The e-health market - France (2024)

1.2 A growing global market

The global healthtech market

The HealthTech ecosystem brings together : Biotech, MedTech and E-health. The evolution of the global HealthTech market therefore gives an idea of the evolution of the global e-health market, or at least of the ecosystem in which it evolves.

In ****, $** billion was raised for HealthTech startups, a sector encompassing e-health startups; double the amount raised in ****, and up +**% since ****. However, the amount raised in **** is down by **% on ****, and by *** transactions. In ****, $**.* billion was raised for HealthTech startups, through *** transactions .

It should be noted, however, that financing for healthcare innovation in **** is still higher than in ****, and that many investors are ready to deploy their capital in the coming years.

Ten years of global funding for innovation in the HealthTech sector World, ****-****, in billions of dollars and number of deals Source: ****

An emerging investment trend in recent years has been the rise of mega-deals (***) in HealthTech.Despite this slowdown, the upward trend in digital health funding remains relevant and is driven by several factors:

An aging population; The massive developmentof new technologies - notably connected health objects and AI-based data analysis tools; The growth of chronic diseases; The implementation of regulatory changes, such as the coverage of ...

1.3 In France, a promising market

Sales in the French e-health market

As previously stated,e-health is part of "healthtech" and encompasses innovations in the use of information and communication technologies (***) for health-related activities. Its sales are estimated at * billion euros in **** in France [***]

The French healthtech ecosystem comprises over *,*** companies, including *** biotech, *,*** medtech and *** e-health start-ups. According to a study by the Institut Montaigne, in association with McKinsey, the deployment of e-health could generate between ** and ** billion euros per year .

This gain would be evaluated as follows[***] :

Between *.* and *.* billion euros unlocked by empowering patients through digital solutions such as digital self-diagnosis software and mobile applications for disease management and monitoring; Between *.* and *.* billion euros unlocked by improving the flow of patient information through dematerialized exchanges such as e-prescription and data-sharing tools: Between *.* and *.* billion euros unlocked by telemedicine, enabling access to a healthcare professional, thereby combating the phenomenon of medical deserts; Between *.* and *.* billion euros unlocked by an improved patient experience and more efficient structures: with tools enabling healthcare establishments to improve the performance and availability of teams, medical equipment and technical facilities; Between *.* and *.* billion euros thanks to more reliable medical decisions with the help of Artificial Intelligence: AI software helps healthcare professionals reduce ...

2.1 Determinants of professional demand

Platform architecture, services and core repositories

Source: ****

Professional structures capable of adopting e-health innovations

Healthcare professionals working in private practice or in healthcare institutions are important targets for e-health players. Here is an overview of the French medical landscape.

Physician density by region France, ****, number of doctors per **,*** inhabitants Source: ****

The benefits of e-health

Practitioners are above all looking for tools to simplify their day-to-day use (***), as well as greater fluidity in the exchange of information between hospitals and patients[***]. According to the same report, over **% of doctors and professionals see e-health as a route to better prevention, through regular monitoring of one's health, diet and so on.

Teleconsultations have grown exponentially since the announcement of the confinement : while the Assurance Maladie counted less than **,*** per week until the beginning of March, it recorded **,*** the week of March ** (***). [***]

Thus, thanks to containment, the share of teleconsultations in GP activity rose from *.*% in January **** to **.*% in April ****, then varied between *% and *.*% between June **** and August ****.

In ****, although the share of teleconsultations has stagnated at around *-*%, it is well above that of January **** (***).

Share of teleconsultations in GP activity France, ****-****, in percent Source: ****

In September ****, Medeo conducted a survey of *** doctors ...

2.2 Determinants of patient demand for e-health solutions

APA (***) beneficiaries

For telemedicine, the target groups are people suffering from chronic illnesses, the elderly and dependent, and people exposed to the phenomenon of a medical desert.

The Allocation personnalisée d'autonomie (***) was set up to provide assistance to people aged ** or over who are dependent and losing their autonomy. It therefore enables us to visualize the increase in the number of people likely to use e-health services.

