6533b82bfe1ef96bd128de71

RESEARCH PRODUCT

Intervention publique et déploiement la télémédecine : une analyse par les théories de l'innovation

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Telemedicine is a health sector innovation which implies remote management of patient, future will tell if this innovation is a revolution for geographical healthcare access. In this perspective but despite or because of spontaneous telemedicine uses which have not spread, public authorities launched in France, in 2011, a national strategy to support the spread of telemedicine. In this context, this thesis analyzes complex interactions between public intervention and the diffusion process of telemedicine by using the theories of innovation diffusion. We built a framework for innovation diffusion of complex innovations such as telemedicine and identify three levers for diffusion that public authorities can implement. We illustrate our point of view with three studies that we conducted on two telemedicine pilots in Burgundy. First, economic evaluation is a lever to convince health professionnals to adopt telemedicine and to assimilate telemedicine in the health system. Financing telemedicine is a second lever with respect of one prerequisite: being able to measure the financial impact of telemedicine in order to plan appropriate funding modalities for telemedicine activity and material resources. Management of organisational change is a third lever. In Burgundy, management of organisational change takes the form of a dual policy, mixing flexibility and constraints. This thesis sheds a new light on the room for manoeuvre of public authorities regarding the support of telemedicine diffusion.