Success of online medical portal Doctolib highlights the French state’s failure to digitise

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French company Doctolib’s website and app allow users to book medical appointments through an online portal. They boomed in popularity during the Covid-19 pandemic – allowing many to access both vaccinations and consultations with relative ease – and the company now plans to expand to Italy and Germany. But the emergence of a private firm to fill a gap in France’s public health sector also highlights the country’s failure to modernise the medical services industry.

The French government’s latest Covid-19 announcements are always followed by a mad rush to the Doctolib website and app, with people rapidly filling all available time slots. When it was first announced that a health pass would be required to access restaurants and public venues back in July, some 1.35 million people raced to book a vaccine appointment, crashing Doctolib’s site.

In the 24 hours after Health Minister Olivier Véran announced that a third jab would be required for the health pass to continue being valid from January 15, more than 1.2 million people rushed to Doctolib to book a booster.

With 60 million users and an estimated turnover of between €150 million and €200 million in 2020, Doctolib has established itself as a French tech success story.

This French “unicorn” – meaning a start-up whose valuation has exceeded $1 billion without going public – has seen its payroll triple since it was set up in 2013. With more than 1,700 employees, the company has continued to expand: It currently has more than 250 job offers posted on its website for locations in France, Germany and Italy. In October, it acquired an Italian company performing the same service,

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Data stored by Amazon

Doctolib has become a key player in vaccination in France ever since Covid-19 emerged, offering access to nearly 90 percent of French Covid vaccination centres, according to Le Monde.

Competitors have emerged – including Maija, Allodocteur and Vitodoc – but Doctolib’s rapid development and its continuing position as a near monopoly in the online medical appointments field raises some difficult questions.

“Healthcare is a sensitive area of the economy because of the personal data recorded; and storing this data safely is an essential public service,” said Frédéric Bizard, an economist specialised in public health, to FRANCE 24.

Doctor and patient associations raised some of the issues relating to Doctolib at France’s highest court for administrative law, the Council of State, in March. They argued that because Doctolib was storing patient data on Amazon Web Services – the cloud computing arm of the US behemoth – then Amazon, as a US company, would be required to comply with any demands for information made by US intelligence agencies.

The court ruled in Doctolib’s favour, saying that “safeguards” were already in place in case US authorities request French patient data from Amazon. Doctolib also noted that it encrypts its data.

But an investigation by France Inter radio in March found that Doctolib’s data was not encrypted once it arrived in the Amazon Web Services cloud. Moreover, Doctolib’s German branch found itself embroiled in controversy over data usage in June, when media outlets accused it of sending information about local users to Facebook and the Internet marketing company Outbrain. Information on searches people performed on the Doctolib site had been sold to the two firms along with their IP addresses.

Doctolib immediately back-pedaled, deleting those cookies from its German version and promising never to sell such data again.

“Above all, Doctolib is a private company whose aim is to make money and to expand quickly; the French government mustn’t forget that,” said Bizard.

The government had left a gap in public services that was then exploited by Doctolib, Bizard said, adding that the company’s runaway success was due to France’s own “failure to digitise the state health system”.

“The UK and Spain don’t need an equivalent of Doctolib because they have succesfully digitised (the health sector),” Bizard said. “The UK put £3 billion into digitisation a decade ago whereas France invested a mere €150 millon back in 2005.”

French doctors are also reluctant to use the digital tools offered by the state social security system, Bizard said. They are much more willing to use Doctolib because it “offers them assistance to make the technology very easy for them to use”.

Doctolib’s popularity has soared with doctors as well as patients as a result, with the number of healthcare professionals registered on the site quadrupling from 75,000 to 300,000 over the past two years.

This article was translated from the original in French.

Artmotion S.Africa

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