Number of APA beneficiaries France, ****-****, in billions of people Source: ****

The number of APA beneficiaries can be seen in the graph above: it more than doubled between **** (***) and ****, rising from ***,*** to *.*** million, before dropping slightly by *.*% in ****. This drop can be explained by the rise in mortality among the elderly in the health context experienced by France in ****. [***]. People with a chronic or long-term illness Share of people declaring a chronic or long-term illness or health problem, by age bracket and household category France, ****, in % Source : Insee Chronic or long-lasting illnesses or health problemsdevelop mainly among the oldest people, as well as among people with so-called "poor" living conditions. Thus, on average, **.*% of non-poor French people have chronic or long-lasting illnesses or health problems, compared with **. *% of poor people (***). **.*% of people over ...

2.3 Barriers to e-health adoption

Professionals' lack of confidence

According to a study conducted by MACSF in ****, healthcare professionals were wary of e-health for a variety of reasons. **% of those surveyed considered digital healthcare tools to be a threat to medical confidentiality. In addition, **% of healthcare professionals deplored the lack of clarity surrounding e-health objects in terms of liability: in the event of misdiagnosis, is it the company at fault, or the doctor who recommended the tool?

The same fears can be found in the study conducted by IPSOS and ASIP Santé on doctors in the digital age (***) .

Patient mistrust

This mistrust is confirmed from the patients' point of view by an IFOP survey for the Délégation à l'Information et à la Communication (***) of the Ministry of Solidarités et de la Santé in ****. Regarding the reasons for not using healthcare apps or connected objects, respondents put forward several concerns:

Reasons for not using a health app or connected object France, ****, % of respondents Source: ****

In both surveys on health apps and connected objects, we find the issue of price as a reason for rejection, for **% and **% of respondents respectively. It's also worth mentioning in both cases that over a third of respondents see little use in ...

2.4 The central role of public authorities

The national e-health **** strategy is structured around four key priorities[***]: Develop connected medicine, enabling remote monitoring or interpretation of medical data via applications ; Encourage collaboration between healthcare professionals, citizens and economic players; Simplify administrative procedures for patients (***); Reinforce the security of healthcare information systems. Some of the actions in the national e-health **** strategy have already been underway since ****, involving the regional health agencies (***) to varying degrees: Personal medical records (***) Connected objects and mobile health applications Health information systems Digital hospital program Digital healthcare territory program The PIPAME report cites various public initiatives in different e-health fields: At national level : the government provides financial support for innovative e-health projects, not to mention the Fonds unique interministériel (***). At a more local level: local initiatives are also important: projects are piloted by local authorities and bring together public and private players, service providers and funders, notably insurers, enabling innovations in both functional aspects and business models to decompartmentalize care for the population. In addition, the State plays a significant role in providing a legal framework for e-health. For example, teleconsultation has been reimbursed by the French health insurance system since September ****. The same goes for telecare, when the patient remotely seeks the advice ...

3.1 E-health: a vast field

E-health has a wide range of applications, which France Biotech analyzes in the following graph, concerning the areas of expertise of e-health companies in France.

Areas of e-health application France, ****, % of total Source: ****

Connected objects account for **% of the activity of e-health companies in France, digital diagnostics and patient telemonitoring for **% and **% respectively. other e-health activities are carried out by French companies, including data analysis, digital therapy or telemedicine, but fewer companies practice them.

In ****, the online secretarial start-up for healthcare professionals, Simplify, recalled the predominance of start-ups in e-health, being present on many innovations, such as:

surgical robots(***) ; connected devices such as activity trackers and bathroom scales(***); the creation of artificial hearts for transplants(***); analyzing patients' symptoms to deliver the most plausible diagnosis possible(***); etc.

