It also regrets the current lack of ambition

While the continued lengthening of life expectancy increases the number of persons in loss of autonomy, the use of information and communication technologies appears as a solution to help them live better and at home longer. With the publication, end of 2010, a decree governing the practice of telemedicine, it shows more clear on the legal and regulatory plan. The Ministry of health, a Steering Committee, led by the Directorate-General of the Organization of care, is working on the definition of the conditions of implementation and financial support. "For the first time, national and regional governance is in running order to make a reality of this new medical practice", said Pierre Traineau, Director General of the Catel, French network of telehealth.

While studies are lacking to assess precisely the potential savings, the estimated thousands of euros per patient, particularly for chronic diseases. Today, the public expenditure devoted to dependent people (more than 1 million in France) is estimated at about EUR 22 billion per year by the commission for Social Affairs of the National Assembly. And this figure is called progress, with a population of more than 75 years, estimated at more than 10 million people in 30 years. To alleviate note, technologies could promote home maintenance, and thus back medicalized institutionalization.

"Technology is at the stage of maturity," stressed Deputy Pierre Labordes, author of a report entitled "telehealth: a new asset in the service of our well-being", published in 2009. Today, 300 experiments of telemedicine are underway. Some are to remotely monitor the health status of patients with medical sensors. "New technologies can also be selected when they promote interactivity between patients and doctors, while improving the quality of the support of the patient," said Pierre Traineau. These include combat medical desertification of rural areas. Finally, maintain the social connection of isolated individuals is a priority objective. In fact, yet, few devices are today industrialized and generalized.

If no one disputes the interest of these technologies - when they are put in place with the consent of the patient-, the choice of the economic model is indeed problematic. Who must pay This question is still unanswered. Economists point out the need to share the efforts throughout the value chain, between communities, social workers, physicians, social protection, installers, assistance...

"It will not return the telehealth to medical uses, said Gilles Duthil, President of the Institute Silverlife, a centre for research on the economy. Achieve this, to expand the use valid seniors for well-being. "It also regrets the current lack of ambition. "Experiments are a few dozens of people, or must see greater, at European level." Below 100,000 people, it proves nothing.

In addition, experiments in telemedicine toil for the moment to bring together all stakeholders concerned. Engineers often develop solutions that are never applied. "Everyone agrees that interdisciplinarity is essential, but it is very difficult to work together people finds Valérie Ayache, Director of the Association for the development of biotechnology in the Grenoble conurbation (Adebag).". And especially the France sanitary and social, are separated.

One solution could come from new approaches, such as the Living lab. This European label brings together different partners (local, business communities, associations, research laboratories) in order to guide innovation by demand and thus involve users as early as the design.

First to obtain this label in France in the field of health, the project e-Care Lab, in Rhône-Alpes located. It is dedicated to the development of new technologies at the service of autonomy. "This collaboration and co-creation approach is essential to develop socially useful and economically viable solutions," said Valérie Ayache.

For Stéphane Renouard, researcher at the Evry Handicom lab, home care must not be synonymous with confinement at home. "Too often, home maintenance comes with a cut of the world and physical and psychological degradation", he observed. This is why it works in the development of warning systems coupled to the geolocation to reassure frail people and their families during their travels. But, if advanced they are, these technologies cannot substitute for human contacts. All studies show, the old people who have a more rich relational life age better.