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eHealth market in France Julien Venne Description & opportunities 2014-2015
eHealth market in France!
Julien Venne
Description & opportunities 2014-2015
Key figures!
France – Key figures!
¡ Population: around 65 Millions
¡ Health system organisation!¡ National Health plan: French Ministry of Health and Social Affairs / agencies ¡ Regional approach: Regional Health Agency (27 regions) ¡ Ageing: local authorities (local counties) ¡ Public & private Hospitals ¡ Public & Private specialists and nurses ¡ Private GPs ¡ Numbers
¡ 547 public hospitals (incl. 30 university hosp.) à 65% of beds ¡ 208 727 physicians / 52% GPs – 48% specialists
¡ Epidemiologic/demographic main data!¡ Chronic disease Patients = about 15 millions patients ¡ Ageing population: +60 years old à 23,8% in 2013 ; > 30% in 2030
France – Key figures!
¡ Funding!¡ Mainly the National Public Insurance (CNAM) funded by taxes
¡ Ex. : Chronic diseases à 100% ; GPs à 100% ¡ Private insurances (complementary, ¡ Ageing: mix of national and local tax allocated by local authorities
¡ Health Expenditures (2013) à 243 billions € ¡ 35 % for the hospitalisation care ¡ 21% ambulatory care ¡ 20 % drugs
¡ > 12% GDP (3rd country of OECD) ¡ 4 300 € per person
¡ eHealth market (2013) à 2,4 billions € ¡ Growth expected between 4% and 10% per year until 2017 ¡ Telemedicine market: between 80 and 140 millions € (2013) ¡ Main fund for ageing and independent living (APA): 5,5 billions €
Policies!
Overview of French policies!
French National Health Strategy !(2013)!
¡ Priority 1: develop prevention approach!¡ Prevention programmes, health education (new Health law 2014)
¡ Priority 2: improve organisation of care, access equality!¡ Comprehensive approach: reinforce primary care (GP as the “main gate”) and collaborative work
with hospitals and social care ¡ Reinforce medical research ¡ Modernise Health professionals training ¡ Develop information systems
¡ Work on interoperability of IS between GPs, hospitals, housing, social care ¡ Develop Patient record “DMP 2” ¡ Improve Data access ¡ Develop telemedicine / with funding scheme adjustments
¡ Priority 3: governance!¡ national orientations...…but a regional approach
« To avoid distrust due to a lack of confidence in quality, which could eventually also threaten the transaction, companies, industries and the State are all getting involved in two types of key actions: risk reduction after the purchase (contracts, guarantees, insurance, maintenance, after sales services, etc.) and imposing minimum standards or criteria on objective classification »
From Lucien Karpik, « L’économie de la qualité ». In: Revue française de sociologie. 1989, 30-2. pp. 187-210
Silver economy: a quality economy!(2013)!
Silver economy: a French national commitment!¡ The Silver Economy National Agreement, signed:
¡ 12 December 2013 ¡ By 2 ministers: A. Montebourg (Industry), M. Delaunay (Social Affairs/Elderly people) ¡ By representatives of companies, industries federations, academics ¡ By local authorities and private funders
¡ 6 main objectives!¡ Create the good conditions for a real Silver Economy market ¡ Develop competitiveness of the Silver Economy sector ¡ Support for internationalisation of AHA products & services ¡ Professionalise the stakeholders of Silver Economy ¡ Communicate positively and widely to the public and the distributors, around seniors, elderly people and “well
ageing” ¡ Develop Innovation for Active & Healthy Ageing
Silver economy: action plan!¡ Create the Silver Economy (SE) market!
¡ Governance!¡ Creation of regional ecosystems for SE with institutions, purchasers, users, companies, academics…
¡ Infrastructures and IT services!¡ National plan for Home environment adaptation for elderly (80 000+ housing between 2014-2017) ¡ Create regional Information System to collect data / Personal Health Folder ¡ Develop Tourism sector with adapted services for seniors
¡ Offer and Demand!¡ Create a label for products & services based on a set of quality criteria for public purchase process – High quality
for Independent Living ¡ Normalization process of products & services (in link with European partners) ¡ Creation of a National framework for public purchase and purchase platforms ¡ Develop Innovative Purchase processes & Business models (PCP, PPI, risk sharing models…) ¡ Develop distribution networks
¡ CNR Santé (National Reference Centre for Homecare & Independent Living) ¡ www.cnr-sante.fr
French Market & opportunities!
