De nouvelles organisations et pratiques de soins par télémédecine

The increasing prevalence of chronic diseases together with the decreasing medical demography call for new healthcare organizations. In France, the recent HPST bill emphasizes the role of telemedicine. It pretends to improve patient management and to reduce the need for hospitalization, allowing “the right care” at “the right cost”. We describe the four different legal frameworks of telemedicine activities (teleconsulting, teleexpertise, telemonitoring, teleassistance), the medical duties and the planned financing modalities. At home telemonitoring of chronic diseases improves patients' quality of life and safety. The long term economical viability of these new organisations requires a rigorous medico-economical assessment.