3.2 The different players

Major players

Typical players vary according to the e-health segment under consideration[***]:

The information systems segment is dominated on the one hand bypure players and diversified publishers, and on the other by public operators . The telemedicine segment is dominated by telemedicine specialists and medical device manufacturers . The telehealth sector is facing the arrival of new players: insurance companies and mutual insurers, who see predictive medicine and connected objects as a way of improving their knowledge of health risks; pharmaceutical laboratories, which are still limited to digitization of existing practices; and the GAFAs (***).

The e-health field is split into two distinct parts:

On the one hand, a regulated sector with a legal framework for e-health solutions and reimbursements in place, with long-established players, but which is facing the emergence of new players On the other, a sector with little or no regulation, bringing together mostly new players, but also increasingly attracting incumbents.

The obstacles are now well known for many segments of the offer, and require major systemic changes in order to move away from the experimental mode supported by specicial funding, and move on to large-scale deployment, the only way to deliver a real return on investment in transforming our healthcare ...

3.3 GAFA's major role in e-health

The intervention of GAFA

Over the past ** years, the GAFAMs (***) have paved the way for the progressive industrialization of healthcare. Previously, healthcare was strictly the preserve of health professionals, as a major pillar of solidarity. But as needs have exploded, payers such as GAFA have been forced to question the limits of this solidarity in the face of demographic challenges, technological progress and the rise of chronic diseases. Their healthcare projects tend to focus on age-related diseases.

The life sciences department ofAlphabet, Google's parent company, has teamed up with numerous biotech and pharmaceutical companies to develop diabetes management tools and bioelectronic devices to treat rheumatoid arthritis, for example.other initiatives include major funding for Aspire Health, a palliative care start-up, and a Google DeepMind project to determine whether machine learning can be used to analyze eye scans. going forward, Alphabet is likely to have a role to play in setting the standard for technological innovation in healthcare. Apple has also invested heavily in the development of healthcare technologies. In ****, the giant launched its ResearchKit and CareKit software frameworks, enabling developers to create integrated, FDA-approved (***).

The limits of this involvement

Amazon, too, has entered this segment with Amazon Care, a pilot offering ...

3.4 France 2030 and the structuring of digital healthcare

Digital health is one of the key sectors of France ****, and in particular of its *.* billion euro" Innovation Santé **** " program. It is the subject of a dedicated €*** million strategy.

Two years after its launch, the "Santé numérique" acceleration strategy has met the triple challenge of structuring the sector:

Involving the entire digital healthcare ecosystem, with broad consultation of its players. Quickly support project leaders, with schemes that have financed ** winners to date, for a total commitment of almost *** million euros. Commit to a multi-year, systemic approach.

To step up these initiatives and create a more preventive and predictive medicine based on health data, the government has announced the following:

The ** winning consortia in waves * and * of the " Skills and professions of the future " call for expressions of interest, for a total of ** million euros in funding. An increase of **.* million euros in the budget for training in the use of digital technology in healthcare. In particular, this budget will enable us to reach a target of **% of students in medical, paramedical and social training courses trained in these skills, i.e. a total of ***,*** students per year. The launch of the "Digital Health" Priority Research Program and Equipment (***). Co-piloted by ...

4.1 An offer that spans the entire value chain

E-health service providers are present along the entire value chain, from prevention to consultation, diagnosis, treatment and follow-up.

Prevention and information: applications; connected objects; online information or discussion platforms; serious games (***). Consultation : online appointment booking; teleconsultation; patient medical records. Diagnosis / therapeutic decision: tele-expertise; tele-imaging; connected medical equipment; patient medical record. Inpatient or outpatient care: connected objects; coordination platform for caregivers; data exchange; patient medical record. Ambulatory care: remote monitoring; SMS; connected medical devices; patient medical record.

The French National Authority for Health (***), according to their intended use, and supplemented by :

The ability of the digital solution to take into account user/patient parameters (***). The autonomous or non-autonomous nature of the digital solution, making it possible to distinguish between technologies requiring human intervention to implement a theor diagnostic action, and those that generate the same type of action by themselves, i.e. without any prior human intervention.

