Telemedicine in nursing homes programme: deployment in the Nouvelle-Aquitaine region
About this good practice
WHY?
>Since 2018, teleconsultations (TLC) have started to be reimbursed in France by the Primary Health Insurance Funds and the Regional Health Agency (ARS, representing the State) has initiated programmes to WIDESPREAD THE DEPLOYMENT OF TELEMEDICINE.
>This support was based on 2 successive regional calls for applications. Following these 2 calls, 78% (= more than 700 nursing homes) of nursing homes in the Nouvelle-Aquitaine (NA) region have been supported by the ARS in the deployment of TLC and tele-expertise (TLX). 84% of them are operational (=equipped + trained)
FOR WHOM?
Nursing homes (and medico-social structures)
WHAT IS IT FOR?
In order to deploy telemedicine, CLUSTERS of 10-15 establishments have been created and have been piloted by a pilot establishment and a cluster coordinator funded by the ARS.
>These clusters had to create a CHAIN OF TELEMEDICINE ACTORS: an expert centre (eg: an hospital) + requesting establishments (nursing homes) + 2 medical specialities.
OBJECTIVES:
>Structuring major REGIONAL PROJECTS for the deployment of TLC/TLX and supporting pilot projects
>Structuring regional OFFERS of TECHNICAL solutions that can be used in telemedicine
>Methodological SUPPORT for project leaders in the development of their projects and in monitoring initial telemedicine usage
>An AGILE and ADAPTIVE support strategy
3 LEVELS OF SUPPORT:
>Territorial (project by project)
>Regional (common tools: methodology and reporting)
>Digital (E-Learning platform)
Resources needed
FINANCIAL
>Coordination aid package granted to each pilot establishment in a cluster: €30,000 (0,5 FTE – 1 year)
>Package to launch the process: €6,000/nursing home
>Equipment package: €8,000/nursing home
HUMAN
>1 cluster coordinator for 10-15 nursing homes
MATERIAL
>1 digital tablet/nursing home
Evidence of success
>100% of nursing homes in NA have been EQUIPPED with a digital tablet to carry out TLC and maintain family ties
> +90 TLC or TLX chains of telemedicine actors have been opened > supported by local expert centres and based on tools chosen by each centre
>FOR RESIDENTS: improved access to care and less travel required
>FOR PROFESSIONALS: effective collaboration between the doctor and the nurse accompanying the patient, saving medical time
>FOR THE NATIONAL HEALTH INSURANCE FUND: reduced costs
Potential for learning or transfer
>The involvement of ARS NA and ESEA (e-health in Action) in structuring major regional projects, offering technical solutions, providing methodological support, and coordinating support at different levels (territorial, regional, digital) demonstrates a COMPREHENSIVE APPROACH.
>The evidence of success provided, including the high percentage of nursing homes equipped with digital tablets, and the positive outcomes demonstrates the MEASURABLE IMPACT of the deployment in NA.
>The AGILE AND ADAPTIVE SUPPORT STRATEGY including training, information sharing, and monitoring of regional and local activities, highlights the importance of flexibility and responsiveness.
>The success of telemedicine deployment in the region is partly due to the REGULATORY AND PRICING FRAMEWORK which favours its development.
This suggests that regions looking to implement similar programmes should ensure that regulatory barriers are minimised and that pricing structures support the adoption of telemedicine.
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