Covid-19 drives Europe patients to virtual doctors

Paris

THE new coronavirus that is forcing lockdowns and roiling economies is spurring a silent revolution in the field of telemedicine.

As Covid-19 spreads across Europe, leaving new patients in its wake, the fear of infection and a saturated health-care system are driving large numbers of people online for medical consultations.

And virtual-doctor startups like General Atlantic-backed Doctolib and insurer AXA-supported Qare in France, Swedish Kry International AB's unit Livi, the UK's Push Doctor and Germany's Compugroup Medical SE are raking it in.

"It's unfortunate, but the current epidemic is pushing patients to make the leap, and it can accelerate a change in habits," said Olivier Thierry, chief executive officer of Qare, a French platform that offers video consultations with its team of doctors. "Forecasts on growth are changing by the day."

The business of connecting doctors and patients through video consultations has had a slow start in Europe because of patient reticence, an unfriendly regulatory environment, disparities in health-care systems and insurance rules.

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Now, with hospitals struggling to cope with the virus, patients are turning to such services, and governments are setting aside reservations about the risks of such "couch consultations" to ease regulations.

The European Commission in 2018 estimated that the global telemedicine market would reach 37 billion euros (S$58.3 billion) by 2021, with an annual growth rate of 14 per cent. Those numbers may now be surpassed as virus concerns boost demand, making such consultations more routine and widely accepted.

Qare's chief executive sees telemedicine representing about 10 per cent of France's 400 million annual medical consultations by the end of 2021 from negligible numbers now. Qare, which takes a 20 per cent fee for consultations, said that in the past couple of weeks, it added 25 per cent more bookings than usual. Last year, it had 80,000 appointments, up from 8,000 in its first full year of operation in 2018.

For Sweden's Kry, consultations for virus-related infections - like colds, flu, cough and fever - and other general demands has jumped 41 per cent week-on-week in markets outside its home base, said its co-founder Johannes Schildt.

The jump came "as health-care systems in our core markets struggle to cope with the coronavirus-related strain", he said.

Doctolib, the top French startup helping to set up medical appointments, reported a 40 per cent increase in bookings last week. It clocked 130,000 video consultations in its first year in the business last year.

The startups that manage to broaden their customer base during the virus crisis will find themselves in an increasingly crowded race.

In France alone, the market is spread among Qare, Livi, Mesdocteurs, HelloConsult, Medaviz, Hellocare, DoctoConsult and Doctolib.

In the UK, the business is shared by Babylon Health (which got funding from Saudi Arabia's Public Investment Fund), Push Doctor, askmyGP and Livi.

The current epidemic will show which players are "equipped, scaled and have the ability to face the crisis", said Wais Shaifta, the chief executive of Push Doctor, whose backers include Partech and Draper Venture Network. The UK company, which works with the National Health Service, has added 20 per cent more consultations since the start of the year, with a bump since last week. Mr Shaifta expects the virus to push numbers even higher.

Telemedicine includes consultations not only with general practitioners, but also with specialists in mental health, cardiology, dermatology and others, depending on local regulations. Dutch startup Ksyos has invested in the business in the Netherlands, Italy and Austria, and helps patients with long-term ailments to consult doctors on a regular basis.

For all its growth, though, telemedicine is not without its detractors.

In April, PWC cited an American paediatric doctors' analysis report that said that "telemedicine may benefit patients by making care more convenient and accessible, but new data suggests it may also contribute to the over-prescribing of antibiotics by physicians who aren't able to physically examine their patients".

Jean-Paul Hamon of the French doctors' federation said: "Health care is a serious thing and reliable treatments cannot be traded for the comfort of consultations from a couch.

"Telemedicine must be used with more judgment and the authorities must make sure it's not spreading into a business." He said the novel coronavirus should not be the excuse to market telemedicine.

At the December congress of the industry group called Telemedicine Society, Nicolas Revel, who heads France's state health-insurance system, said he was not comfortable with the rise of "patient-consumers".

Countries like Switzerland and Estonia have long used the system, initially with telephone consultations. Switzerland is starting to test video medicine with connected self-measurement devices that patients can use in their homes.

In the Netherlands, the government says people who want "care and support at home should be able to communicate with their care provider 24-hours a day via a screen". A startup called BeterDichtbij, "Better-Closer" in Dutch, offers a Whatsapp-type consultation with doctors.

In Germany, the state has started relaxing rules on remote treatment, but the national culture around privacy and data protection remains a barriers. Doctolib, which entered the market with its appointment-booking offer, has yet to try telehealth in Europe's biggest market, while Kry's Livi is starting to make inroads.

Governments have been cautious about the spread of the practice, putting the brakes mainly through what they are willing to reimburse and what is covered by health insurance. The French state, for instance, has been concerned about what it sees as the emergence of a parallel "private health-care" system.

"It's not about our growth, but the government has put limits that don't allow people to access telemedicine in some remote areas," said Qare's Thierry, calling such regulations a "straitjacket".

The virus may be changing that.

French Health Minister Olivier Veran this week said the government has published a decree easing reimbursement rules for patients using telemedicine. BLOOMBERG