Functional classification of digital solutions used in medical/paramedical care

Source: ****

4.2 A wide range of products and services

The range of e-health products and services on offer is highly fragmented, depending on the customer (***). The market can thus be segmented according to the following typology:

Healthcare information systems

This first segment is largely dominated by products linked to the Hospital Information System (***). This not only improves patient care, but also aids decision-making by avoiding contraindications, tracking patient pathologies and optimizing hospital or clinic stays. This segment is logically dominated by software publishers specializing in healthcare data management and computerization. There are within this segment:

Solutions for the care, health and even life cycle. Pooling and outsourcing of information production. Refocusing on the needs of patients and operators.

In ****, according to L'Atlas des SIH ****, **** software and *** companies were referenced in RELIMS, an increase of **% and **% respectively, compared to ****.

Information sharing and community networks

The rise of new technologies has also led to the development of platforms enabling patients and healthcare professionals to share health-related information, share their experience or even connect with each other. There are various product categories within this segment:

Patient communities and networks. Communities and networks for healthcare professionals. Information sites and forums.

These tools for exchanging and sharing information enable patients to inform themselves (***) and break ...

4.3 Price overview

Connected devices

When it comes to connected health devices, the offer is very broad, andprice ranges can vary enormously depending on the quality of the devices. In the connected watch market , for example, entry-level products can be purchased for as little as ** euros, while more sophisticated models can cost up to *** euros. The average price is between *** and *** euros. [***]

Consumer connected blood pressure monitors can cost between €** and €*** [***].

Telehealth

The range of telehealth services on offer is equally vast. A comparison of the most popular online appointment scheduling solutions for healthcare professionals, for example, reveals the following prices:

Doctolib: Subscription €**/month incl. VAT for healthcare professionals [***]. Docavenue: between€**/month for a diary offer and €**/month for a teleconsultation offer [***]. Rdvmedicaux. com(***): **€/month with no commitment[***]. Keldoc: Two formulas, *€/month with no commitment, with *** SMS reminders and *** online appointments OR **€/month incl. VAT for the first year, then **€/month incl. VAT with no commitment, unlimited SMS reminders, unlimited appointments [***].

The MonPasseportSanté site, which lets you digitize your health record, offers four different packages, from * to *€ per month for the whole family

HIS

Finally, the price ranges for Hospital Information Systems vary enormously according to the size and nature of the hospital establishment. ...

5.1 Current regulations

Telemedicine regulationsThe first regulations concerning telemedicine date back to ****, with article ** of law ****-***. According to the French Ministry of Health and Solidarity, telemedicine covers a range of activities, including telemedicine, telemedicine, telemedicine, telemedicine, telemedicine, telemedicine and telemedicine.teleconsultation, tele-expertise, telemonitoring, teleassistance and medical regulation. In ****, telemedicine became part of common medical practice law.in concrete terms, one of its components, teleconsultation, has been reimbursed by the health insurance scheme since September **, in the same way as "classic" consultationsfrom February ****, reimbursement of telerexpertise, which enables a doctor to remotely seek the opinion of a colleague when faced with a given medical situation.

Regulations governing the online sale of medicinesThe Ordre national des pharmaciens(***), including article ****-* of the CSP, which sets out the "good practices" to be observed when carrying out this activity, and article R****-** of the CSP, which details the rules governing online drug sales sites.

Compliance with the General Data Protection Regulation (***) reminds professionals of the processes to follow: setting up a data processing register, sorting data, respecting users' rights, protecting data.

Certifications and labels (***)

Certification des hébergeurs de données de santé: you need to be certified(***) to be able to collect and use patient ...

6.1 Segmentation

• Withings
• FitBit
• Doctolib
• InnovHealth
• Umanlife
• Simplify
• Cerner
• Cegedim
• Acetiam
• Parsys
• Qare (HealthHero)
• Omnidoc
• Maincare
• Ortif- Outil Régional de Télémédecine d’Île-de-France
• Alan
• NEHS Digital
• Mediprix
• Docaposte
• Olaqin
• Synapse Medecine
• Nabla