Getting started with medical tele-expertise in France: a practical guide (2025)

Tele-expertise allows a general practitioner to request a specialist's opinion without moving the patient. Regulated in France since 2019, it remains underused: most physicians have never sent a request. This guide explains in practical terms how to get started with tele-expertise, step by step, with the right tools.

What tele-expertise is: a regulatory refresher

Tele-expertise is one of the five telemedicine acts defined by the French Public Health Code. It allows a physician (the "requesting" physician) to ask a colleague (the "requested" physician) for an opinion on a clinical case, without the patient being physically present during the exchange.

Since the 2022 reform, access conditions have been simplified:

• Any physician listed in the RPPS (the national health professional register) can be a requesting or requested physician
• The act can be billed to French national health insurance (Assurance Maladie) under the RQD code
• No prior agreement between the requesting and requested physicians is required
• Tele-expertise is open to all specialties

Who does what: requesting and requested physicians

The requesting physician initiates the request. They send the relevant clinical data (reports, images, ECGs, vital signs) and frame their question. In practice, this is often the patient's primary care physician or the coordinating physician in a nursing home (EHPAD).

The requested physician is the specialist who receives the request, analyzes the data and gives an opinion. The opinion can be returned within a few hours (the observed average turnaround) or in real time during a synchronous video call.

On the MedConnect platform, the requesting physician launches the request directly from the patient record. Clinical data — ECG tracings, dermatoscopic images, vital signs — is automatically attached to the request. No more scanning, emailing or hunting for a fax machine.

Steps to get started with tele-expertise

1. Sign up for a tele-expertise platform

In France, Omnidoc is the reference platform for tele-expertise. With more than 110,000 registered healthcare professionals and an estimated 85–90% market share, it is the densest network. MedConnect integrates Omnidoc natively: you sign up through your MedConnect account, without creating a separate one.

2. Configure your tele-expertise software

On the MedConnect platform, tele-expertise is a built-in module. Setup includes:

• Linking your Omnidoc account
• Configuring the specialties you consult most often (cardiology, dermatology, etc.)
• Enabling automatic attachment of device data

3. Send your first case

From the patient record, click "Request a specialist opinion." Select the specialty, write your clinical question, and the relevant data is attached automatically: the latest ECG, the latest vital signs, images captured during the consultation. The specialist receives the request and responds within a few hours on average.

TE1 vs TE2: when to use which

The regulations distinguish two levels of tele-expertise:

TE1 — Simple question: the requested physician answers a targeted question without needing additional tests. Examples: "Does this skin lesion require a biopsy?", "Does this ECG tracing show atrial fibrillation?". The fee is €10 per act for the requested physician (RQD code), with a maximum of 4 acts per patient per year.

TE2 — Complex analysis: the requested physician must analyze a complete file with several additional tests. Examples: a full geriatric assessment in a nursing home, analysis of a cardiology workup with ECG + Holter. The requested physician's fee is higher and the response time generally longer.

The most active specialties in tele-expertise

According to Omnidoc data and MedConnect field feedback, the most frequently consulted specialties in tele-expertise are:

1. Dermatology: a visual exam par excellence, dermatology is ideally suited to tele-expertise with high-resolution images
2. Cardiology: ECG tracings sent to the specialist for interpretation, Holter analysis via Cardiomatics
3. Neurology: post-stroke assessment, epilepsy follow-up, remotely guided neurological exam
4. Geriatrics: complex nursing home resident files, multiple chronic conditions
5. Ophthalmology: retinal image analysis, diabetic retinopathy screening

MedConnect's Omnidoc integration covers all of these specialties and gives access to more than 110,000 specialists across France.

Common mistakes physicians make when starting out

Having supported tele-expertise rollouts in more than 150 installations, here are the most common mistakes:

• Sending a case without structured data: an email saying "diabetic patient, what should I do?" is not enough. Attach vital signs, history and relevant tests. MedConnect automatically attaches data from the patient record.
• Not specifying the question: "Opinion please" is too vague. Ask a precise clinical question: "Should the antihypertensive treatment be changed given this BP of 170/95 and this ECG?"
• Confusing tele-expertise with teleconsultation: tele-expertise is an exchange between physicians; the patient is not present. If the specialist needs to see the patient, it is a teleconsultation.
• Forgetting to bill: the RQD act is reimbursable. Omnidoc handles the billing paperwork, but the setup has to be correct.

How MedConnect simplifies the tele-expertise workflow

The difference from standalone tele-expertise software is that MedConnect builds tele-expertise into the existing consultation workflow. Here is what changes in practice:

• Auto-attached data: when you request an opinion from the patient record, the ECG, vital signs and images are attached automatically. No downloading, no copy-pasting.
• Response in the same record: the specialist's opinion arrives directly in the MedConnect patient record, not in a separate inbox.
• Full traceability: every request and response is archived in the patient's history, timestamped and with the requested physician identified.
• Escalation to teleconsultation: if the specialist decides they need to see the patient, they can launch a teleconsultation directly from the platform.

In a CPTS (primary care network), this workflow lets the GP request a cardiology opinion directly from the consultation — with ECG, images or vital signs attached automatically. In a nursing home, the coordinating physician submits a complete geriatric file without moving the resident.

FAQ

Do you need a specific platform for tele-expertise?

Yes. Assurance Maladie requires tele-expertise to be performed through a compliant platform. Omnidoc is the most widely used in France (110,000+ professionals). MedConnect integrates Omnidoc natively in its tele-expertise module.

How much does tele-expertise pay the requested physician?

The RQD act pays €10 per act, with a maximum of 4 acts per patient per year. Billing paperwork is handled by Omnidoc.

Does the patient need to be present during tele-expertise?

No. Tele-expertise is an exchange between physicians, not with the patient. However, the patient must have consented to the sharing of their medical data.

What is the difference between synchronous and asynchronous tele-expertise?

Asynchronous tele-expertise (the most common) means sending a file and receiving a written opinion within a few hours. Synchronous tele-expertise is a real-time video exchange between the requesting and requested physicians.

Can you do cardiology tele-expertise with a connected ECG?

Yes, it is one of the most common use cases. The GP records a 12-lead ECG with a connected device, and the tracing is sent directly to the cardiologist through the tele-expertise platform. The cardiologist receives a high-resolution tracing and returns an interpretation.

Can you start tele-expertise without connected equipment?

Technically yes — you can attach photos or scanned documents. But the clinical value is limited. With connected devices (ECG, stethoscope, dermatoscope), the data sent is clinical-grade, which improves the quality of the opinion.