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NextHealth

CAN’T FIND A DOCTOR? THIS HI-TECH TELEMEDICINE BOOTH OFFERS A HANDY, HANDS-ON
CHECKUP

H4D's "Consult Station" is a hi-tech telemedicine booth where patients carry out
their own physical exam while guided by a doctor on a video call.
- Copyright Courtesy H4D
By Natalie Huet
Published on 04/02/2023 - 10:00
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Copy/paste the article video embed link below: Copied

Inside this hi-tech telemedicine cabin, patients carry out their own physical
exam, guided by a doctor on a video call. I gave it a try.

A friendly face appears on the screen and so begins what could be yet another
Zoom call – except I’m sitting inside a white booth that looks like a doctor’s
office designed to fit on an airplane, and I’m a little nervous.

Attached to the walls are a stethoscope, a blood pressure monitor, an oximeter
and other scopes that I will be instructed to use on myself throughout my
teleconsultation.

As France struggles with a shortage of doctors, its worst-hit regions are
rolling out hi-tech telemedicine booths, where patients can conduct their own
checkups while on a video call with a physician in another part of the country.

It’s a slightly surreal experience, as I found out firsthand, and a
controversial solution to a very human problem being repeated across Europe.

While France’s healthcare system is often hailed as one of the best in the
world, it’s facing a demographic crisis in which doctors are getting older and
are not being replaced where they’re needed the most.

* Junior doctors strike: Which countries pay doctors the most and least in
Europe?

According to government data, nearly 7 million people in France – one in 10 –
don’t have a referring general practitioner (GP), and 30 per cent live in a
medical desert.

Those are regions where it’s nearly impossible to see a doctor because there
simply aren’t any nearby, or because the few in the area are so busy they don’t
take new patients.

In places like Montréal-la-Cluse, a village east of Lyon close to the Swiss
border, authorities are now hoping tech can help fill the gap.

“This is a very dynamic region economically, and we regularly have more people
settling here. So the population is growing, the needs are growing, but our
doctors are getting older, and when they retire, they’re unfortunately not being
replaced,” said Murielle Derderian, manager of a local pharmacy.

Just next door, in the town’s health centre, sits the “Consult Station” – a
hi-tech booth made by start-up H4D, whose connected medical instruments allow
patients to conduct their own physical exam while speaking to a doctor on a
screen.

Inside H4D's telemedicine booths, doctors on a video call show patients how to
use an otoscope and other instruments to carry out their own physical exam.
Courtesy H4D

PLAYING DOCTOR

Inside, you follow the physician’s guidance and manipulate the tools yourself to
take your temperature, blood pressure, blood oxygen level and heart rate.

Other scopes allow you to check the inside of your ears and mouth and share the
high-definition imagery with the doctor in real time.

The doctor instructs you to insert these at the right angle and to adjust the
focusing wheel a bit like you would using binoculars – except here, your target
is not a rare bird but your swollen tonsils or your infected eardrum – until a
shockingly sharp image appears on the screen.

It’s graphic – way more information than you would get from a normal
consultation, as you’re now seeing what the doctor sees, and it won’t look
pretty if you’re sick.

Dr Arnaud Mehats, the general practitioner who guided me through my trial
consultation, said the H4D booth was especially useful when it comes to ears,
nose and throat (ENT) pathologies like rhinopharyngitis, a sore throat or a
sinus infection, as well as pulmonary pathologies like asthma and bronchitis.

“For all of this, it's like being in a doctor's practice. There’s no difference
in terms of the quality of the physical examination,” he said.

* Nursing shortages: Helper robots are being deployed to ease the burden on
overworked hospital staff

Using a connected dermatoscope, patients can also flash a light on specific
moles and freckles. They will appear on the screen as if under a microscope and
help the doctor assess remotely whether any of them look suspicious and need
further checks.

Handling all these applications requires a powerful Internet connection, so H4D
partnered with Bouygues Telecom to provide a wireless 5G hotspot together with
the booth.

“We could even connect it to a satellite if needed,” the company’s managing
director Valérie Cossutta told Euronews Next.

