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May 23, 2019

How telemedicine helps AXA tackle the healthcare challenge?

Guillaume Borie, CEO of AXA Next and Group Chief Innovation Officer at AXA, shares his views on telemedicine: how is this service meeting the health sector challenges, and why is it relevant for a leading global insurer.

In the quest to become a genuine partner of the customers, AXA Next is working on the development of new businesses and services that go beyond insurance - telemedicine is a key component of it. What is the current state of the telemedicine market, both in France and around the world?

The telemedicine market is growing worldwide and is expected to reach 130 billion dollars by 2025, compared with 38 billion dollars today. While AXA's focus has often been on teleconsultation with services such as Bonjour Docteur and Qare, it is just one of many facets of telemedicine services. Indeed, any remotely delivered medical practice that uses technology is an integral part of the whole system. For example, tele-adjustments, remote monitoring and assistance, medical emergency dispatchers, etc.

So, beyond the pure growth we are seeing in this market, there is increasing diversification in terms of its players, as illustrated by the new services developed within our incubator Kamet Ventures, which include elder care with Birdie and reproductive fertility assistance with Apricity. Slower in Europe, strong growth and diversification are currently being driven by the US – which represents around 50% of the total market today – and Chinese markets. Players based in the US and in China have already begun their international expansion, through acquisitions – for the telemedicine provider Teladoc which has made multiple acquisitions in Europe over the past 18 months – as well as through expansion into Southeast Asia, which is the case for Ping An Good Doctor, the leading platform for online medical care and prescriptions with 228 million users. These two international leaders are now publicly-traded companies with high market valuations, because the expectations for future growth are also high.

What do you see as the main opportunities and challenges facing AXA?

We’re convinced that telemedicine in its various forms offers a great opportunity for AXA to implement its Payer to Partner strategy. As one of its health initiatives, AXA Next seeks to simplify the patient experience by making medical care more accessible and by providing new services for all. Telemedicine is a good example, because it offers the first level of solutions available around the clock and at all points within a given territory.

While advances in technology are making access increasingly seamless and secure today, there are still major obstacles to development: regulations, which tend to evolve less quickly than technology and the ability to demonstrate that telemedicine makes healthcare more cost effective. The solutions are still too recent to show a significant impact, but the early results are promising, especially in the United States; not to mention buy-in from the doctors themselves who need to find added value for their practice that goes beyond mere access to the patient.

Taken together, these different aspects can sometimes make it difficult to develop a stable and sustainable business model. Another challenge is the international scalability of solutions. In fact, even within a single market like Europe, the health and regulatory systems are very different. This not only requires a great deal of local adaptation on the technological side but also with respect to the integration of these solutions within local ecosystems such as hospitals, doctors, and pharmacies.

AXA has taken several initiatives in this area, especially in France – Bonjour Docteur, Qare by Kamet Ventures, and the partnership that was announced last year with the region Hauts-de-France, whose aim is to facilitate access to healthcare in medical deserts. How would you characterize them generally and what are the key takeaways in terms of learning?

The second offer was incubated by our start-up studio Kamet Ventures with the telemedicine platform Qare. The start-up has been offering video consulting services for a year and a half. Users access the platform via a mobile application. From there, they can communicate with practitioners representing seventeen different specialties: general medicine, gynecology, psychology, etc. This system empowers patients: they choose the professional with whom they want to videoconference and schedule their medical appointments from among the proposed time slots. The latest news is that Qare is experimenting in several French cities with an at-home or at-work prescription drug delivery service. Once they sign up, customers have access to unlimited consultations. The other offer is B2B and is contracted by companies for their employees. Combining these two offers, Qare now performs nearly 200 daily consultations.

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We are realizing that the winning models are those that combine several digital services into a 360° approach to user needs. For instance, remote access to medical advice, online appoint scheduling, teleconsultation, etc. Users should be able to access a tool no matter what their specific healthcare need and get help navigating among the various solutions they have to choose from.

Can we say a little more about the next steps in the Hauts-de-France partnership?

Access to healthcare is a high priority for the French government, which is eager to find new solutions. In this area, AXA rolled out a unique partnership with the Hauts-de-France region last year whose aim is to promote the integration of the telemedicine solution with local doctors. We are setting up a physical teleconsultation space where local residents are greeted by a nurse, who organizes teleconsultations with a remotely located doctor and uses powerful connected objects (blood pressure monitor, otoscope, stethoscope, etc.). Being greeted and cared for by a nurse is very important in acclimating to the telemedicine solution, especially when patients are elderly. The physicians on the AXA Assistance staff provide the training for local doctors in this new practice. What we have here is a beautiful public-private partnership whose aim is to show that telemedicine is not limited to off-the-grid areas but, on the contrary, is a vital addition to the landscape of local physical medical practice.

There have also been several initiatives launched by the entities. How are you working with them?  

By definition, the role of AXA Next is to go beyond the initiatives undertaken by entities, with a focus on the development of specific economic models for the business that can stand the test of time without being attached to any one particular insurance product. To that end, we can also conduct M&A transactions and conclude long-term partnerships with global ambitions that are uncorrelated to insurance strategy. That said, we also work hand in hand with entities to facilitate their access to the AXA Next ecosystem – and more specifically solutions associated with Kamet Ventures and AXA Partners, or with the start-up portfolio of AXA Venture Partners. This relationship with the entities is piloted by the Labs, and we are currently in talks with the executive committees of the ten principal entities and markets.

How do you plan to develop telemedicine in the years ahead?

We are pulling out all the stops now in an effort to industrialize our existing solutions, both within entities and beyond - to increase use and the number of users. At the same time, we are building up our capacity to provide better service to users through new technologies, such as artificial intelligence. We are also actively seeking strategic partners to accelerate our market positioning and development.

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We also continue to explore different solutions and different development models across different units of AXA Next. The heart of our innovation strategy is to combine the best solution for the end user with the strongest business model. The biggest players in telemedicine were founded just ten years ago and have not yet found all the answers - we are in a market where we will win in the long run!

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