings such as blood pressure and glucose levels to doctors over the internet. Following successful trials, the use of this for certain conditions has been formalised, with doctors able to set up a monitoring protocol, with them being paid on a monthly basis. This is currently for patients suffering from heart or kidney failure, breathing problems, diabetes, cancer, or an irregular heartbeat. Other conditions may be added if they receive approval from the Haute Autorité de Santé.

In another French innovation, a nurse at a Rennes hospital built a medical translation site which helps staff communicate with patients who speak foreign languages.

France also prides itself on being a leader in research into medical technologies of the future. For example, French firm Carmat developed an artificial heart which is now used in certain hospitals. Cardiology teams have been trained to use it at several Paris hospitals as well as Lyon, Rennes, Lille, Strasbourg, Montpellier, Nantes, and Dijon. At present it is used as a stop-gap for patients with severe heart problems for whom a donor heart is not yet available. 

In future, the firm hopes it will be approved as a permanent heart replacement, and trials towards this are expected to start in 2025, with patients deemed unsuitable for a normal transplant.

Another French firm, Urgo, based near Dijon, is working to create artificial skin to treat severe burns and injury victims, in a €100 million project that if successful would be a world first. The company is already known for its ‘second skin’ products that help ease and heal severe blisters or burns. But the Genesis project seeks to create ‘genuine’ artificial skin that could be used to help heal patients with severe injuries or burns.

Currently, patients needing extra skin often require grafts from other parts of their body, which can cause scarring, pain, infection, and other risks. Such grafts also require long hospital stays and long follow-up care. The company hopes to achieve its goal of making artificial skin by 2030.

Hospitals across France are also starting to receive a new exoskeleton that has been found to allow some wheelchair users to learn to walk again. It was tested in Paris with stroke victims. Called Oxilio, the exoskeleton has small wheels and strong armrests, along with computer-controlled supports around the thighs and hips of the patient. A lifting system helps the user to stand, and then the exoskeleton supports movement so they can take steps.