“We must return to common sense and I want a lot ! “: Dr. Franck Baudino, entrepreneur, humanist, and pioneer of the teleconsultation
Frank BAUDINO is the founder of H4D a pioneer in the field of tele-consultation, and obviously on the front in the framework of the fight against the COVID 19 for his medical practice connected to allows to perform meaningful consultations with the instruments and medical sensors present within the cabin of telemedicine. He is a general practitioner and has completed the full course of Sciences Po.
FranceSoir : You are a doctor or business owner ?
Franck Baudino : Welcome to H4D. I am a physician and President and founder of this structure, which offers a full-service tele-consultation via our Consult Station®. And to be back in the thick of the subject, I suggest you try it. Go enter !
(We are moving into a cabin ultra-modern, with instruments everywhere, and we settle in to a comfortable seat in a confidential environment, medical, white, clear, connected. The door closed, the screen turns on and here we are, in a real situation. We are rediscovering the Dr. Baudino behind the screen and we are in the Teleconsultation… ed)
We’ve completed. The balance sheet of France Soir is positive. Everything is going well !
FS : Thank you for this immersion. How have you faced personally and professionally in this crisis of the so-called Coronavirus ?
FB : I like many of my colleagues immediately offered my services around me, especially with those who do not consult more with their general practitioner for conditions that conventional and unrelated to the Covid-19. We also have in H4D offered our services for tele-consultation to all of our partners to provide a response servicielle credible and immediately available to reduce congestion in the er and re-invent the medical time for practitioners but also for all the patients. Many companies and communities have sought us out. We responded present.
FS : We talked a lot about tele-consultation during the crisis, since people could not move. The consultation in visio was developed. Can you describe the teleconsultation ? How does it work ?
FB : In fact, the current crisis has enabled patients to speak to or see their doctor by visio-conference. But this is not really a consultation. The teleconsultation such as is the practice among the H4D is simply a consultation. Telemedicine is medicine and, therefore, there is no telemedicine without a doctor. It is an interaction between a patient and a doctor.
A consultation is a process standard that allows the end to make a diagnosis and treat a patient. First step : get the patient in a private space in order to make the consultation starting, of course, by asking questions. Second step : to Perform a clinical examination, which happens in two stages : action and then the testing for the symptoms described. Third step : establish a diagnosis.
The limit of the visio-conference is that it does not, for example, to auscultation. I put my brothers in the challenge to cure a cough by visio-conference !
We have put 9 years to develop the medical protocols that allow a doctor to perform a clinical examination by tele-consultation. Our system enables you to comply with the protocol of public health. With a video-conference on Skype, the patient has no confidential space, and this does not comply with the security protocols of the data. It took us 5 years to develop the system of data encryption.
FS : so You have a cutting-edge technology ?
FB : above all, It is a technology that must meet medical standards and procedures well-framed. The technology may seem advanced, but above all it is functional and it is important to properly train the doctors.
FS : When did you create the company H4D ?
FB : In 2010 and the first patents date back to 2006-2007. Very quickly, I had a demand in Africa, especially during epidemics, and this has led me to think about this solution in a public health context. And the current crisis has demonstrated that we were prepared to tele-consultation and H4D responded to both the need of communities and businesses for the support for the screening.
FS : Why did you create this technological solution ?
FB : first of all I am a doctor and I have had the chance to go in various places in France and abroad and I realized that we did not have access to the care of the same way. In other words, in a department of the French declined, the care is not as easy access for simple logistical reasons. As a doctor, we must treat all the world. We want to give the same attention and an equal chance to the patient that it is in a village removed the bottom end of India or in a neighborhood in the middle of Paris. And so logically I had this idea to recreate a medical practice because the most important thing for me was to keep first the singular meeting between the patient and the doctor and allow the doctor the best possible care of his patient. It is he for example who takes the initiative to start the measurements of the sensors and instruments remotely. In the cabin you’re in a private space but it is the doctor who guides you in the use and handling of the instruments. There is thus a time saving for the practitioner and the patient. We must also trust the patient, empower, help and assist in taking the measurements. In the end, it becomes an actor of his health (editor’s note : the proper medical interview is well scripted, for example, for the use of the stethoscope, the doctor told me where and how to place it)
Long-distance consultation H4D
FS : What are the conditions for medical consultations at a distance that you develop are, in the minds of all, equivalent to a medical consultation in a law firm traditional ?
Telemedicine is our business. The tele-consultation is our specialty ! Our goal is simple. First, we provide, through a connection, access to care, in an equitable manner to all, whether you’re at the bottom end of a French department or an indian village. Secondly, we strictly adhere to the side a private and confidential medical consultation for the patient, while leaving the hand doctor during the consultation. Finally, we fully trust the patient in the use of the instruments, rather than calling a nurse. The “self-safe-consultation” in any way.
FS : solutions and travelling more traditional also exist in France and abroad ?
FB : Yes, of course. When I was in Vietnam, for example, I’ve worked in mobile trucks. These trucks make it obviously a true one-time service. It brings the patient the opportunity of treatment, it is true. It works very well and it is very useful. But what happens to the patients when the truck leaves ? I remember fondly that when I leave here, I pulled the access to care… for me, This is like a double punishment on the day when they fell ill. Because patients never know when they will fall sick and obviously when the truck will return to…
FS : And, specifically, during the epidemic of Covid that happened ?
FB : The device has been installed in hospitals in emergency to take care of the patients in stand-alone mode, which allowed players to take charge more quickly and relieve the doctors who were obviously overwhelmed. The devices were deployed in 24 hours and resulted in a gain of time in the care of patients.
