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The Momentum for Health Accessibility — French Perspective

Most of French people have a good opinion on the quality of healthcare services provided in their country (80%, i.e. higher than most of their European counterparts, according to DRESS). However, only 40% believe they benefit from the same quality of care whatever their income or place of living may be.

And there are rightly so. An indicator measuring the level of accessibility to non-hospital healthcare created by INSEE (indicateur d’accessibilité potentielle localisée) demonstrates this very thruth. Health accessibility -in terms of distance to professionals- is still very unequal in France. When accessibility to generalist doctors has been improving - access to certain functions -such as nurse or midwifes (see maps below) - remains critically low.

“Indicateur d’accessibilité potentiel” réalisé for doctors, nurses and midwifes (INSEE, 2019)

Practical accessibility is not the only issue. Indeed, Covid has highlighted major health issues that have been under-treated for lack of financial accessibility. According to a large survey by Axa in Europe, 34% of surveyed suffered from mental illness but only one in four had access to treatment or professional health. For 30% of them, the reason was unaffordability.

That’s why health accessibility has been on top of mind at Ring for a few months. Here is a quick snapshot of our most insightful findings!

💡 Accessibility relies on four pillars

When we think a little bit more deeper about the topic, we discover that there are really four dimensions to accessibility :

  • Availability in practical terms, such as being able to go to the doctor in less than an hour drive;
  • Accessibility in being able to pay the cost;
  • Acceptance, meaning that the treatment is perceived as sufficiently valuable for a people to accept it;
  • Sensibility to the disease-which suppose that people perceive it as a
    i- medical issue and ii-an important issue.

⚖️ An broken reality but a realizable dream

From anti vaccine movements (sensibility and acceptance), to medical deserts (availability), the rise of mental health as a major public health issue (sensibility)and to the opacity of complementary health coverage (accessibility), health accessibility is strongly threatened.

Strong legal decisions have been made towards the digitalization of health since the beginning of the pandemic, both to optimize public spendings and to facilitate accessibility. To name but a few:

👨‍💻 Tech has been efficient in dealing with public health issues

Let’s take two examples of how tech has recently improved health accessibility :

  • The rise of mental health as a public health issue. Seventy-four percent of people in Europe have never used a professional to deal with mental problems (Axa 2020 Report); and the cost of reduced productivity due to mental illness was over 260 billion euros in 2018 (OECD). However, mental health was never treated as a public health issue until Covid. Remote working strenghtened the need and made it the responsability of employers. Solutions were complicated by i/lack of sensibilization and lack of reliable sources of information ii/difficulty to find the right professional especially in medical deserts iii/cost of treatment. Tech has provided great tools, such as all-in-one app combining i/diagnosis/assessment ii/reliable content and iii/teleconsultation with psychologists and coaches (see Moka.care, Teale, etc.).
  • The underdiagnosis of autism, dyslexia/dyspraxia and attention deficit disorders. Indeed, nearly a quarter of children are on the spectrum of these three pathologies — often underdiagnosed or untreated by i/the cost of diagnosis ii/the lack of specialized professional iii/the lack of recognition as a medical disease and thus untreated. But companies are offering scalable diagnosis and curative tools, at the edge of healthtech, edtech and gaming. This is the case of Mila Learn.

From this understanding of the models that work the most, we have deduced the following segmentation.

🔬 Both patient and professional-oriented tools are needed

Most obviously, patients-oriented startups are plentiful:

  • All-in-one apps ☎️ combining trusted content, teleconsultation and chat on a specific area- such as mental health for Moka Care and Teale. What is amazing about all-in-one apps is that they make it easier to ask for help and pave the way for treatment and prevention. Their strenght (and acceptance) also comes from the fact that the ROI of such tools is measurable by employers. Standalone teleinformation (Lyv, Vik) or teleconsultation apps (Epoca, Qare) may also evolve into all-in-one.
  • Telesurveillance 📈 tools- either generalist (Cureetly) or specialized health focus (Diabnxt). In a context of medical deserts and cost reduction telesurveillance has become one of the key axes of the governement transformation plan of our healthcare system. Experiments are underway since 2018 on five major pathologies (incl. diabete and respiratory insufficiency) that could lead to the reimbursment of telesurvaillance tools in a few months.
  • Gaming apps for diagnosis and/or treatment🎮 of specific diseases -Dyslexia/Dyspraxia with Mila — or chronic ophtalmologic disease with Tilak. Those tech could be considered as a subsector of telesurveillance as they assess the state of the patient - and track their progress.
Overview of the Tilak Healthcare app

Regarding professionals-oriented startups, two value propositions are particularly relevant.

  • Tools for diagnosis 🔭. Indeed, when trying to pose a diagnosis professionals too often lack granular macro data that is easily available on drugs, pathologies or patients. Companies like Posos (or Synapse Medicine) are constructing a platform leveraging digitalized patient files, research and drug dictionaries to provide personalized, fast and reliable answers for drug prescription (reducing side effects and drug risks).Finally, Omnidoc facilitates medical collaboration in diagnosis.
  • Medical training apps 🏃🏻 for professionals such as Invivox or Doctrio. These platforms are dedicated to sharing knowledge and experience among between health professionnals all around the globe.
Overview of the Invivox platform

Such tools rest on “enablers” :

  • Financial enablers 💸- bring transparency and convenience in complementary health coverage and adapt it to new forms of living and employment.
  • Digitalization enablers 💻- open doors in terms of information access. To name but a few Arkhn is adressing the lack of digitalization of patient files, and Libheros the digitalization of health professionals directories.

🔴 One key issue remains — health accessibility requires prevention

And finding an effective business model around prevention is a bottleneck (special thanks to our friends at 50 Partners for your insightful event on the matter). Indeed, most health spending in France is financed by the State (c. 80%) and the rest by complementary health insurers (c. 20%). The problem is they would not financed something where the benefit is delayed or difficult to mesure.

In the US, companies like Ginger or Incare work with insurers to expand their use rapidely (with the commitment of offline health professionals) and then measure the ROI of their solutions. White space areas for investment include i/preventive solutions targeting a very specific issue that is related to a very specific job or ii/solutions addressing major public health issues on which one government wants to quickly progress (first aid, andometriosis,…).

Special thanks to our readers, and don’t hesitate to drop a line of comment!

. . .

You are a digital health founder and you would like to reach out ? Contact me at gf@ringcp.com or any other member of the team on Linkedin. 📥




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