Who are the customers?!¡ National public insurance (CNAM)!
¡ Principle: pricing for each medical procedure, each medical device ¡ Evolution of funding schemes (2015)
¡ Regional Health Agencies (27 ARS) ¡ Regional funds for health care
¡ Local authorities !¡ Ageing, public housing and social care
¡ Hospitals (public and private) ¡ Public Hospital: National plan “Digital Hospital” à 400 M€
¡ Private physicians, GPs, nurses, paramedics…!
¡ Private insurances!
¡ Private housing!
¡ Citizens!
CE Marking!
Health Technology Assessment!(Assessment of medical and societal values)!
Pricing!(Medico-economic assessment)!
Coverage Decision!
Submission of a file by the company!Submission of a file by scientific
societies & and medical team!
Economic Committee for Health Products & Services!à Negotiate with the company!à Fixes Prices!
Committee of Grading of Medical Procedures!
à Negotiates with Health professionals unions!à Fixes reimbursement prices and rates!
Ministry of Health! National Health Insurance!à Establishes list of reimbursable Medical Devices (LPPR)!
à Establishes list of reimbursable Medical Procedures!
1!
2!
3!
Medical Device !Process!
Medical Procedure !Process!
Regional Health Agencies!¡ 27 Regional Health Agencies (ARS)
¡ Regional Health Plans (with Telemedicine plans) ¡ Digital departments (ENRS)
¡ Opportunities 2014-2015!¡ National Programme “Investments for the Future”
¡ Regional Health Agencies funding “TSN” à 80 M€ ¡ 5 regions selected in July 2014
¡ Tenders from ARS for Digital technologies & services: ¡ Public health (addictions, mental health, security of care…) ¡ Comprehensive Health solutions:
¡ Prevention programmes ¡ Health education ¡ Chronic diseases management solutions ¡ Neurodegenerative diseases ¡ Disabilities ¡ Ageing & independent living ¡ Informal carers…
Informal comments on French market!¡ French players for partnerships: innovative companies (SMEs) and academics
¡ Opportunities in 2014 with regions!¡ Governance: regional ecosystems ¡ Adaptation of funding schemes ¡ Funds for projects on EHR/HIE, continuity of data, chronic diseases and ageing
¡ Key success factors!¡ Break the silos (health vs social, hospitals vs GPs, public vs private, physicians vs nurses, payers vs payers…) ¡ Identify the couple user-payer for your product/service ¡ Regional approach ¡ Public-private partnerships ¡ Medical oriented projects (with physicians involved) ¡ Primary care = important stakeholder in the organisational model ¡ Integrate the complex regulatory processes (data, certification…) ¡ Multidimensional Assessment and proof of concept ¡ Unclear Business models, new contracts
Some links!¡ Ministry of Health and social affairs (fr)
¡ http://www.sante.gouv.fr
¡ ASIP Santé (Information systems standards) ¡ http://esante.gouv.fr/en
¡ Medical devices process ¡ http://www.has-sante.fr/portail/upload/docs/application/pdf/2010-03/guide_dm_gb_050310.pdf
¡ Silver Economy in France (fr) ¡ http://www.social-sante.gouv.fr/espaces,770/personnes-agees-autonomie,776/dossiers,758/silver-economie,2432/ ¡ http://www.redressement-productif.gouv.fr/les-10-silver-actions-du-contrat-filiere-silver-economie
¡ CNR Santé (fr) ¡ http://www.cnr-sante.fr
¡ OneMoreLife Community ¡ http://www.onemorelife-community.com
¡ Report on French Health system CIVITAS ¡ http://www.civitas.org.uk/nhs/download/france.pdf
Julien Venne!Mobile 1: +34 625 233 416 Mobile 2: +33 787 064 006
Email : [email protected] Skype : julienvenne1