Local authorities paid €100,000 to install the booth in October 2020, at the
height of the COVID-19 pandemic. It now sees about 30 patients a week, and
several others have been deployed across the region.

The doctor instructs you to insert the scopes at the right angle and to adjust
the focusing wheel until a shockingly high-definition image appears on the
screen. Courtesy H4D

NO OTHER CHOICE

Of course, there are limitations to the tech. Patients are screened for this
booth when they make their appointment online. For instance, they cannot make a
booking if they have gastrointestinal, neurological or haemorrhagic symptoms.

And if anything alarming occurs during the teleconsultation, the doctor can
directly alert emergency services, which will come to pick the patient up
directly at the booth.

While the tech may seem intimidating, there are also staff inside the medical
centre to guide patients, give instructions and disinfect the booth after each
consultation.

> Overall, the patients who’ve used this booth are very satisfied. But I see it
> only as a temporary fix. It's not a sustainable solution

Murielle Derderian
Pharmacy manager in Montréal-la-Cluse

“What’s important is that the patients who come here get a medical answer and
know that they can come back, which they often do. Some patients come back
because unfortunately, in the meantime, they have not found a doctor,” said
Caroline Millet, who looks after the booth in Montréal-la-Cluse.

A teleconsultation costs €25 to €30, the same as a normal visit to the doctor.

But not everyone in the village is willing to give it a go. Several elderly
people quizzed in the neighbouring pharmacy said they were put off by the very
idea of not seeing a doctor in person.

Others who tried the cabin said it was certainly better than nothing.

“Overall, the patients who’ve used this booth are very satisfied,” said
Derderian, the pharmacy manager. “But I see it only as a temporary fix. It's not
a sustainable solution, and it doesn’t fit with the idea we have of a family
doctor, and the ability to follow up”.

Listening to instructions before trying out H4D's telemedicine booth in
Montréal-la-Cluse, France, January 26, 2023. Euronews

‘WHY CAN’T DOCTORS ALSO WORK FROM HOME?’

H4D has rolled out around 140 of its booths so far and it has another 100 in the
works, mainly smaller and cheaper ones designed for offices. Its main market is
France, but these days it’s also shipping to Italy, Portugal, and the UK.

Other companies such as Medadom and Tessan are rolling out hundreds of
telemedicine booths across health facilities, pharmacies, and even grocery
stores across France.

“It’s important that everyone has access to healthcare,” Cossutta said. “But the
way doctors and the population are spread out is uneven, so with telemedicine
cabins, you solve part of that equation”.

Companies argue that the COVID-19 pandemic has made telemedicine much more
acceptable to patients, and the tech around it is getting smarter and smarter.

> The way doctors and the population are spread out is uneven, so with
> telemedicine cabins, you solve part of that equation

Valérie Cossutta
Managing director, H4D

Another start-up, i-Virtual, has just received EU certification for its new
contactless diagnosis technology, which can monitor vital signs using just a
30-second selfie video. ‘Caducy’ measures a patient’s heart rate, respiratory
rate and stress level by analysing how the blood flows through their skin.

The company says a clinical trial on over 1,000 patients showed 95 per cent
accuracy. It now hopes to license the tech to teleconsultation and
telesurveillance platforms, to provide healthcare professionals with quick
insight into their patients’ vital signs.

There’s no need for patients to manipulate any complicated instruments, nor to
disinfect them after each consultation, said Myriam Benfatto, marketing manager
at i-Virtual.

“It reduces unnecessary trips to a doctor’s office and can easily be added to a
tablet that a nurse could carry around from one patient to the next, instead of
taking their vitals each time – it’s much quicker,” she explained.

* UK nurses strike: Which countries pay nurses the most and the least in
Europe?

Asked what doctors made of the technology, she said there were “two schools”.

“One school is more traditional and reluctant about digital health. But others
are very enthused at the prospect of saving time. They realise that digital is
part of our lives,” she said.

“One doctor recently told me: ‘why can everyone work from home, but not
doctors?’ His point was that they too should be able to do some things
remotely”.

For more on this story, watch the video in the media player above.

Video editor • Mert Can Yilmaz

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