We had, for example, lift and immediate information for the patient that came with no symptoms, but could find themselves with a rate of oxygenation of the blood the bottom. It was, therefore, put our cabin in the centres of The Red Cross at the front in order to facilitate the screening and to relieve the medical staff. In addition we put our cabins in place in communities to facilitate the care of patients who had chronic disease, these famous patients who are ill for several weeks. This allowed the patients to continue to be cared for traditional care.
FS : In a period of COVID with the rules of distancing social required, teleconsultation appears to be accepted by common sense ?
FB : first of All, a patient who arrives for a teleconsultation is taken immediately, without going through the waiting room. This is an important point in a period of Covid : the patient is isolated, which allows us to respect the rules of social distancing. The doctor is also protected because it is not in direct contact with the patient.
FS : You can earn many caps. Where did that come from ?
FB : I love people. Little, I wanted to be an ethnologist, but my father thought that this was not a job ! And I made the ethnology through the medicine. The 2 things that I look at when I arrive in a country : the structuring of the health care system and the people. Taking more than simply a coffee, I look at people in the street in order to observe how they move, talk, meet, work…
FS : We hear regularly about in all the media that we are victims in France, and beyond, the development of medical deserts ? Is this a fantasy politico-journalistic or a reality either partial or generalized ?
FB : Everything is relative. In Africa there is a true desert medical with a doctor for 30,000 people. In France, we have a concentration of care in hospitals, a decrease of care in the community with the closure of health centres and peripheral hospitals. There has been a decrease of doctors who want to make night guards, start early in the morning or finish late in the evening. This change has resulted in a feeling of the population of a decreasing supply of care that is experienced as a medical desert. In western countries, we see a decrease in the medical time available. There is a decrease of points of access to care. And this is where we come in. We respond to the problem of medical isolation (distance to the) care by putting our cabins in the villages and towns rather than to the notion of desert medical.
FS : If the tele-consultation is so important how is it that you don’t find your cabins everywhere ?
FB : Until this episode of Covid, medicine was regarded as a cost rather than an investment. We have seen an upsurge in orders for our cabins. It comes from living a historic moment where we will finally reinvest in the health. Investment in health is essential for a population that is healthy, it is a population who lives well and works better. The technology is new including to the public authorities. But the change happens very quickly with regions that require us to equip entire departments in collaboration with the health care system in place. Our solution allows you to get beyond the cabin, a health project for the territory which also includes the training.
FS : Why a patient can’t access the care with his smartphone ? Is it that allow a patient to consult his or her doctor with a simple smartphone, corresponds to a real medical consultation ?
FB : I’m all for the gear and the complementarity of offerings. You can do lots of things with a smartphone, but it does not allow the clinical examination, such as the cabin of clinical telemedicine H4D allows. The smartphone allows you to take certain steps and collect information. It is a good tool for communication and exchanges, but for example, there are no stethoscope or other instruments of auscultation.. so We can’t treat a patient who complains of a pain in the ear. You can’t auscultate. The smartphone, however, allows us to give an advice, a medical opinion. In the continuum of the medical, the smartphone does not occur at the same time. You’re not on a highway with a bike… The smartphone is a tool for routing and complementary to the Consult Station®.
FS : The rules on access to tele-consultation have been relaxed significantly in recent weeks, in particular due to, or thanks to the COVID 19 ? Is your Consult Station® allows for an economic gain ?
FB : If we push the model until the end, the doctor may not have to pay the walls of his office because the physical footprint of a cabin is very low. The cabin will be able to treat 98% of medical pathologies in general medicine. The only things that we can’t do that are the vaccination, the laying of the plaster and the life-threatening emergencies. And so this represents a gain of time and efficiency.
FS : a Lot of people criticize inside and outside of our health system ? That is what doesn’t work in France ? I want to tell you very directly : what is the problem ?
FB : first of all, we have forgotten to trust the patient. The current crisis will surely help deliver a lot of things flat. For the issues, I see four : the first is the too strong a barrier between the public sector and the private sector, as we have seen during the crisis. You must re-enter the private system in the health system by reconsidering the interaction between the private and the public. In the second place, it is necessary to reconnect the medicine to the town with the hospital medicine. The physicians of the city are the first point of contact with patients and it is necessary to trust them. The third issue is that health care is not a good as another. It is a long-term investment, in the same way that education, as it helps protect against risk. It is also necessary to integrate the digitization of the medicine in the device in an intelligent manner in order to complete the offer of care.
FS : You’ve travelled a lot what would you say of the French health system compared to other countries ?
FB : Our health system works well, but the administrative system and the major policy orientations of health are reviewing. One of the fundamental elements of this system compared to other countries, it is free. However, it is necessary to learn to better respect it because it does not believe that it is free. The French take a lot of drugs for not very much and have a consumption of care may be more important because it is free. There must be an awareness that this service has a value more than a cost.
FS : Your company has just completed a new fundraising of 15M€ for the period from Covid. Is it that it is difficult to be an entrepreneur in the field of health in France ?
FB : In France and not in health, the rigidity of the economic system and the administrative complexity make it very difficult for an entrepreneur, especially in the field of health because there are specific standards. The normative system shows its limitations. The crisis of the Covid has highlighted the opportunities in telemedicine and the digital, and therefore there will be very substantial funds in this sector which we are part. We have 60 qualified employees and ultra-motivated, and the goal is to capitalize on our know-how and know-be to export the technology, especially in the USA.
FS : The government has announced a large health plan “, The Segur of health” to enhance the caregivers, the caregivers, and above all to restore the means and budgets of our health system. What does it do ?
FB : first of all, it is not necessary to do it is to oppose the kinds, public against private, for example. It is especially necessary to make the system more efficient by giving more place to the care and simplifying administrative that kills the system. An OECD study has shown recently that there were too many administrative staff compared to the caregivers in the hospitals of france. We must return to common sense and I want a lot !