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Télémédecine : une expérience infructueuse de télé-expertise en néphrologie

Authors
Journal
La Presse Médicale
0755-4982
Publisher
Elsevier
Publication Date
Volume
39
Issue
5
Identifiers
DOI: 10.1016/j.lpm.2009.10.014
Disciplines
  • Communication
  • Economics
  • Law
  • Medicine

Abstract

Summary Introduction We developed a new system of medical tele-expertise to improve detection and care of chronic renal failure by way of a better communication between general practitioners and specialists. It has been known for long that the incidence of chronic renal failure is increasing while cost of its treatment is very high. Unfortunately, late referral of patients with kidney diseases remains around 30%. Our goal was to help physicians to get access to nephrologists, hence to improve the cure of renal diseases. An early treatment of nephropathies may avoid the evolution to the stage of dialysis. Methods We created a website with the technical support of the firm Unimedecine. It allowed a secure and fast exchange of medical data, all about the case of a one patient. Results General practitioners seemed enthusiastic, but at the end, only a few of them did use the website. The number of connexion remained low throughout a 3-year experience. Questions were about advices but no progressive nephropathy was discovered. The cost of the website was a prohibitive 75 000 euros for 3 years. Therefore, we had no choice that to close the experience. Discussion Telemedicine needs juridical rules and specific finances to work on a long run. Ce qui était connu • L’incidence croissante et le coût élevé du traitement de l’insuffisance rénale chronique nécessitent des actions de prévention. • Malgré une morbidité et une mortalité accrues, la prise en charge spécialisée trop tardive des patients en insuffisance rénale reste toujours de l’ordre de 30 %. • La télémédecine pourrait constituer un moyen d’améliorer le diagnostic et l’évolution vers le stade terminal de l’insuffisance rénale. Ce qu’apporte l’article • Cet article rapporte une expérience de télémédecine dédiée à la prévention de l’insuffisance rénale. Un système de télé-expertise médicale peut parfaitement fonctionner mais son efficacité dépend d’une réelle sensibilisation de la communauté des médecins traitants. • Un cadre juridique solide et un support financier adapté sont les conditions indispensables au développement de la télé-expertise médicale.

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