IPSO Santé puts the doctor-patient relationship at the heart of the health system. Proximity medicine is being reshaped thanks to doctors, engineers and organisational experts working on this project. Centred on interdisciplinarity, peer learning, the use of new technologies and listening to the patient, IPSO Santé is developing an innovative way of giving the patient-doctor relationship its rightful place.
The French health system is under an increasing demographic and economic pressure that degrades access to care and fosters two-tier medicine.
Due to a well-anchored “hospital-centered” care services, primacy used to be given to medical technique over prevention and accessibility. Thus, for years, focus has not been on reinforcing primary care, whereas, as it has been highlighted by the WHO and OECD, this is absolutely key to help improve the efficiency of Western healthcare systems. An American study showed an over-cost of 56% of global healthcare expenses for patients who are not regularly followed by a general practitioner in comparison with a patient who has access to a regular follow-up. Prioritizing medical technique and hospitals also reflects on scientific research: scientific research on primary care medicine is almost nonexistent whereas this type of care represents most of the medical acts, thus making it hard to improve the primary care practices.
In France, the primary care sector is mainly managed by independent general practitioners, isolated and under-equipped. The sector really lacks structure, efficiency, and technological modernisation. As a result, the primary care sector lacks attractivity for health professionals. In addition to a restrictive numerus clausus, there is a crucial lack of GPs, which first affected rural areas and now threatens the cities. For instance, Paris lost 28% of its GPs in recent years and expects a shortage of doctors in the next few years. At the same time, health care expenses keep rising due to ageing populations, more chronic diseases and technical progress. This makes access to primary care for all a major social issue.
The approach of French medicine is paternalistic and sometimes not very empathic towards the patient whose medical history and wishes are too often disregarded by health professionals. Now that patients have increasing access to online medical information, studies show a growing frustration on the part of patients regarding their relationship with practitioners.
Ashoka Fellow Benjamin Mousnier-Lompré founded IPSO Santé to challenge these care practices. Through his innovation, he is creating a dense, accessible, coordinated and prevention-oriented primary care network.
Technical details & Operations
Considering the multifactorial aspect of the primary care sector crisis, Benjamin brought together several professions to rethink the system and design it patient-centred: general practitioners, engineers and organisation specialists. In 2015, the entrepreneur opened a first primary healthcare pilot centre with a dual purpose. First, proving that his model best serves the patient in terms of quality and accessibility while being attractive to GPs and cost-efficient for the healthcare system. Second, using the pilot centre as a platform to experiment collaborative ways of working with other medical groups.
Benjamin decided to settle the pilot centre in an urban area, to test his model on a wide range of publics. He strategically chose Paris for two reasons: first, Paris crucially needs more general practitioners; second, it allows Ipso Santé to connect with a rich network to collaborate and test new solutions while gaining visibility.
His model is based on four core pillars. First, a respectful and empathic approach to the patient. It means training doctors to actively listen to the patients, to be non-judgmental and to clearly explain every medical act. It also means letting patients be more active in their care and respecting their choices that should always prevail. Second, the collaborative approach allows the best recommendations to be given to patients, thanks to collective intelligence. In addition, GPs can improve their practices through a peer-to-peer feedback system, weekly meetings to discuss specific cases and satisfaction questionnaires filled by the patients. Thirdly, Benjamin relies on research and development of new technologies to enable practitioners to reduce their administrative burdens and focus fully on the patient. Finally, the healthcare centre promotes innovation and medical research in primary care: it is open to medical entrepreneurs and researchers working to improve the healthcare system.
Deployment & Impact
The first center was successful: it welcomed more than 800 patients within the first year and 99% of them would recommend Ipso Santé. The center also attracts general practitioners. Over 200 applications were received in a few months, whereas fewer and fewer medical practitioners wanted to settle in Paris. Moreover, the quality and efficiency indicators are higher than the sector standards: first estimations show that Ipso Santé’s patients cost 44% less to the health insurance funds than the Paris region average.
These results were essential for Ipso Santé to gain legitimacy in the healthcare system. Today, Benjamin favours collaborations with other medical and non-medical organisations to create complementary solutions to target populations that he cannot reach in the same way as in the cities. He thus incubates projects within the pilot centre, including telemedicine projects that link doctors and nurses to reach isolated patients or those with reduced mobility. In that sense, Ipso Santé also forms partnerships with crèches and retirement homes.
In addition, Benjamin turns Ipso Santé practitioners into real ambassadors. They contribute to spread his vision through teaching in famous French medical universities such as the Université Paris Descartes, and mentoring medicine students. In addition, he shares his innovation with other existing medical centres, which encourages them to change their practices. He also trains teams of doctors at his centre to experience and fully assimilate the fundamental pillars of Ipso Santé. He was thus able to open three more centres.
Finally, Benjamin, as a social entrepreneur, uses the legitimacy and credibility acquired by his organisation to play an advocacy role. By establishing links with public health authorities and policy makers, he wants to steer medical investments towards primary care reform. This power of influence also goes beyond France, as the visit of the South Korea’s Minister of Health in Ipso Santé’s first center proves it. Furthermore, Benjamin released his first research publications in 2017 in specialised media to reach and convince even more medical professionals that deeply reforming primary care is possible.
Furthermore, Benjamin introduces his approach in a broader cross-sectoral collaboration focused on impact. With 11 other innovative health and non-health organisations, he participates in designing new toolkits for citizens to easily access multidimensional support, including care, housing, employment, or vocational training. This initiative is supported by the European Commission.